The Place of Immune Reconstitution Therapy in the Management of Relapsing Multiple Sclerosis in France: An Expert Consensus.

Disease-modifying therapy Immune reconstitution therapy Multiple sclerosis

Journal

Neurology and therapy
ISSN: 2193-8253
Titre abrégé: Neurol Ther
Pays: New Zealand
ID NLM: 101637818

Informations de publication

Date de publication:
Apr 2023
Historique:
received: 25 10 2022
accepted: 29 11 2022
medline: 24 12 2022
pubmed: 24 12 2022
entrez: 23 12 2022
Statut: ppublish

Résumé

The treatment strategy in relapsing multiple sclerosis (RMS) is a complex decision requiring individualization of treatment sequences to maximize clinical outcomes. Current local and international guidelines do not provide specific recommendation on the use of immune reconstitution therapy (IRT) as alternative to continuous immunosuppression in the management of RMS. The objective of the program was to provide consensus-based expert opinion on the optimal use of IRT in the management of RMS. A Delphi method was performed from May 2022 to July 2022. Nineteen clinical assertions were developed by a scientific committee and sent to 14 French clinical experts in MS alongside published literature. Two consecutive reproducible anonymous votes were conducted. Consensus on recommendations was achieved when more than 75% of the respondents agreed or disagreed with the clinical assertions. After the second round, consensus was achieved amongst 16 out of 19 propositions: 13 clinical assertions had a 100% consensus, 3 clinical assertions a consensus above 75% and 3 without consensus. Expert-agreed consensus is provided on topics related to the benefit of the early use of IRT from immunological and clinical perspectives, profiles of patients who may benefit most from the IRT strategy (e.g. patients with family planning, patient preference and lifestyle requirements). These French expert consensuses provide up-to-date relevant guidance on the use of IRT in clinical practice. The current program reflects status of knowledge in 2022 and should be updated in timely manner when further clinical data in IRT become available.

Identifiants

pubmed: 36564664
doi: 10.1007/s40120-022-00430-z
pii: 10.1007/s40120-022-00430-z
pmc: PMC10043116
doi:

Types de publication

Journal Article Review

Langues

eng

Pagination

351-369

Informations de copyright

© 2022. The Author(s).

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Auteurs

Jerome De Sèze (J)

Department of Neurology, Strasbourg University Hospital, Strasbourg, France. Jerome.deseze@chru-strasbourg.fr.

Laurent Suchet (L)

Department of Neurology, Hôpital Européen, Marseille, France.

Claude Mekies (C)

Clinique des Cèdres, Toulouse/Department of Neurology, CHU Toulouse, Toulouse, France.

Eric Manchon (E)

Department of Neurology, Gonesse Hospital, Gonesse, France.

Pierre Labauge (P)

Department of Neurology, Montpellier University Hospital, Montpellier, France.

Anne-Marie Guennoc (AM)

Department of Neurology, Tours University Hospital, Hôpital Bretonneau, Tours, France.

Gilles Defer (G)

Department of Neurology, Caen University Hospital, Caen, France.

Pierre Clavelou (P)

Department of Neurology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France.

Giovanni Castelnovo (G)

Department of Neurology, Nîmes University Hospital, Hopital Caremeau, Nîmes, France.

Bertrand Bourre (B)

Department of Neurology, CHU Rouen, 7600, Rouen, France.

Caroline Bensa-Koscher (C)

Department of Neurology, Fondation Rothschild Hospital, Paris, France.

Abdullatif Al Khedr (A)

Department of Neurology, Amiens University Hospital, Amiens, France.

Julie Le Mao (J)

CEMKA, Bourg-La-Reine, France.

Lauriane Villemur (L)

CEMKA, Bourg-La-Reine, France.

Stephane Bouée (S)

CEMKA, Bourg-La-Reine, France.

Laura Luciani (L)

Real-World Evidence, Merck Santé (an affiliate of Merck KGaA, Darmstadt, Germany), Lyon, France.

Patrick Vermersch (P)

University of Lille, INSERM UMR1172 LilNCog, CHU Lille, FHU Precise, Lille, France.

Classifications MeSH