Universität zu Köln

Schweitzer, Finja, Laurent, Sarah, Fink, Gereon R. ORCID: 0000-0002-8230-1856, Barnett, Michael H., Reddel, Stephen, Hartung, Hans-Peter and Warnke, Clemens (2019). Age and the risks of high-efficacy disease modifying drugs in multiple sclerosis. Curr. Opin. Neurol., 32 (3). S. 305 - 313. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1473-6551

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Abstract

Purpose of review A variety of high-efficacy disease-modifying therapies (DMTs) are available for the treatment of multiple sclerosis (MS). After evaluation and approval by regulatory agencies, DMTs are likely to be administered to patients whose characteristics differ from those enrolled in clinical trials. This may contribute to the emergence of unexpected adverse events observed in the real-world setting. Higher age may be a relevant factor that could change the benefit-risk balance of DMTs, as it may associate with lower efficiency and higher frequency of adverse events. Recent findings The absolute and relative number of patients with MS who reach the age of 55 and higher increases. Growing evidence demonstrates lower efficacy of DMTs in older persons with MS. Specific risks during DMTs for MS, such as the risk of developing progressive multifocal leukoencephalopathy (PML) or the outcome following PML, have been associated with age. It is hypothesized that age-related and therapy-induced alterations to the immune system may have (super) additive effects, resulting in an acceleration of physiological immunosenescence and inflamm-aging. Summary In this article, we review the risks of high-efficacy DMTs in MS with a specific focus on age-related efficacy and risks, including opportunistic infections, malignancies, and autoimmune reactions.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schweitzer, Finja UNSPECIFIED UNSPECIFIED UNSPECIFIED Laurent, Sarah UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Gereon R. UNSPECIFIED orcid.org/0000-0002-8230-1856 UNSPECIFIED Barnett, Michael H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Reddel, Stephen UNSPECIFIED UNSPECIFIED UNSPECIFIED Hartung, Hans-Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Warnke, Clemens UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-138394
DOI:	10.1097/WCO.0000000000000701
Journal or Publication Title:	Curr. Opin. Neurol.
Volume:	32
Number:	3
Page Range:	S. 305 - 313
Date:	2019
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1473-6551
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PLACEBO-CONTROLLED TRIAL; IMMUNE-SYSTEM; INTERFERON BETA-1A; ORAL FINGOLIMOD; PREVALENCE; NATALIZUMAB; ALEMTUZUMAB; CANCER Multiple languages Clinical Neurology; Neurosciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13839