Article Dans Une Revue Multiple Sclerosis and Related Disorders Année : 2021

How to switch disease-modifying treatments in multiple sclerosis: Guidelines from the French Multiple Sclerosis Society (SFSEP)

Mikaël Cohen
Françoise Durand-Dubief
Elisabeth Maillart
  • Fonction : Auteur
Evelyne Planque
  • Fonction : Auteur
Hélène Zephir
Christine Lebrun-Frenay

Résumé

BACKGROUND: Today, there are no recommendations on switching disease-modifying treatments (DMTs) in multiple sclerosis (MS). OBJECTIVES: To establish guidelines on switching DMTs MS. METHODS: A Steering Committee composed of seven MS experts from the French Group for Recommendations in Multiple Sclerosis (France4MS) defined 15 proposals. These proposals were then submitted to a Rating Group, composed of 48 French MS experts, for evaluation. The proposals were classified as 'appropriate', 'inappropriate' or 'uncertain'. RESULTS: Switching from a first-line therapy to another first-line therapy or a second-line therapy could be done without a washout period. Switching from a second-line therapy to a first-line therapy could be done without a washout period with fingolimod or natalizumab, after 3 months with ocrelizumab or mitoxantrone, and, if disease activity occurs with alemtuzumab or cladribine. The switch from a second-line therapy to another second-line therapy could be done after a washout period of 1 month with fingolimod or natalizumab, after 3 months with ocrelizumab, after 6 months with mitoxantrone, and, if disease activity occurs, with alemtuzumab or cladribine. CONCLUSION: This expert consensus approach provides physicians with some guidelines on optimizing the benefit/risk ratio when switching DMTs in patients with MS.

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hal-03779577 , version 1 (02-08-2023)

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Kévin Bigaut, Mikaël Cohen, Françoise Durand-Dubief, Elisabeth Maillart, Evelyne Planque, et al.. How to switch disease-modifying treatments in multiple sclerosis: Guidelines from the French Multiple Sclerosis Society (SFSEP). Multiple Sclerosis and Related Disorders, 2021, 53, ⟨10.1016/j.msard.2021.103076⟩. ⟨hal-03779577⟩
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