Disease-modifying therapies for multiple sclerosis

What you need to know: Disease-modifying therapies (DMTs) early in the course of active relapsing multiple sclerosis can prevent relapses, new brain and spinal cord lesions, and worsening neurological disability; Some DMTs are associated with potentially serious adverse reactions, and careful monito...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:BMJ (Online) Jg. 363; S. k4674
Hauptverfasser: De Angelis, Floriana, John, Nevin A, Brownlee, Wallace J
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England BMJ Publishing Group LTD 27.11.2018
Schlagworte:
ISSN:0959-8138, 1756-1833, 1756-1833
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Abstract What you need to know: Disease-modifying therapies (DMTs) early in the course of active relapsing multiple sclerosis can prevent relapses, new brain and spinal cord lesions, and worsening neurological disability; Some DMTs are associated with potentially serious adverse reactions, and careful monitoring is required, usually through a specialist multiple sclerosis clinic; Newer DMTs have better short term outcomes than older DMTs, but there are insufficient data about their long term effectiveness and harms. A 32 year old woman with multiple sclerosis presented to her general practitioner with a five day history of numbness and weakness in the right leg. She felt well in herself and did not describe any symptoms to suggest an intercurrent infection. She had been taking weekly intramuscular injections of interferon beta-1a for the previous 18 months and reported flu-like symptoms that could last for up to 24 hours after each dose. She asked if there was a need to change her treatment and what alternatives were available.
AbstractList What you need to know: Disease-modifying therapies (DMTs) early in the course of active relapsing multiple sclerosis can prevent relapses, new brain and spinal cord lesions, and worsening neurological disability; Some DMTs are associated with potentially serious adverse reactions, and careful monitoring is required, usually through a specialist multiple sclerosis clinic; Newer DMTs have better short term outcomes than older DMTs, but there are insufficient data about their long term effectiveness and harms. A 32 year old woman with multiple sclerosis presented to her general practitioner with a five day history of numbness and weakness in the right leg. She felt well in herself and did not describe any symptoms to suggest an intercurrent infection. She had been taking weekly intramuscular injections of interferon beta-1a for the previous 18 months and reported flu-like symptoms that could last for up to 24 hours after each dose. She asked if there was a need to change her treatment and what alternatives were available.
Author John, Nevin A
Brownlee, Wallace J
De Angelis, Floriana
Author_xml – sequence: 1
  givenname: Floriana
  surname: De Angelis
  fullname: De Angelis, Floriana
– sequence: 2
  givenname: Nevin A
  surname: John
  fullname: John, Nevin A
– sequence: 3
  givenname: Wallace J
  surname: Brownlee
  fullname: Brownlee, Wallace J
BackLink https://www.ncbi.nlm.nih.gov/pubmed/30482751$$D View this record in MEDLINE/PubMed
BookMark eNplkDtPwzAUhS1UREvpwB9AkVhgSOtHnMeIylOqxAKz5bjX4JLEwXaG_ntcSpcy3eU7555zztGosx0gdEnwnBCWL-p2M__K8iI7QRNS8DwlJWMjNMEVr9KSsHKMZt5vMMaUFWWV8zM0ZjgracHJBNF740F6SFu7Nnpruo8kfIKTvQGfaOuSdmiC6RtIvGrAWW_8BTrVsvEw-7tT9P748LZ8TlevTy_Lu1WqGGEhzRknNa9ryiUrNKcVxmtaA4mvJegMM4ZrBSompqpkFeWKUMCacVUQrQGzKbrZ-_bOfg_gg2iNV9A0sgM7eEFjtzzjhPKIXh-hGzu4LqbbURUmnBdlpK7-qKFuYS16Z1rptuKwRgQWe0DFot6BFsoEGYztgpOmEQSL3eQiTi5-J4-K2yPFwfQ_-wPmEX9y
CitedBy_id crossref_primary_10_1007_s00109_023_02312_9
crossref_primary_10_1136_bmj_2020_061514
crossref_primary_10_1007_s10926_023_10142_2
crossref_primary_10_1016_j_msard_2021_103285
crossref_primary_10_1016_j_msard_2023_105129
crossref_primary_10_1111_ene_14589
crossref_primary_10_1016_j_msard_2022_104456
crossref_primary_10_1002_med_21710
crossref_primary_10_1016_j_msard_2023_105421
crossref_primary_10_1177_13524585211035948
crossref_primary_10_1038_s41551_020_00627_3
crossref_primary_10_1016_j_msard_2019_08_016
crossref_primary_10_1080_17483107_2021_2010819
crossref_primary_10_1111_ene_16363
crossref_primary_10_1186_s12913_020_05664_x
crossref_primary_10_1016_j_msard_2023_104757
crossref_primary_10_1177_1352458520954167
crossref_primary_10_1186_s13102_023_00790_5
crossref_primary_10_3389_fnhum_2024_1449388
crossref_primary_10_1097_WNO_0000000000001424
crossref_primary_10_1212_WNL_0000000000012084
crossref_primary_10_1007_s11940_019_0588_8
crossref_primary_10_3389_fneur_2022_1015256
crossref_primary_10_1016_j_msard_2020_102077
crossref_primary_10_1186_s12883_020_01937_4
crossref_primary_10_1515_tnsci_2020_0141
crossref_primary_10_1080_14740338_2021_1897566
crossref_primary_10_1007_s11136_021_03041_7
crossref_primary_10_1007_s11910_019_1002_3
crossref_primary_10_1002_advs_202102853
crossref_primary_10_1038_s41582_024_01023_0
crossref_primary_10_3390_ijms22137173
crossref_primary_10_3390_ijms241612912
crossref_primary_10_2147_TCRM_S257714
crossref_primary_10_1016_j_msard_2022_103894
crossref_primary_10_3389_fimmu_2020_00594
crossref_primary_10_3390_cells9061396
crossref_primary_10_1038_s41598_022_23685_w
crossref_primary_10_3389_fneur_2022_1062847
crossref_primary_10_3389_fneur_2024_1479476
crossref_primary_10_3390_ijms21051663
crossref_primary_10_3389_fneur_2025_1618519
crossref_primary_10_1016_j_intimp_2020_106314
crossref_primary_10_7759_cureus_24895
crossref_primary_10_1007_s11940_021_00666_4
crossref_primary_10_1007_s00415_022_11519_8
crossref_primary_10_1007_s00415_022_11320_7
crossref_primary_10_1212_WNL_0000000000009507
Cites_doi 10.1007/s40120-017-0063-y
10.1002/ana.24747
10.1056/NEJMoa0902533
10.1080/14656566.2018.1446944
10.1056/NEJMoa1606468
10.1111/j.1468-1331.2005.01083.x
10.1056/NEJMoa1206328
10.1016/j.msard.2015.04.006
10.1001/jamaneurol.2014.3537
10.1016/S0140-6736(12)61769-3
10.1212/WNL.0000000000003319
10.1007/s40263-018-0496-6
10.1586/14737175.2015.1040768
10.1007/s004150050066
10.1007/s10072-017-3081-8
10.1056/NEJMra1401483
10.1212/WNL.0000000000005347
10.1016/j.clinthera.2009.08.003
10.1212/WNL.0000000000003345
10.1016/S1474-4422(18)30040-1
10.1001/jamaneurol.2015.2154
10.1016/S1474-4422(13)70308-9
10.1002/ana.21102
10.1136/jnnp-2014-309243
10.1056/NEJMoa1114287
10.1056/NEJMoa044397
10.1001/jama.2012.7625
10.1016/S0140-6736(16)30959-X
10.1212/WNL.0000000000000036
10.1136/practneurol-2015-001139
10.1136/bmj.i3518
10.1056/NEJMoa1014656
10.1007/s13311-017-0566-3
10.1136/bmj.h1765
10.1111/ene.13536
10.1016/S0140-6736(98)03334-0
10.1177/1352458517698052
10.1016/S1474-4422(17)30470-2
10.1056/NEJMoa0909494
10.1177/1352458511399611
10.1016/S1474-4422(14)70049-3
10.1016/S0140-6736(12)61768-1
10.1177/1352458516645671
10.1212/WNL.43.4.655
10.1056/NEJMoa1601277
10.1016/S1474-4422(15)00018-6
10.1212/WNL.45.7.1268
ContentType Journal Article
Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go tohttp://group.bmj.com/group/rights-licensing/permissions2018BMJ
Copyright_xml – notice: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go tohttp://group.bmj.com/group/rights-licensing/permissions2018BMJ
DBID AAYXX
CITATION
NPM
3V.
7RV
7X7
7XB
88I
8AF
8FE
8FH
8FI
8FJ
8FK
8G5
ABUWG
AFKRA
AN0
ASE
AZQEC
BBNVY
BENPR
BHPHI
BTHHO
CCPQU
DWQXO
FPQ
FYUFA
GHDGH
GNUQQ
GUQSH
HCIFZ
K6X
K9.
KB0
LK8
M2O
M2P
M7P
MBDVC
NAPCQ
PHGZM
PHGZT
PJZUB
PKEHL
PPXIY
PQEST
PQGLB
PQQKQ
PQUKI
PRINS
Q9U
7X8
DOI 10.1136/bmj.k4674
DatabaseName CrossRef
PubMed
ProQuest Central (Corporate)
Nursing & Allied Health Database
Health & Medical Collection
ProQuest Central (purchase pre-March 2016)
Science Database (Alumni Edition)
STEM Database
ProQuest SciTech Collection
ProQuest Natural Science Collection
Hospital Premium Collection
Hospital Premium Collection (Alumni Edition)
ProQuest Central (Alumni) (purchase pre-March 2016)
Research Library (Alumni)
ProQuest Central
ProQuest Central UK/Ireland
British Nursing Database
British Nursing Index
ProQuest Central Essentials - QC
Biological Science Collection
ProQuest Central
Natural Science Collection
BMJ Journals
ProQuest One Community College
ProQuest Central Korea
British Nursing Index (BNI) (1985 to Present)
Proquest Health Research Premium Collection
Health Research Premium Collection (Alumni)
ProQuest Central Student
ProQuest Research Library
SciTech Premium Collection
British Nursing Index
ProQuest Health & Medical Complete (Alumni)
Nursing & Allied Health Database (Alumni Edition)
ProQuest Biological Science Collection
Research Library
Science Database (ProQuest)
Biological Science Database (ProQuest)
Research Library (Corporate)
Nursing & Allied Health Premium
Proquest Central Premium
ProQuest One Academic
ProQuest Health & Medical Research Collection
ProQuest One Academic Middle East (New)
ProQuest One Health & Nursing
ProQuest One Academic Eastern Edition (DO NOT USE)
ProQuest One Applied & Life Sciences
ProQuest One Academic (retired)
ProQuest One Academic UKI Edition
ProQuest Central China
ProQuest Central Basic
MEDLINE - Academic
DatabaseTitle CrossRef
PubMed
Research Library Prep
ProQuest Central Student
ProQuest One Academic Middle East (New)
ProQuest Central Essentials
ProQuest Health & Medical Complete (Alumni)
ProQuest AP Science
ProQuest Central (Alumni Edition)
SciTech Premium Collection
ProQuest One Community College
ProQuest One Health & Nursing
Research Library (Alumni Edition)
ProQuest Natural Science Collection
ProQuest Central China
ProQuest Central
ProQuest One Applied & Life Sciences
ProQuest Health & Medical Research Collection
Health Research Premium Collection
Natural Science Collection
ProQuest Central Korea
Health & Medical Research Collection
Biological Science Collection
ProQuest Research Library
ProQuest Central (New)
ProQuest Science Journals (Alumni Edition)
ProQuest Biological Science Collection
ProQuest Central Basic
ProQuest Science Journals
ProQuest One Academic Eastern Edition
British Nursing Index with Full Text
British Nursing Index
ProQuest Nursing & Allied Health Source
ProQuest Hospital Collection
Health Research Premium Collection (Alumni)
Biological Science Database
ProQuest SciTech Collection
ProQuest Hospital Collection (Alumni)
Nursing & Allied Health Premium
ProQuest Health & Medical Complete
ProQuest One Academic UKI Edition
BMJ Journals
ProQuest Nursing & Allied Health Source (Alumni)
ProQuest One Academic
ProQuest One Academic (New)
ProQuest Central (Alumni)
MEDLINE - Academic
DatabaseTitleList Research Library Prep
Database_xml – sequence: 1
  dbid: NPM
  name: PubMed
  url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
  sourceTypes: Index Database
– sequence: 2
  dbid: BENPR
  name: ProQuest Central
  url: https://www.proquest.com/central
  sourceTypes: Aggregation Database
DeliveryMethod fulltext_linktorsrc
Discipline Medicine
EISSN 1756-1833
ExternalDocumentID 30482751
10_1136_bmj_k4674
Genre Journal Article
GeographicLocations United Kingdom--UK
GeographicLocations_xml – name: United Kingdom--UK
GroupedDBID 23N
39C
4.4
40O
53G
5GY
7RV
7X7
88I
8AF
8F7
8FE
8FH
8FI
8FJ
8G5
AACGO
AANCE
AAWJN
AAYXX
ABBHK
ABIVO
ABJNI
ABPLY
ABTLG
ABUWG
ABVAJ
ABXSQ
ACGFS
ACGOD
ACHIC
ACMFJ
ACPRK
ADQXQ
ADULT
AEUPB
AEXZC
AFFHD
AFKRA
AHMBA
AHNKE
AHQMW
AJYBZ
ALMA_UNASSIGNED_HOLDINGS
AN0
AQVQM
AZQEC
BBNVY
BENPR
BHPHI
BPHCQ
BTHHO
C45
CCPQU
CITATION
CS3
DCCCD
DWQXO
EBS
EJD
F5P
FYUFA
GNUQQ
GUQSH
H13
HAJ
HCIFZ
HMCUK
HZ~
IAG
IBB
IMI
IPSME
JAAYA
JBMMH
JENOY
JHFFW
JKQEH
JLS
JLXEF
JPM
JSG
JST
L7B
LK8
M2O
M2P
M7P
NAPCQ
NXWIF
O9-
OVD
PHGZM
PHGZT
PJZUB
PPXIY
PQGLB
PQQKQ
PROAC
R53
RHI
RMJ
RV8
SA0
TEORI
UKHRP
VVN
WOQ
YFH
YQY
0R~
ADIXU
AGFXO
ALIPV
DOOOF
NPM
RHF
3V.
7XB
8FK
ASE
FPQ
K6X
K9.
MBDVC
PKEHL
PQEST
PQUKI
PRINS
PUEGO
Q9U
7X8
ID FETCH-LOGICAL-c313t-6351b5bb25a37f52900d2be1048aef40330bcec7562c83925c12e0f35c71ffe03
IEDL.DBID M7P
ISICitedReferencesCount 76
ISICitedReferencesURI http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000452126800001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
ISSN 0959-8138
1756-1833
IngestDate Thu Oct 02 19:10:22 EDT 2025
Mon Sep 08 13:52:30 EDT 2025
Wed Feb 19 02:33:24 EST 2025
Tue Nov 18 22:29:56 EST 2025
Sat Nov 29 04:33:49 EST 2025
IsPeerReviewed true
IsScholarly true
Language English
LinkModel DirectLink
MergedId FETCHMERGED-LOGICAL-c313t-6351b5bb25a37f52900d2be1048aef40330bcec7562c83925c12e0f35c71ffe03
Notes ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 14
ObjectType-Report-3
ObjectType-Case Study-4
content type line 23
PMID 30482751
PQID 2139015578
PQPubID 2043523
ParticipantIDs proquest_miscellaneous_2138645125
proquest_journals_2139015578
pubmed_primary_30482751
crossref_citationtrail_10_1136_bmj_k4674
crossref_primary_10_1136_bmj_k4674
PublicationCentury 2000
PublicationDate 2018-11-27
PublicationDateYYYYMMDD 2018-11-27
PublicationDate_xml – month: 11
  year: 2018
  text: 2018-11-27
  day: 27
PublicationDecade 2010
PublicationPlace England
PublicationPlace_xml – name: England
– name: London
PublicationTitle BMJ (Online)
PublicationTitleAlternate BMJ
PublicationYear 2018
Publisher BMJ Publishing Group LTD
Publisher_xml – name: BMJ Publishing Group LTD
References key20190314145725_ref26
key20190314145725_ref25
key20190314145725_ref24
key20190314145725_ref23
key20190314145725_ref29
key20190314145725_ref28
key20190314145725_ref27
key20190314145725_ref22
key20190314145725_ref21
key20190314145725_ref20
key20190314145725_ref4
key20190314145725_ref37
key20190314145725_ref3
key20190314145725_ref36
key20190314145725_ref6
key20190314145725_ref35
key20190314145725_ref5
key20190314145725_ref34
key20190314145725_ref2
key20190314145725_ref39
key20190314145725_ref1
key20190314145725_ref38
key20190314145725_ref33
key20190314145725_ref32
key20190314145725_ref31
key20190314145725_ref30
key20190314145725_ref8
key20190314145725_ref7
key20190314145725_ref9
key20190314145725_ref48
key20190314145725_ref47
key20190314145725_ref46
key20190314145725_ref45
key20190314145725_ref49
key20190314145725_ref40
key20190314145725_ref44
key20190314145725_ref43
key20190314145725_ref42
key20190314145725_ref41
Tramacere (key20190314145725_ref10) 2015
key20190314145725_ref15
key20190314145725_ref14
key20190314145725_ref13
key20190314145725_ref12
key20190314145725_ref19
key20190314145725_ref18
key20190314145725_ref17
key20190314145725_ref16
key20190314145725_ref11
References_xml – ident: key20190314145725_ref27
  doi: 10.1007/s40120-017-0063-y
– ident: key20190314145725_ref43
  doi: 10.1002/ana.24747
– ident: key20190314145725_ref15
  doi: 10.1056/NEJMoa0902533
– ident: key20190314145725_ref37
  doi: 10.1080/14656566.2018.1446944
– ident: key20190314145725_ref6
  doi: 10.1056/NEJMoa1606468
– ident: key20190314145725_ref36
  doi: 10.1111/j.1468-1331.2005.01083.x
– ident: key20190314145725_ref17
  doi: 10.1056/NEJMoa1206328
– ident: key20190314145725_ref41
  doi: 10.1016/j.msard.2015.04.006
– ident: key20190314145725_ref42
  doi: 10.1001/jamaneurol.2014.3537
– ident: key20190314145725_ref22
  doi: 10.1016/S0140-6736(12)61769-3
– ident: key20190314145725_ref29
  doi: 10.1212/WNL.0000000000003319
– ident: key20190314145725_ref49
  doi: 10.1007/s40263-018-0496-6
– ident: key20190314145725_ref34
  doi: 10.1586/14737175.2015.1040768
– ident: key20190314145725_ref24
  doi: 10.1007/s004150050066
– ident: key20190314145725_ref48
  doi: 10.1007/s10072-017-3081-8
– ident: key20190314145725_ref1
  doi: 10.1056/NEJMra1401483
– ident: key20190314145725_ref9
  doi: 10.1212/WNL.0000000000005347
– ident: key20190314145725_ref35
  doi: 10.1016/j.clinthera.2009.08.003
– ident: key20190314145725_ref47
  doi: 10.1212/WNL.0000000000003345
– ident: key20190314145725_ref38
  doi: 10.1016/S1474-4422(18)30040-1
– ident: key20190314145725_ref46
  doi: 10.1001/jamaneurol.2015.2154
– ident: key20190314145725_ref20
  doi: 10.1016/S1474-4422(13)70308-9
– ident: key20190314145725_ref31
  doi: 10.1002/ana.21102
– ident: key20190314145725_ref33
  doi: 10.1136/jnnp-2014-309243
– ident: key20190314145725_ref16
  doi: 10.1056/NEJMoa1114287
– ident: key20190314145725_ref25
  doi: 10.1056/NEJMoa044397
– ident: key20190314145725_ref32
  doi: 10.1001/jama.2012.7625
– ident: key20190314145725_ref2
  doi: 10.1016/S0140-6736(16)30959-X
– ident: key20190314145725_ref39
  doi: 10.1212/WNL.0000000000000036
– ident: key20190314145725_ref7
  doi: 10.1136/practneurol-2015-001139
– ident: key20190314145725_ref11
– ident: key20190314145725_ref4
  doi: 10.1136/bmj.i3518
– ident: key20190314145725_ref21
  doi: 10.1056/NEJMoa1014656
– ident: key20190314145725_ref44
  doi: 10.1007/s13311-017-0566-3
– ident: key20190314145725_ref5
  doi: 10.1136/bmj.h1765
– ident: key20190314145725_ref8
  doi: 10.1111/ene.13536
– ident: key20190314145725_ref14
  doi: 10.1016/S0140-6736(98)03334-0
– ident: key20190314145725_ref40
  doi: 10.1177/1352458517698052
– ident: key20190314145725_ref3
  doi: 10.1016/S1474-4422(17)30470-2
– ident: key20190314145725_ref18
  doi: 10.1056/NEJMoa0909494
– ident: key20190314145725_ref30
  doi: 10.1177/1352458511399611
– ident: key20190314145725_ref19
  doi: 10.1016/S1474-4422(14)70049-3
– ident: key20190314145725_ref23
  doi: 10.1016/S0140-6736(12)61768-1
– ident: key20190314145725_ref28
  doi: 10.1177/1352458516645671
– ident: key20190314145725_ref13
  doi: 10.1212/WNL.43.4.655
– ident: key20190314145725_ref26
  doi: 10.1056/NEJMoa1601277
– ident: key20190314145725_ref45
  doi: 10.1016/S1474-4422(15)00018-6
– start-page: CD011381
  issue: 9
  year: 2015
  ident: key20190314145725_ref10
  article-title: Immunomodulators and immunosuppressants for relapsing-remitting multiple sclerosis: a network meta-analysis
  publication-title: Cochrane Database Syst Rev
– ident: key20190314145725_ref12
  doi: 10.1212/WNL.45.7.1268
SSID ssj0002378965
Score 2.5376942
Snippet What you need to know: Disease-modifying therapies (DMTs) early in the course of active relapsing multiple sclerosis can prevent relapses, new brain and spinal...
SourceID proquest
pubmed
crossref
SourceType Aggregation Database
Index Database
Enrichment Source
StartPage k4674
SubjectTerms Blood pressure
Case reports
Clinical decision making
Clinical trials
Copolymer 1
Cost analysis
Creatinine
Decision making
Drug dosages
Drug therapy
Echocardiography
EKG
Evidence-based medicine
Hepatitis B
HIV
Human immunodeficiency virus
Injection
Interferon
Leukoencephalopathy
Magnetic resonance imaging
Monoclonal antibodies
Multiple sclerosis
Neurology
Patient care planning
Progressive multifocal leukoencephalopathy
Thrombocytopenic purpura
Thyroid
Tuberculosis
Urea
Varicella
Title Disease-modifying therapies for multiple sclerosis
URI https://www.ncbi.nlm.nih.gov/pubmed/30482751
https://www.proquest.com/docview/2139015578
https://www.proquest.com/docview/2138645125
Volume 363
WOSCitedRecordID wos000452126800001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
journalDatabaseRights – providerCode: PRVPQU
  databaseName: Biological Science Database (ProQuest)
  customDbUrl:
  eissn: 1756-1833
  dateEnd: 20251004
  omitProxy: false
  ssIdentifier: ssj0002378965
  issn: 0959-8138
  databaseCode: M7P
  dateStart: 19940108
  isFulltext: true
  titleUrlDefault: http://search.proquest.com/biologicalscijournals
  providerName: ProQuest
– providerCode: PRVPQU
  databaseName: Health & Medical Collection
  customDbUrl:
  eissn: 1756-1833
  dateEnd: 20251004
  omitProxy: false
  ssIdentifier: ssj0002378965
  issn: 0959-8138
  databaseCode: 7X7
  dateStart: 19940108
  isFulltext: true
  titleUrlDefault: https://search.proquest.com/healthcomplete
  providerName: ProQuest
– providerCode: PRVPQU
  databaseName: Nursing & Allied Health Database
  customDbUrl:
  eissn: 1756-1833
  dateEnd: 20251004
  omitProxy: false
  ssIdentifier: ssj0002378965
  issn: 0959-8138
  databaseCode: 7RV
  dateStart: 19940108
  isFulltext: true
  titleUrlDefault: https://search.proquest.com/nahs
  providerName: ProQuest
– providerCode: PRVPQU
  databaseName: ProQuest Central
  customDbUrl:
  eissn: 1756-1833
  dateEnd: 20251004
  omitProxy: false
  ssIdentifier: ssj0002378965
  issn: 0959-8138
  databaseCode: BENPR
  dateStart: 19940108
  isFulltext: true
  titleUrlDefault: https://www.proquest.com/central
  providerName: ProQuest
– providerCode: PRVPQU
  databaseName: Research Library
  customDbUrl:
  eissn: 1756-1833
  dateEnd: 20251004
  omitProxy: false
  ssIdentifier: ssj0002378965
  issn: 0959-8138
  databaseCode: M2O
  dateStart: 19940108
  isFulltext: true
  titleUrlDefault: https://search.proquest.com/pqrl
  providerName: ProQuest
– providerCode: PRVPQU
  databaseName: Science Database (ProQuest)
  customDbUrl:
  eissn: 1756-1833
  dateEnd: 20251004
  omitProxy: false
  ssIdentifier: ssj0002378965
  issn: 0959-8138
  databaseCode: M2P
  dateStart: 19940108
  isFulltext: true
  titleUrlDefault: https://search.proquest.com/sciencejournals
  providerName: ProQuest
link http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV3JTsMwEB1BQYgL-1KWKiAOXEK9xLFzQqziQqkQoN6ixHWksrTQFL6fseMWIQEXLpaijBNrbI_feOw3AAfUsqrxXIWG8CKMEhKFieW9jdAQylgYRWTmkk3IVkt1Oknbb7iV_ljl2CY6Q90daLtH3mTUeec4wI5f30KbNcpGV30KjWmYsSwJzB3da0_2WBiXKomFJxSiPG7mL49HTzbBxvdl6Bds6daYy8X_tm4JFjy6DE6q4bAMU6a_AnPXPn6-Cuy8iseEL4Nuz91wCqoLWOgvBwhfg_H5wqDE-tjyXrkG95cXd2dXoc-aEGpO-ShEBEFzkedMZFwWgiWEdFlu0O1SmSkiwjnJtdESgY-26EhoygwpuNCSFgV22TrU-oO-2YTAShSUZWgUdaQVumZdYfkLs4yoIk5YHQ7HSky1pxS3mS2eU-da8DhFfadO33XYn4i-VjwaPwntjLWb-qlUpl-qrcPe5DVOAhvZyPpm8O5kVBwhdhF12Kh6cPIXTizTqaBbf398G-YRCyl7zZDJHaiNhu9mF2b1x6hXDhswLW8fbNmRrlQNmDm9aLVv8ema3biy3XCj7xNDddwQ
linkProvider ProQuest
linkToHtml http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMw1V1LT8MwDLbGQ8CF92MwoCCQuBTyaNr0gBACpiFg4gASt9JmqTQeG9AB4k_xG3HSdggJuHHgXDdtY9f5nNifATaoYVXjiXQ14anrhcRzQ8N766EjDHyhJQli22wiaDbl1VV4XoH3shbGpFWWPtE66lZXmT3yHUZtdI4Gtvfw6JquUeZ0tWyhkZvFiX57xZAt2z0-RP1uMlY_ujhouEVXAVdxynsurrA0EUnCRMyDVLCQkBZLNIYlMtapRzDAT5RWAQIDZdCDUJRpknKhApqm-Ek47gAMIYxgzKYKnvf3dBgPZOiLgsCIcn8nub_ZvjUNPb4uez9gWbum1Sf-22xMwniBnp393NynoKI70zByVuQHzAA7zM-b3Ptuq20ruJy8wKytMwfhuVPmTzoZ3o8z1c5m4fJP3ngOBjvdjl4Ax0iklMXo9JWnJIaeLWH4GeOYyNQPWRW2SqVFqqBMN5077iIbOnE_Qv1GVr9VWO-LPuQ8Id8J1UptRoWryKJPVVZhrX8Zf3JzchN3dPfZykjfQ2wmqjCfW0z_KZwYJldBF38ffBVGGxdnp9HpcfNkCcYQ90lTUsmCGgz2np71Mgyrl147e1qxNu3A9V-bzQdv4zF2
linkToPdf http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMw1V3db9MwED-Ngqq9bHxtdOsgIJB4yeqPOHYepmlaqagGVR9A2ltIXFvqYG1p2k371_bX7ewknZBgb33gORc78Z3vfmffB8B76qqq8VyFhnAbRgmJwsTVvY1QEcpYGEVk5ptNyMFAnZ8nww24rXNhXFhlrRO9oh5NtTsj7zDqvXMUsI6twiKG3d7x7HfoOki5m9a6nUYpImfm5hrdt-Ko30Vef2Cs9-nb6eew6jAQak75IkRrS3OR50xkXFrBEkJGLDfooqjM2Iigs59royWCBO2QhNCUGWK50JJai7-H4z6CxzKKSeTDBoer8x3GpUpiURUzojzu5JcXhz9dc48_TeA_cK23b73t_3llnsJWhaqDk3IbPIMNM3kOza9V3MALYN3yHiq8nI7GPrMrKBPPxqYIELYHdVxlUOD7uGrj4iV8X8sX70BjMp2YVxA4CktZhsZAR1qhSzoSrm5jlhFl44S14GPNwFRXpdRdR49fqXepeJwir1PP6xa8W5HOyvohfyNq15xNKxVSpPdsbcHb1WPc_O5GJ5uY6dLTqDhCzCZasFtKz2oWTlyFV0H3Hh78DTRRWtIv_cHZPmwiHFQu05LJNjQW86U5gCf6ajEu5q-9eAfwY91ScwdPzjo8
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Disease-modifying+therapies+for+multiple+sclerosis&rft.jtitle=BMJ.+British+medical+journal+%28Clinical+research+ed.%29&rft.au=De+Angelis%2C+Floriana&rft.au=John%2C+Nevin+A&rft.au=Brownlee%2C+Wallace+J&rft.date=2018-11-27&rft.pub=BMJ+Publishing+Group+LTD&rft.eissn=1756-1833&rft.volume=363&rft_id=info:doi/10.1136%2Fbmj.k4674&rft.externalDBID=HAS_PDF_LINK
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0959-8138&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0959-8138&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0959-8138&client=summon