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. 2020 Jun 12;26(9):1352458520924595.
doi: 10.1177/1352458520924595. Online ahead of print.

Aggressive multiple sclerosis (2): Treatment

Georgina Arrambide  1 , Ellen Iacobaeus  2 , Maria Pia Amato  3 , Tobias Derfuss  4 , Sandra Vukusic  5 , Bernhard Hemmer  6 , Lou Brundin  2 , Mar Tintore  1 ; 2018 ECTRIMS Focused Workshop Group
Collaborators, Affiliations

Aggressive multiple sclerosis (2): Treatment

Georgina Arrambide et al. Mult Scler. .

Abstract

The natural history of multiple sclerosis (MS) is highly heterogeneous. A subgroup of patients has what might be termed aggressive MS. These patients may have frequent, severe relapses with incomplete recovery and are at risk of developing greater and permanent disability at the earlier stages of the disease. Their therapeutic window of opportunity may be narrow, and while it is generally considered that they will benefit from starting early with a highly efficacious treatment, a unified definition of aggressive MS does not exist and data on its treatment are largely lacking. Based on discussions at an international focused workshop sponsored by the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), we review our current knowledge about treatment of individuals with aggressive MS. We analyse the available evidence, identify gaps in knowledge and suggest future research needed to fill those gaps. A companion paper details the difficulties in developing a consensus about what defines aggressive MS.

Keywords: Aggressive; disability; highly active; multiple sclerosis; relapsing–remitting; treatment response.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: G.A. has received compensation for consulting services or participation in advisory boards from Sanofi, Merck and Roche; research support from Novartis; travel expenses for scientific meetings from Novartis, Roche and Stendhal; and speaking honoraria from Sanofi and Merck. E.I. has honoraria for advisory boards or lecturing for Sanofi Genzyme and Merck outside the submitted work. M.P.A. has received research grants and personal fees as a speaker and member of advisory boards by Biogen, Sanofi Genzyme, Merck Serono, Novartis, Roche and Teva outside the submitted work. T.D. reports grants from Novartis and Biogen. His institution received financial support from Novartis, Biogen, Roche, Merck Serono, Celgene, Sanofi Genzyme, MedDay, GeNeuro, Mitsubishi Pharma and Actelion for his activities as steering committee or advisory board member or consultant. S.V. has received grants, personal fees and non-financial support from Biogen, Celgene, Geneuro, Genzyme, Medday, Merck Serono, Novartis, Roche, Sanofi and Teva outside the submitted work. B.H. has served on scientific advisory boards for Novartis and as DMSC member for AllergyCare and TG therapeutics, he or his institution have received speaker honoraria from Desitin, holds part of two patents: one for the detection of antibodies against KIR4.1 in a subpopulation of MS patients and one for genetic determinants of neutralizing antibodies to interferon. L.B. has received honoraria for advisory boards for Biogen, Sanofi Genzyme, Novartis, and Teva and has received lecturing fees from Biogen, Novartis, Teva and Sanofi Genzyme outside the submitted work. M.T. has received compensation for consulting services and speaking honoraria from Almirall, Bayer Schering Pharma, Biogen Idec, Genzyme, Merck Serono, Novartis, Roche, Sanofi Aventis and Teva Pharmaceuticals. M.T. is the co-editor of Multiple Sclerosis Journal–ETC.

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