scholarly journals Pregnancy in multiple sclerosis: from scientific aspects to practical

2021 ◽  
Vol 64 (3) ◽  
pp. 78-84
Author(s):  
Anna Belenciuc ◽  
◽  
Ana-Maria Bubuioc ◽  
Olesea Odainic ◽  
Marina Sangheli ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Family Planning ◽  
Immune Reconstitution ◽  
Interferon Beta ◽  
Reproductive Age ◽  
Childbearing Age ◽  
Disease Modifying Drugs ◽  
Choice Of Treatment ◽  
Key Issues ◽  
Disease Modifying

Background: Multiple sclerosis (MS) is a disease that affects young people of reproductive age (20-40 years old), predominantly women. Therefore, almost every patient has questions about pregnancy and breastfeeding. Family planning is one of the key issues in the choice of treatment tactics. Despite the growing number of therapeutic options for individualized treatment, it is still a question how to manage women with MS who become pregnant while taking disease-modifying drugs or want to become pregnant after starting this treatment. Conclusions: Women with MS should not be discouraged from pregnancy due to their illness. It is necessary to proactively discuss pregnancy planning with all women with MS of childbearing age. Based on available data, interferon beta and glatiramer acetate appear to be most suitable for use up until the time of confirmed pregnancy. A large amount of data (more than 1000 cases) obtained from registries shows that use of interferon beta before conception and during pregnancy suggests no evidence of increase in the rate of congenital anomalies or spontaneous abortions. For women with persistent high disease activity, pulsed immune reconstitution therapy gives additional opportunity for family planning after the last dose. The choice between available options for pulsed immune reconstitution therapy should be based on efficacy balanced against the risks.

scholarly journals Adherence to Multiple Sclerosis Disease-Modifying Therapies in Ontario is Low

2011 ◽  
Vol 38 (3) ◽  
pp. 429-433 ◽  
Author(s):  
Janice Wong ◽  
Tara Gomes ◽  
Muhammad Mamdani ◽  
Michael Manno ◽  
Paul W. O'Connor
Keyword(s):  
Multiple Sclerosis ◽  
Glatiramer Acetate ◽  
Interferon Beta ◽  
Patient Adherence ◽  
Disease Modifying Drugs ◽  
Drug Plan ◽  
Persistence Rates ◽  
Disease Modifying ◽  
Public Drug

Background/Objective:Differences in patient adherence to various disease-modifying drugs (DMDs) in the treatment of multiple sclerosis (MS) are not well understood. The goal of this study was to evaluate adherence of adult MS patients in Ontario with public drug plan coverage to various DMDs: intramuscular interferon beta-1a (i.m. IFNβ-1a, Avonex), subcutaneous interferon beta-1a (s.c. IFNβ-1a, Rebif), subcutaneous interferon beta-1b (IFNβ-1b, Betaseron) or glatiramer acetate (Copaxone).Methods:In this retrospective cohort study, Ontario Public Drug Plan beneficiaries aged 15 or older who were newly treated with i.m. IFNβ-1a, s.c. IFNβ-1a, IFNβ-1b or glatiramer acetate between April 2006 and March 2008 were followed forward until treatment discontinuation, switch to another DMD or a maximum two year follow-up period. Cumulative persistence rates were analyzed by the Kaplan-Meier method. The proportion of patients reaching the study endpoints after the two year follow-up period was also calculated.Results:Cumulative persistence rates for all four DMDs were similar over time (p=0.80), ranging from 73.6-79.1% at six months, 59.1-63.1% at one year and 41.5-47.4% at two years. After two years, the proportion of patients who had discontinued treatment, switched to another DMD or died was similar among DMDs (p=0.79, Fisher's exact test). Switching between DMD types was low and occurred in 3.4-6.5% of new DMD users.Conclusions:Adherence to DMDs in adult MS patients in Ontario is poor, which is consistent with previously reported adherence rates to MS DMDs in other regions. No significant differences in adherence exist between the DMDs evaluated in this study.

Headache in multiple sclerosis - pharmacological aspects

2021 ◽  
Vol 27 ◽  
Author(s):  
Marcel Gebhardt ◽  
Peter Kropp ◽  
Frank Hoffmann ◽  
Uwe K. Zettl
Keyword(s):  
Multiple Sclerosis ◽  
Interferon Beta ◽  
Cerebral Vasculitis ◽  
General Will ◽  
Specific Therapy ◽  
Disease Modifying Drugs ◽  
Secondary Headaches ◽  
Red Flag ◽  
Disease Modifying ◽  
The One

: For decades, headache was not considered a typical symptom of multiple sclerosis (MS) and was construed as a "red flag" for important differential diagnoses such as cerebral vasculitis. Meanwhile, several studies have demonstrated an increased prevalence of headache in MS compared to the general population. This is due to the heterogeneity of headache genesis with frequent occurrence of both primary and secondary headaches in MS. On the one hand, MS and migraine are often comorbid. On the other hand, secondary headaches occur frequently, especially in the course of MS relapses. These are often migraine-like headaches caused by inflammation, which can improve as a result of MS-specific therapy. Headaches are particularly common in the early stages of chronic inflammatory CNS disease, where inflammatory activity is greatest. In addition, headache can also occur as a side effect of disease-modifying drugs (DMDs). Headache can occur with most DMDs and is most frequently described with interferon-beta therapy. The aim of this work is to present the prevalence of headache and describe the heterogeneity of possible causes of headache in MS. In addition, important therapeutic aspects in the treatment of MS patients in general will be presented as well as different approaches to the treatment of headache in MS depending on the etiological classification.

scholarly journals The cross-reactivity of binding antibodies with different interferon beta formulations used as disease-modifying drugs in multiple sclerosis patients

Medicine ◽  
2016 ◽  
Vol 95 (45) ◽  
pp. e5337 ◽  
Author(s):  
Agnieszka Wencel-Warot ◽  
Slawomir Michalak ◽  
Marcin Warot ◽  
Alicja Kalinowska-Lyszczarz ◽  
Radoslaw Kazmierski
Keyword(s):  
Multiple Sclerosis ◽  
Interferon Beta ◽  
Cross Reactivity ◽  
Disease Modifying Drugs ◽  
Disease Modifying ◽  
The Cross ◽  
Multiple Sclerosis Patients

scholarly journals Disease-Modifying Drugs and Family Planning in People with Multiple Sclerosis: A Consensus Narrative Review from the Gulf Region

2020 ◽  
Vol 9 (2) ◽  
pp. 265-280
Author(s):  
Raed Alroughani ◽  
Jihad Inshasi ◽  
Abdullah Al-Asmi ◽  
Jaber Alkhabouri ◽  
Taoufik Alsaadi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Family Planning ◽  
Narrative Review ◽  
Gulf Region ◽  
Disease Modifying Drugs ◽  
Disease Modifying

scholarly journals A Comprehensive Cost-Effectiveness Analysis of Treatments for Multiple Sclerosis

2011 ◽  
Vol 13 (3) ◽  
pp. 128-135 ◽  
Author(s):  
Ashley N. Newton ◽  
Christina M. Stica
Keyword(s):  
Multiple Sclerosis ◽  
Cost Effectiveness ◽  
Interferon Beta ◽  
First Line ◽  
Disease Modifying Drugs ◽  
Future Studies ◽  
Relapsing Remitting ◽  
Disease Modifying ◽  
The Cost ◽  
Relapsing Remitting Multiple Sclerosis

The purpose of this study was to examine the cost-effectiveness of four disease-modifying drugs (DMDs) used to treat multiple sclerosis (MS): glatiramer acetate (GA; Copaxone), interferon beta-1a (IFNβ-1a) intramuscular (IM) injection (Avonex), IFNβ-1a subcutaneous (SC) injection (Rebif), and interferon beta-1b (IFNβ-1b) SC injection (Betaseron). Cost-effectiveness analyses are useful in countering the financial uncertainties and treatment efficacy concerns faced by people with MS. We conducted simulation analyses of the principal findings of a 2009 study by Goldberg et al. (Goldberg LD, Edwards NC, Fincher C, et al: Comparing the cost-effectiveness of disease-modifying drugs for the first-line treatment of relapsing remitting multiple sclerosis. J Manag Care Pharm. 2009;15:543–555) to frame the researchers' findings from the perspectives of cost-conscious and cost-neutral MS patients. We found that for the cost-conscious consumer, the ranking of most (1) to least (4) preferred DMDs was 1) IFNβ -1a IM (Avonex), 2) GA (Copaxone), 3) IFNβ-1a SC (Rebif), and 4) IFNβ-1b SC (Beta-seron). For the cost-neutral consumer who places priority on effectiveness over costs, the ranking was 1) IFNβ-1a SC (Rebif), 2) IFNβ-1b SC (Betaseron), 3) GA (Copaxone), and 4) IFNβ-1a IM (Avonex). Future studies could examine cost-effectiveness over extended periods of time (eg, 15–20 years) and more closely examine the cost-effectiveness of natalizumab (Tysabri) relative to the four primary DMDs.

scholarly journals Family Planning for People with Multiple Sclerosis in Saudi Arabia: an Expert Consensus

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Mohammed Al Jumah ◽  
Yaser Al Malik ◽  
Nuha M. AlKhawajah ◽  
Jameelah Saeedi ◽  
Ibtisam AlThubaiti ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Saudi Arabia ◽  
Disease Activity ◽  
Interferon Beta ◽  
Childbearing Age ◽  
Management Options ◽  
Kingdom Of Saudi Arabia ◽  
Life Goal ◽  
Disease Modifying Drugs ◽  
Relapsing Remitting

More than half of all patients with multiple sclerosis (MS) in the Kingdom of Saudi Arabia (KSA) are women of childbearing age. Raising a family is an important life goal for women in our region of the world. However, fears and misconceptions about the clinical course of relapsing-remitting MS (RRMS) and the effects of disease-modifying drugs (DMDs) on the foetus have led many women to reduce their expectations of raising a family, sometimes even to the point of avoiding pregnancy altogether. The increase in the number of DMDs available to manage RRMS and recent studies on their effects in pregnancy have broadened management options for these women. Interferon beta now has an indication in Europe for use during pregnancy (according to clinical need) and can be used during breastfeeding. Glatiramer acetate is a further possible option for women with lower levels of RRMS disease activity who are, or about to become, pregnant; natalizumab may be used up to 30 weeks in patients with higher levels of disease activity. Where possible, physicians need to support and encourage women to pursue their dream of a fulfilling family life, supported where necessary by active interventions for RRMS that are increasingly evidence based.

scholarly journals Induction or aggravation of other immune-mediated disorders by disease-modifying therapy in treatment of multiple sclerosis

2019 ◽  
Author(s):  
Seyed Mohammad Baghbanian ◽  
Mohammad Ali Sahraian
Keyword(s):  
Multiple Sclerosis ◽  
Interferon Beta ◽  
Immunomodulatory Agents ◽  
Disease Modifying Drugs ◽  
Disease Modifying Therapy ◽  
Immune Mediated ◽  
Relapsing Remitting ◽  
Disease Modifying ◽  
Relapsing Remitting Multiple Sclerosis

Interferon beta (IFN-β) and glatiramer acetate (GA) are the primary therapeutic immunomodulatory agents that interfere with relapsing-remitting multiple sclerosis (RRMS), and the most commonly-used drugs as well. Induction or aggravation of other immune-mediated diseases has been reported following INF-β administration. We have reviewed the reported cases to notify the treating physicians about these rare adverse events. Although co-morbid autoimmune disorders have been reported in patients with MS, the pro-inflammatory role of disease-modifying drugs, especially INF-β, could affect and enhance this co-occurrence. Clinical or laboratory autoimmunity histories suggest the use of GA over INF-β as the treatment of choice.

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