Spanish Neurology Society consensus document on the use of drugs in multiple sclerosis: Escalating therapy

García Merino, A.; Fernández, O.; Montalbán, X.; de Andrés, C.; Arbizu, T.

doi:10.1016/S2173-5808(10)70070-5

Información del artículo

Resumen

Bibliografía

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Abstract

Introduction

Treatment of multiple sclerosis has advanced considerably in the last few years, at the same time as its complexity has increased. The purpose of this consensus document is to provide specific recommendations and rules on the strategy to follow in the treatment of multiple sclerosis in order to modify its course.

Material and methods

Experts on the treatment and clinical research on multiple sclerosis proposed by the Demyelinating Diseases Group of the Spanish Neurology Society (SEN) prepared an initial document with recommendations for the treatment of this disease. The final version of this document was submitted to members of the Demyelinating Diseases Group of the SEN, who were able to make modifications and suggest changes to the final manuscript.

Results and conclusions

A review has been made of the evidence levels and indications for the treatment of the different clinical forms of multiple sclerosis, and recommendations made for the use of drugs. As well as authorised drugs, a review has also been made of other occasionally used products, as well as combined therapy, therapeutic response criteria, levels of treatment changes, and finally a proposal is made on therapeutic escalation.

Keywords:

Multiple sclerosis

Isolated demyelinating syndrome

Combined treatment

Therapeutic escalation

Resumen

Introducción

La terapéutica de la esclerosis múltiple ha avanzado notablemente en los últimos años al tiempo que ha aumentado su complejidad. El propósito de este documento de consenso es presentar recomendaciones y pautas concretas sobre la estrategia que seguir en el tratamiento para modificar el curso de la esclerosis múltiple.

Material y métodos

Expertos en el tratamiento y en investigación clínica en esclerosis múltiple propuestos por el grupo de enfermedades desmielinizantes de la Sociedad Española de Neurología (SEN) elaboraron un documento inicial con recomendaciones para el tratamiento de esta enfermedad. La versión final de este documento fue remitida a los miembros del grupo de enfermedades desmielinizantes de la SEN, quienes pudieron realizar modificaciones y sugerir cambios al manuscrito final. Tras considerar estas enmiendas, el comité de expertos validó el documento final.

Resultados y conclusiones

Se revisan los niveles de evidencia y las indicaciones para el tratamiento de las diferentes formas clínicas de esclerosis múltiple y se hacen recomendaciones de uso de los medicamentos. Además de los fármacos autorizados, se revisan también otros productos ocasionalmente empleados, así como la terapia combinada, los criterios de respuesta terapéutica, los niveles de cambio de tratamiento y finalmente se hace una propuesta de escalado terapéutico.

Palabras clave:

Esclerosis múltiple

Síndrome desmielinizante aislado

Terapia combinada

Escalado terapéutico

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