ECTRIMS/EAN guideline on the pharmacological treatment of people with multiple sclerosis

Background and purpose Multiple sclerosis (MS) is a complex disease with new drugs becoming available in the past years. There is therefore a need for a reference tool compiling current data to aid professionals in treatment decisions. The objective was to develop an evidence‐based clinical practice...

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Vydáno v:European journal of neurology Ročník 25; číslo 2; s. 215 - 237
Hlavní autoři: Montalban, X., Gold, R., Thompson, A. J., Otero‐Romero, S., Amato, M. P., Chandraratna, D., Clanet, M., Comi, G., Derfuss, T., Fazekas, F., Hartung, H. P., Havrdova, E., Hemmer, B., Kappos, L., Liblau, R., Lubetzki, C., Marcus, E., Miller, D. H., Olsson, T., Pilling, S., Selmaj, K., Siva, A., Sorensen, P. S., Sormani, M. P., Thalheim, C., Wiendl, H., Zipp, F.
Médium: Journal Article
Jazyk:angličtina
Vydáno: England John Wiley & Sons, Inc 01.02.2018
Témata:
Central nervous system
Clinical medicine
Decision making
demyelinating
diseases
disease‐modifying treatment
Drug therapy
Drugs
Europe
Experimental allergic neuritis
GRADE methodology
guideline
Health care
Humans
Medical personnel
Multiple sclerosis
Multiple Sclerosis - drug therapy
neurological disorders
Neurology
Neurology - standards
Pharmacology
Practice Guidelines as Topic - standards
Pregnancy
Quality
research methods
Safety
Societies, Medical - standards
Europe
research methods
GRADE methodology
multiple sclerosis
guideline
neurological disorders
diseases
demyelinating
disease-modifying treatment
ISSN:1351-5101, 1468-1331, 1468-1331
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Popis
Shrnutí:Background and purpose Multiple sclerosis (MS) is a complex disease with new drugs becoming available in the past years. There is therefore a need for a reference tool compiling current data to aid professionals in treatment decisions. The objective was to develop an evidence‐based clinical practice guideline for the pharmacological treatment of people with MS. Methods This guideline has been developed using the GRADE methodology and following the updated EAN recommendations for guideline development. Clinical questions were formulated in PICO format (patient, intervention, comparator, outcome) and outcomes were prioritized according to their relevance to clinical practice. Literature searches up to December 2016 were performed and the evidence is presented narratively and, when possible, combined in a meta‐analysis. The quality of evidence was rated into four categories – very high, high, low and very low − according to the risk of bias. The recommendations with assigned strength (strong, weak) were formulated based on the quality of evidence and the risk−benefit balance. Consensus between the panelists was reached by use of the modified nominal group technique. Results A total of 10 questions have been agreed, encompassing treatment efficacy, response criteria, strategies to address suboptimal response and safety concerns and treatment strategies in MS and pregnancy. The guideline takes into account all disease‐modifying drugs approved by the European Medicine Agency at the time of publication. A total of 21 recommendations were agreed by the guideline working group members after three rounds of consensus. Conclusion The present guideline, which includes descriptions of the evidence together with recommendations, will enable homogeneity of treatment decisions across Europe.
Bibliografie:Multiple Sclerosis Journal
European Journal of Neurology
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[Correction added on 13 February 2018, after online and print publication: (a) The abstract has been updated and a conclusion section in now included; (b) Recommendation 4 and 7 has been amended, and an additional recommendation has been added after the latter].
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ISSN:1351-5101
1468-1331
1468-1331
DOI:10.1111/ene.13536