Disease modifying treatments (DMTs): switching and stopping guidelines
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Disease modifying treatments (DMTs): switching and stopping guidelines. Adverse events, Poor compliance. Fully referenced neurology checklist.
Indications for switching DMTs
- Adverse events
- Poor compliance
- Poor efficacy of DMT
- Neutralizing antibodies to β interferon
Assessments before switching DMTs
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Considerations for stopping DMTs in relapsing remitting MS (RRMS)
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Indications for stopping DMTs in secondary progressive MS (SPMS)
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Related checklist
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References
- Wingerchuk DM, Weinshenker BG. Disease modifying therapies for relapsing multiple sclerosis. BMJ 2016; 354:i3518.
- Gajofatto A, Benedetti MD. Treatment strategies for multiple sclerosis: When to start, when to change, when to stop? World J Clin Cases 2015; 3:545-555.
- Rae-Grant A, Day GS, Marrie RA, et al. Practice guideline recommendations summary: Disease-modifying therapies for adults with multiple sclerosis: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology 2018; 90:777-788.
- Scolding N, Barnes D, Cader S, et al. Association of British Neurologists: revised (2015) guidelines for prescribing disease-modifying treatments in multiple sclerosis. Pract Neurol 2015; 15:273-279.
- Corboy JR, Fox RJ, Kister I, et al. Risk of new disease activity in patients with multiple sclerosis who continue or discontinue disease-modifying therapies (DISCOMS): a multicentre, randomised, single-blind, phase 4, non-inferiority trial. Lancet Neurol 2023; 22:568-577.
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