多发性硬化症的疾病修正治疗：波兰神经病学学会多发性硬化症与神经免疫学分会的建议

Disease-modifying therapy in multiple sclerosis: recommendations of Multiple Sclerosis and Neuroimmunology Section of Polish Neurological Society.

作者信息

Kułakowska Alina, Mirowska-Guzel Dagmara, Kalinowska Alicja, Bartosik-Psujek Halina, Brola Waldemar, Stasiolek Mariusz, Głąbiński Andrzej, Losy Jacek, Potemkowski Andrzej, Rejdak Konrad, Sarzyńska-Długosz Iwona, Siger Małgorzata, Stępień Adam, Wawrzyniak Sławomir, Zaborski Jacek, Zakrzewska-Pniewska Beata, Adamczyk-Sowa Monika

机构信息

Department of Neurology, Medical University of Bialystok, Bialystok, Poland.

Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland.

出版信息

Neurol Neurochir Pol. 2024;58(6):569-585. doi: 10.5603/pjnns.102356.

DOI:10.5603/pjnns.102356

PMID:39737584

Abstract

The treatment of multiple sclerosis (MS) has undergone significant changes since the first disease-modifying therapy (DMT) drug was introduced. Currently, 19 original DMT drugs are registered in the European Union. The choice of optimal therapy is becoming increasingly challenging in the absence of reliable biomarkers on the basis of which disease progression and prognosis can be determined. In addition, longer availability and a growing number of drugs used in MS mean that doctors and patients may have to change therapy when the treatment is ineffective or is associated with the occurrence of adverse effects. The ageing of the MS population, comorbidities, and administration of other drugs during DMT should also be considered. This paper presents recommendations for initiating, monitoring, changing and possibly discontinuing DMT.

摘要

自从第一种疾病修正疗法（DMT）药物问世以来，多发性硬化症（MS）的治疗发生了重大变化。目前，欧盟已注册了19种原创DMT药物。在缺乏可靠生物标志物来确定疾病进展和预后的情况下，选择最佳治疗方法变得越来越具有挑战性。此外，MS治疗药物的可获得时间延长以及药物数量不断增加，这意味着当治疗无效或出现不良反应时，医生和患者可能不得不更换治疗方法。还应考虑MS患者群体的老龄化、合并症以及在进行DMT治疗期间使用其他药物的情况。本文提出了关于启动、监测、更换以及可能停用DMT的建议。