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...
Main Authors: | , , , , , , , , , , , , , , , , |
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Format: | Article |
Language: | English |
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Adis, Springer Healthcare
2022-12-01
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Series: | Neurology and Therapy |
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Online Access: | https://doi.org/10.1007/s40120-022-00430-z |
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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 |
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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 |
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