Background: The introduction of new disease-modifying therapies (DMTs) for remitting-relapsing multiple sclerosis (RRMS) has considerably transformed the landscape of therapeutic opportunities for this chronic disabling disease. Unlike injectable drugs, oral DMTs promote patient satisfaction and increase therapeutic adherence.
Review: This article reviews the salient features about the mode of action, efficacy, safety, and tolerability profile of approved oral DMTs in RRMS, and reviews their place in clinical algorithms in the Middle East and North Africa (MENA) region. A systematic review was conducted using a comprehensive search of MEDLINE, PubMed, Cochrane Database of Systematic Reviews (period January 1, 1995-January 31, 2018). Additional searches of the American Academy of Neurology and European Committee for Treatment and Research in Multiple Sclerosis abstracts from 2012-2017 were performed, in addition to searches of the Food and Drug Administration and European Medicines Agency websites, to obtain relevant safety information on these DMTs.
Conclusions: Four oral DMTs: fingolimod, teriflunomide, dimethyl fumarate, and cladribine have been approved by the regulatory agencies. Based on the number needed to treat (NNT), the potential role of these DMTs in the management of active and highly active or rapidly evolving RRMS is assessed. Finally, the place of the oral DMTs in clinical algorithms in the MENA region is reviewed.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1080/03007995.2018.1476334 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Identification of Gut Biomarkers of FPIES in a Longitudinal Comparative Pediatric Study.
Allergy
December 2024
INRAE, Micalis Institute, UMR1319, AgroParisTech, Paris Saclay University, Jouy-en-Josas, France.
Background: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated allergy without known biomarkers. We aimed to compare fecal biomarkers related to gut inflammation and immunity in children with FPIES, with resolved FPIES (tolerant), and in matched controls.
Methods: Stools were collected from FPIES children on elimination diet, before and after an oral food challenge (OFC) performed to assess their natural tolerance, at the end of a follow-up in tolerant FPIES children, and in matched controls (1:1 ratio).
Improvements in quality of life of people with relapsing multiple sclerosis treated with cladribine tablets during the 2-year CLARIFY-MS study: a plain language summary.
Neurodegener Dis Manag
December 2024
oDepartment of Neurology and Center for Clinical Neuroscience, First Medical Faculty, Charles University, Prague, Czech Republic.
Introduction: Real-world studies in the USA report that 41-56% of patients with multiple sclerosis (MS) are ≥ 50 years old, yet data on their response to disease-modifying therapies (DMTs) is limited. Dimethyl fumarate (DMF) is an oral DMT approved for treating relapsing MS. This analysis evaluated the safety, efficacy, and immunophenotype changes of DMF in patients ≥ 50 years compared with patients < 50 years.
View Article and Find Full Text PDFAchievement of No Evidence of Disease Activity-3 with Oral Disease-Modifying Treatment in Patients with Relapsing-Remitting Multiple Sclerosis.
Saudi J Med Med Sci
October 2024
Department of Neurology, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, King Fahd Hospital of the University, Al Khobar, Saudi Arabia.
Background: There is scant data regarding the use of oral disease-modifying treatments (oDMT) in patients with relapsing-remitting multiple sclerosis (PwRRMS) from Saudi Arabia.
Objective: This study aimed to identify the response rate to oDMT in PwRRMS compared to interferon (IFN) in terms of achieving no evidence of disease activity-3 (NEDA-3).
Methods: This retrospective study was conducted at a tertiary care hospital in Saudi Arabia and included all adult PwRRMS over a 2-year period who were on oDMTs or IFN for <1 year.
Costs of Potential Medication Wastage Due to Switching Treatment Among People With Multiple Sclerosis.
J Health Econ Outcomes Res
October 2024
Genentech, Inc., South San Francisco, California, USA.
Article Synopsis
- Unused medications negatively impact healthcare costs and safety, especially among people with multiple sclerosis (PwMS) who frequently switch disease-modifying therapies (DMTs), leading to significant medication wastage and expenses for healthcare payers and patients.
- A study analyzed claims data from 2017 to 2021, finding that around 25% of PwMS had overlapping supplies of DMTs during switches, with an estimated 34% to 38% of the previous medication potentially wasted.
- The total cost of this potential medication wastage (PMW) ranged from approximately $1.49 million, with insurers covering most costs, while patients still incurred significant out-of-pocket expenses, averaging about $846 per person annually.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!