The Place of Immune Reconstitution Therapy in the Management of Relapsing Multiple Sclerosis in France: An Expert Consensus

Abstract The treatment strategy in relapsing multiple sclerosis (RMS) is a complex decision requiring individualization of treatment sequences to maximize clinical outcomes. Current local and international guidelines do not provide specific recommendation on the use of immune reconstitution therapy...

Full description

Bibliographic Details
Main Authors: Jerome De Sèze, Laurent Suchet, Claude Mekies, Eric Manchon, Pierre Labauge, Anne-Marie Guennoc, Gilles Defer, Pierre Clavelou, Giovanni Castelnovo, Bertrand Bourre, Caroline Bensa-Koscher, Abdullatif Al Khedr, Julie Le Mao, Lauriane Villemur, Stephane Bouée, Laura Luciani, Patrick Vermersch
Format: Article
Language:English
Published: Adis, Springer Healthcare 2022-12-01
Series:Neurology and Therapy
Subjects:
Online Access:https://doi.org/10.1007/s40120-022-00430-z
_version_ 1797853551344484352
author Jerome De Sèze
Laurent Suchet
Claude Mekies
Eric Manchon
Pierre Labauge
Anne-Marie Guennoc
Gilles Defer
Pierre Clavelou
Giovanni Castelnovo
Bertrand Bourre
Caroline Bensa-Koscher
Abdullatif Al Khedr
Julie Le Mao
Lauriane Villemur
Stephane Bouée
Laura Luciani
Patrick Vermersch
author_facet Jerome De Sèze
Laurent Suchet
Claude Mekies
Eric Manchon
Pierre Labauge
Anne-Marie Guennoc
Gilles Defer
Pierre Clavelou
Giovanni Castelnovo
Bertrand Bourre
Caroline Bensa-Koscher
Abdullatif Al Khedr
Julie Le Mao
Lauriane Villemur
Stephane Bouée
Laura Luciani
Patrick Vermersch
author_sort Jerome De Sèze
collection DOAJ
description Abstract The treatment strategy in relapsing multiple sclerosis (RMS) is a complex decision requiring individualization of treatment sequences to maximize clinical outcomes. Current local and international guidelines do not provide specific recommendation on the use of immune reconstitution therapy (IRT) as alternative to continuous immunosuppression in the management of RMS. The objective of the program was to provide consensus-based expert opinion on the optimal use of IRT in the management of RMS. A Delphi method was performed from May 2022 to July 2022. Nineteen clinical assertions were developed by a scientific committee and sent to 14 French clinical experts in MS alongside published literature. Two consecutive reproducible anonymous votes were conducted. Consensus on recommendations was achieved when more than 75% of the respondents agreed or disagreed with the clinical assertions. After the second round, consensus was achieved amongst 16 out of 19 propositions: 13 clinical assertions had a 100% consensus, 3 clinical assertions a consensus above 75% and 3 without consensus. Expert-agreed consensus is provided on topics related to the benefit of the early use of IRT from immunological and clinical perspectives, profiles of patients who may benefit most from the IRT strategy (e.g. patients with family planning, patient preference and lifestyle requirements). These French expert consensuses provide up-to-date relevant guidance on the use of IRT in clinical practice. The current program reflects status of knowledge in 2022 and should be updated in timely manner when further clinical data in IRT become available.
first_indexed 2024-04-09T19:51:21Z
format Article
id doaj.art-d85d74469802470f8b09b57b68dc090b
institution Directory Open Access Journal
issn 2193-8253
2193-6536
language English
last_indexed 2024-04-09T19:51:21Z
publishDate 2022-12-01
publisher Adis, Springer Healthcare
record_format Article
series Neurology and Therapy
spelling doaj.art-d85d74469802470f8b09b57b68dc090b2023-04-03T05:45:11ZengAdis, Springer HealthcareNeurology and Therapy2193-82532193-65362022-12-0112235136910.1007/s40120-022-00430-zThe Place of Immune Reconstitution Therapy in the Management of Relapsing Multiple Sclerosis in France: An Expert ConsensusJerome De Sèze0Laurent Suchet1Claude Mekies2Eric Manchon3Pierre Labauge4Anne-Marie Guennoc5Gilles Defer6Pierre Clavelou7Giovanni Castelnovo8Bertrand Bourre9Caroline Bensa-Koscher10Abdullatif Al Khedr11Julie Le Mao12Lauriane Villemur13Stephane Bouée14Laura Luciani15Patrick Vermersch16Department of Neurology, Strasbourg University HospitalDepartment of Neurology, Hôpital EuropéenClinique des Cèdres, Toulouse/Department of Neurology, CHU ToulouseDepartment of Neurology, Gonesse HospitalDepartment of Neurology, Montpellier University HospitalDepartment of Neurology, Tours University Hospital, Hôpital BretonneauDepartment of Neurology, Caen University HospitalDepartment of Neurology, Clermont-Ferrand University HospitalDepartment of Neurology, Nîmes University Hospital, Hopital CaremeauDepartment of Neurology, CHU RouenDepartment of Neurology, Fondation Rothschild HospitalDepartment of Neurology, Amiens University HospitalCEMKACEMKACEMKAReal-World Evidence, Merck Santé (an affiliate of Merck KGaA, Darmstadt, Germany)University of Lille, INSERM UMR1172 LilNCog, CHU Lille, FHU PreciseAbstract The treatment strategy in relapsing multiple sclerosis (RMS) is a complex decision requiring individualization of treatment sequences to maximize clinical outcomes. Current local and international guidelines do not provide specific recommendation on the use of immune reconstitution therapy (IRT) as alternative to continuous immunosuppression in the management of RMS. The objective of the program was to provide consensus-based expert opinion on the optimal use of IRT in the management of RMS. A Delphi method was performed from May 2022 to July 2022. Nineteen clinical assertions were developed by a scientific committee and sent to 14 French clinical experts in MS alongside published literature. Two consecutive reproducible anonymous votes were conducted. Consensus on recommendations was achieved when more than 75% of the respondents agreed or disagreed with the clinical assertions. After the second round, consensus was achieved amongst 16 out of 19 propositions: 13 clinical assertions had a 100% consensus, 3 clinical assertions a consensus above 75% and 3 without consensus. Expert-agreed consensus is provided on topics related to the benefit of the early use of IRT from immunological and clinical perspectives, profiles of patients who may benefit most from the IRT strategy (e.g. patients with family planning, patient preference and lifestyle requirements). These French expert consensuses provide up-to-date relevant guidance on the use of IRT in clinical practice. The current program reflects status of knowledge in 2022 and should be updated in timely manner when further clinical data in IRT become available.https://doi.org/10.1007/s40120-022-00430-zMultiple sclerosisDisease-modifying therapyImmune reconstitution therapy
spellingShingle Jerome De Sèze
Laurent Suchet
Claude Mekies
Eric Manchon
Pierre Labauge
Anne-Marie Guennoc
Gilles Defer
Pierre Clavelou
Giovanni Castelnovo
Bertrand Bourre
Caroline Bensa-Koscher
Abdullatif Al Khedr
Julie Le Mao
Lauriane Villemur
Stephane Bouée
Laura Luciani
Patrick Vermersch
The Place of Immune Reconstitution Therapy in the Management of Relapsing Multiple Sclerosis in France: An Expert Consensus
Neurology and Therapy
Multiple sclerosis
Disease-modifying therapy
Immune reconstitution therapy
title The Place of Immune Reconstitution Therapy in the Management of Relapsing Multiple Sclerosis in France: An Expert Consensus
title_full The Place of Immune Reconstitution Therapy in the Management of Relapsing Multiple Sclerosis in France: An Expert Consensus
title_fullStr The Place of Immune Reconstitution Therapy in the Management of Relapsing Multiple Sclerosis in France: An Expert Consensus
title_full_unstemmed The Place of Immune Reconstitution Therapy in the Management of Relapsing Multiple Sclerosis in France: An Expert Consensus
title_short The Place of Immune Reconstitution Therapy in the Management of Relapsing Multiple Sclerosis in France: An Expert Consensus
title_sort place of immune reconstitution therapy in the management of relapsing multiple sclerosis in france an expert consensus
topic Multiple sclerosis
Disease-modifying therapy
Immune reconstitution therapy
url https://doi.org/10.1007/s40120-022-00430-z
work_keys_str_mv AT jeromedeseze theplaceofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT laurentsuchet theplaceofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT claudemekies theplaceofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT ericmanchon theplaceofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT pierrelabauge theplaceofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT annemarieguennoc theplaceofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT gillesdefer theplaceofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT pierreclavelou theplaceofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT giovannicastelnovo theplaceofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT bertrandbourre theplaceofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT carolinebensakoscher theplaceofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT abdullatifalkhedr theplaceofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT julielemao theplaceofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT laurianevillemur theplaceofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT stephanebouee theplaceofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT lauraluciani theplaceofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT patrickvermersch theplaceofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT jeromedeseze placeofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT laurentsuchet placeofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT claudemekies placeofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT ericmanchon placeofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT pierrelabauge placeofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT annemarieguennoc placeofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT gillesdefer placeofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT pierreclavelou placeofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT giovannicastelnovo placeofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT bertrandbourre placeofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT carolinebensakoscher placeofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT abdullatifalkhedr placeofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT julielemao placeofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT laurianevillemur placeofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT stephanebouee placeofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT lauraluciani placeofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus
AT patrickvermersch placeofimmunereconstitutiontherapyinthemanagementofrelapsingmultiplesclerosisinfranceanexpertconsensus