2026-04-13T06:36:57Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/133462025-10-31T04:47:48Zcom_2072_378070com_2072_378040col_2072_378092

urn:hdl:11351/13346 De-escalating and discontinuing disease-modifying therapies in multiple sclerosis Androdias, Géraldine Maillart, Elisabeth audoin, bertrand Bruijstens, Arlette L. Lunemann, Jan amato, Maria Pia Cobo-Calvo, Alvaro Sastre Garriga, Jaume Tintore, Mar Montalban, Xavier Embaràs Esclerosi múltiple - Tractament Posologia Medicaments immunosupressors - Ús terapèutic DISEASES::Nervous System Diseases::Autoimmune Diseases of the Nervous System::Demyelinating Autoimmune Diseases, CNS::Multiple Sclerosis Other subheadings::Other subheadings::Other subheadings::/drug therapy CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Immunologic Factors::Immunosuppressive Agents Other subheadings::Other subheadings::Other subheadings::/administration & dosage PHENOMENA AND PROCESSES::Reproductive and Urinary Physiological Phenomena::Reproductive Physiological Phenomena::Reproduction::Pregnancy ENFERMEDADES::enfermedades del sistema nervioso::enfermedades autoinmunitarias del sistema nervioso::enfermedades autoinmunes desmielinizantes del SNC::esclerosis múltiple Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::efectos fisiológicos de los fármacos::factores inmunitarios::inmunosupresores Otros calificadores::Otros calificadores::Otros calificadores::/administración & dosificación FENÓMENOS Y PROCESOS::fenómenos fisiológicos reproductivos y urinarios::fenómenos fisiológicos de la reproducción::reproducción::embarazo Discontinuation; Disease-modifying therapy; Multiple sclerosis Interrupció; Teràpia modificadora de la malaltia; Esclerosi múltiple Interrupción; Terapia modificadora de la enfermedad; Esclerosis múltiple The development of disease-modifying therapies (DMTs) for the treatment of multiple sclerosis (MS) has been highly successful in recent decades. It is now widely accepted that early initiation of DMTs after disease onset is associated with a better long-term prognosis. However, the question of when and how to de-escalate or discontinue DMTs remains open and critical. This topic was discussed during an international focused workshop organized by the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in 2023. The aim was to review the current evidence on the rationale for, and the potential pitfalls of, treatment de-escalation in MS. Several clinical scenarios emerged, mainly driven by a change in the benefit-risk ratio of DMTs over the course of the disease and with ageing. The workshop also addressed the issue of de-escalation by the type of DMT used and in specific situations, including pregnancy and paediatric onset MS. Finally, we provide practical guidelines for selecting appropriate patients, defining de-escalation and monitoring modalities and outlining unmet needs in this field. No specific funding was received towards this work, apart from European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) funding for the organization of the focused workshop in Lisbon on 9–10 March 2023. 2025-07-03T12:20:43Z 2025-07-03T12:20:43Z 2025-05 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Brain;148(5) https://doi.org/10.1093/brain/awae409 Attribution-NonCommercial 4.0 International http://creativecommons.org/licenses/by-nc/4.0/ info:eu-repo/semantics/openAccess Oxford University Press Scientia