How patients with multiple sclerosis weigh treatment risks and benefits.

2018 ◽  
Vol 37 (7) ◽  
pp. 680-690 ◽  
Author(s):  
Jared M. Bruce ◽  
David P. Jarmolowicz ◽  
Sharon Lynch ◽  
Joanie Thelen ◽  
Seung-Lark Lim ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Risks And Benefits ◽  
Treatment Risks

Vaccinations in patients with multiple sclerosis: A Delphi consensus statement

2020 ◽  
pp. 135245852095231 ◽  
Author(s):  
Agostino Riva ◽  
Valeria Barcella ◽  
Simone V Benatti ◽  
Marco Capobianco ◽  
Ruggero Capra ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Seasonal Influenza ◽  
Careful Consideration ◽  
Delphi Consensus ◽  
Consensus Process ◽  
Disease Modifying Drugs ◽  
Risks And Benefits ◽  
Modified Delphi ◽  
Increased Risk ◽  
Evidence Based Decision Making

Background: Patients with multiple sclerosis (MS) are at increased risk of infection. Vaccination can mitigate these risks but only if safe and effective in MS patients, including those taking disease-modifying drugs. Methods: A modified Delphi consensus process (October 2017–June 2018) was used to develop clinically relevant recommendations for making decisions about vaccinations in patients with MS. A series of statements and recommendations regarding the efficacy, safety and timing of vaccine administration in patients with MS were generated in April 2018 by a panel of experts based on a review of the published literature performed in October 2017. Results: Recommendations include the need for an ‘infectious diseases card’ of each patient’s infectious and immunisation history at diagnosis in order to exclude and eventually treat latent infections. We suggest the implementation of the locally recommended vaccinations, if possible at MS diagnosis, otherwise with vaccination timing tailored to the planned/current MS treatment, and yearly administration of the seasonal influenza vaccine regardless of the treatment received. Conclusion: Patients with MS should be vaccinated with careful consideration of risks and benefits. However, there is an urgent need for more research into vaccinations in patients with MS to guide evidence-based decision making.

Natalizumab for the treatment of highly active multiple sclerosis: risks and benefits

2019 ◽  
Vol 15 (5) ◽  
pp. 216-222
Author(s):  
Nicola Daykin
Keyword(s):  
Multiple Sclerosis ◽  
Gold Standard ◽  
Risk Profile ◽  
Risks And Benefits ◽  
Highly Active ◽  
History Of ◽  
The Uk ◽  
Highly Active Multiple Sclerosis ◽  
Active Multiple Sclerosis

This article discusses the history of natalizumab (Tysabri), the first monoclonal antibody used to treat multiple sclerosis. It reviews how the medication's difficult beginnings and controversial past have changed how this treatment is monitored. The article looks at the role of clinicians in maintaining patient safety, the benefits and risk profile of this treatment and ways of optimising practice to provide gold standard nationalised natalizumab services throughout the UK.

Natalizumab for the treatment of highly active MS: risks and benefits

2019 ◽  
Vol 1 (8) ◽  
pp. 382-387
Author(s):  
Nicola Daykin
Keyword(s):  
Multiple Sclerosis ◽  
Monoclonal Antibody ◽  
Patient Safety ◽  
Gold Standard ◽  
Risk Profile ◽  
Risks And Benefits ◽  
Highly Active ◽  
History Of ◽  
The Uk

This article discusses the history of natalizumab (Tysabri), the first monoclonal antibody used to treat multiple sclerosis. It reviews how the drug's difficult beginnings and controversial past has changed the treatment is monitored treatment. The article looks at the role of clinicians in maintaining patient safety, the benefits and risk profile of this treatment, and ways of optimising practice to provide gold standard nationalised natalizumab services throughout the UK.

scholarly journals Risk perception in natalizumab-treated multiple sclerosis patients and their neurologists

2010 ◽  
Vol 16 (12) ◽  
pp. 1507-1512 ◽  
Author(s):  
Christoph Heesen ◽  
Ingo Kleiter ◽  
Franziska Nguyen ◽  
Nina Schäffler ◽  
Jürgen Kasper ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Malignant Disease ◽  
Evidence Based ◽  
Shared Decision ◽  
Information Leaflet ◽  
Risks And Benefits ◽  
Natalizumab Treatment ◽  
Life Threatening ◽  
Multiple Sclerosis Patients ◽  
Do So

Background: Natalizumab is associated with the potentially life-threatening side-effect progressive multifocal leukoencephalopathy (PML). Little is known about patients’ and physicians’ risk estimates and attitudes towards natalizumab treatment. Methods: Consecutive natalizumab-treated patients ( n = 69) and neurologists ( n = 66) in two centres and cooperating private practices received an evidence-based three-page information leaflet about natalizumab-associated PML and an evaluation sheet. Results: After reading the information, patients were significantly more likely than physicians to intend continuation of natalizumab treatment and willing to accept higher risks of PML: 49% of physicians would stop treatment at a PML risk of 2 : 10,000 or lower, while only 17% of patients would do so ( p < 0.001). This difference could not be explained by risk calculation abilities or lack of understanding. Both groups overestimated natalizumab treatment effects. Conclusion: Patients had a significantly worse perception of multiple sclerosis as a malignant disease. We conclude that patients were willing to accept a higher risk of PML than neurologists. Coherent with their perception of risks and benefits, patients were also more willing to continue treatment. Open information about treatment-related risks is appreciated and might support shared decision making.

Ocrelizumab in multiple sclerosis: risks and benefits

The Lancet ◽  
2012 ◽  
Vol 379 (9822) ◽  
pp. 1196-1197 ◽  
Author(s):  
Abhijit Chaudhuri
Keyword(s):  
Multiple Sclerosis ◽  
Risks And Benefits

scholarly journals Short-term outcomes of pediatric multiple sclerosis patients treated with alemtuzumab at a Canadian University multiple sclerosis clinic

2020 ◽  
Vol 6 (2) ◽  
pp. 205521732092661
Author(s):  
David Jure Hunt ◽  
Anthony Traboulsee
Keyword(s):  
Multiple Sclerosis ◽  
Stable Disease ◽  
Expanded Disability Status Scale ◽  
Short Term ◽  
Pediatric Multiple Sclerosis ◽  
Risks And Benefits ◽  
Disability Status ◽  
Infusion Reactions ◽  
Multiple Sclerosis Patients

There is a lack of literature documenting the use of alemtuzumab in pediatric multiple sclerosis (MS) patients. Here we describe a 16-year-old and a 17-year-old patient receiving alemtuzumab and being followed for 37 months and 20 months, respectively. Both patients experienced a 1.0 decrease in Expanded Disability Status Scale since initial alemtuzumab infusion and had stable disease. No serious infusion reactions, infections, or definite relapses were recorded on follow-up. Alemtuzumab has been relatively well-tolerated and effective; however, larger, longer-term studies are necessary to understand the specific risks and benefits of alemtuzumab in pediatric MS.

Decision Making in Multiple Sclerosis: Theory to Practice

2006 ◽  
Vol 8 (4) ◽  
pp. 113-120 ◽  
Author(s):  
Linda Morgante ◽  
Gail Hartley ◽  
Diane Lowden ◽  
Marie Namey ◽  
Theresa LaRocca ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cultural Sensitivity ◽  
State Of The Art ◽  
Quality Care ◽  
Current Treatment ◽  
Nursing Knowledge ◽  
Risks And Benefits ◽  
Disease Modifying Therapy ◽  
Theory To Practice ◽  
The Media

Multiple sclerosis (MS) is an uncertain disease that manifests itself in neurological symptoms unique to each individual. People with MS and their families experience the day-to-day variability of the disease and often face difficult decisions regarding their care. Decisions include opting for a disease-modifying therapy soon after the diagnosis of MS is confirmed, choosing various pharmaceutical and nonpharmaceutical treatments for managing the symptoms that result, changing therapies and selecting alternatives when prescribed treatments are not successful, and determining whether to enter a clinical trial of a promising medication. When new therapies become available, nurses are faced with the important task of clarifying expectations, helping patients understand the risks and benefits of the new agent and, if appropriate, the rationale for continuing on their current regimen rather than switching therapies. Patients should be taught to appraise how they are doing on their current treatment and then weigh the evidence of something new in the light of their personal disease course and information available from the media and from peers. A framework for helping patients and families to make complicated decisions is an important step in continuing to provide high-quality care. This can be considered a new domain of MS nursing—one that includes consideration of the patient's hopes and dreams combined with the reality of the evidence. Principles of adult learning, cultural sensitivity, and state-of-the-art nursing knowledge are needed by MS nurses more than ever. The future of MS treatment is one of optimism despite its complexity.

scholarly journals Communicating treatment risks and benefits to cancer patients: a systematic review of communication methods

2020 ◽  
Vol 29 (7) ◽  
pp. 1747-1766 ◽  
Author(s):  
L. F. van de Water ◽  
J. J. van Kleef ◽  
W. P. M. Dijksterhuis ◽  
I. Henselmans ◽  
H. G. van den Boorn ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cancer Patients ◽  
Risks And Benefits ◽  
Communication Methods ◽  
Treatment Risks
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