Author Topic: (Abst.) Switching or discontinuing disease-modifying therapies for MS  (Read 47 times)

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Offline agate

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Although Continuum is a periodical that isn't on the AAAS list of peer-reviewed journals, the topic is important enough, IMO, to deserve notice here. The author, A. E. Miller, is Dr. Aaron Miller of Mount Sinai Medical Center, who is well known in MS research.

One statement in the abstract, in particular, is surprising:

Quote
Currently available data do not permit a conclusion about whether it is ever safe to discontinue disease-modifying therapy in a stable patient without the expectation of return of disease activity.

This may be part of an effort on the part of the medical profession to dissuade insurance companies from causing interruptions in patients' MS disease-modifying therapy.

From PubMed, June 5, 2016:

Quote
Continuum (Minneap Minn). 2016 Jun;22(3, Multiple Sclerosis and Other Demyelinating Diseases):851-863.

Switching or Discontinuing Disease-Modifying Therapies for Multiple Sclerosis

Miller AE.

PURPOSE OF REVIEW:

This article reviews the reasons for discontinuation or switching of multiple sclerosis disease-modifying therapy as well as procedures that might mitigate risk to the patient under such circumstances.

RECENT FINDINGS:


Recent review of the literature, as well as the author's extensive clinical experience, indicate that the discontinuation of multiple sclerosis disease-modifying therapies occurs for many reasons. Often one medication is stopped at the recommendation of the physician in order to switch to another medication. However, often the decision to discontinue medication is made by the patient.

Unfortunately, in still other situations, treatment is stopped because of circumstances beyond the control of either patient or physician (eg, a loss of insurance coverage).

Currently available data do not permit a conclusion about whether it is ever safe to discontinue disease-modifying therapy in a stable patient without the expectation of return of disease activity.

SUMMARY:


Clinicians must help patients avoid unnecessary and undesirable cessation of disease-modifying therapy. While switches of therapy are often necessary, steps to minimize both adverse events and the risk of recurrent disease should be undertaken. Whether disease-modifying therapy can ever be purposely discontinued without incurring a significant risk of disease recurrence remains to be determined.

The abstract can be seen here.
MS Speaks--online for 13 years

SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010.

 

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