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. 2023 Jul 7;18(1):183.
doi: 10.1186/s13023-023-02789-0.

Treatment of relapsing multiple sclerosis in Hungary - consensus recommendation from the Hungarian neuroimmunology society

Cecilia Rajda  1 , Csilla Rózsa  2 , Andrea Mike  3 , Gábor Lovas  2 , Zsolt Mezei  4 , Gábor Jakab  5 , Péter Ács  6 , Gábor Rum  7 , Magdolna Simó  4 , Zita Jobbágy  8 , Zita Bíró  9 , Anita Trauninger  6 , Piroska Imre  10 , Klotild Mátyás  11 , István Deme  12 , Zsolt Illés  13 , Tunde Csepany  14
Affiliations

Treatment of relapsing multiple sclerosis in Hungary - consensus recommendation from the Hungarian neuroimmunology society

Cecilia Rajda et al. Orphanet J Rare Dis. .

Abstract

Multiple sclerosis (MS) may impact quality of life, careers and family plans of the affected individuals. The current treatments with disease modifying therapies aim to prevent people with MS (pwMS) from disability accumulation and progression. Different countries have different reimbursement policies resulting in inequalities in patient care among geographical regions. Access to anti-CD20 therapies for relapsing MS is restricted in Hungary because therapy of individual cases only is reimbursed. In the light of the latest research and national guidelines, 17 Hungarian MS experts agreed on 8 recommendations regarding relapsing pwMS using the Delphi round method. Strong agreement (> 80%) was achieved in all except one recommendation after three rounds, which generated a fourth Delphi round. The experts agreed on treatment initiation, switch, follow-up and discontinuation, as well as on special issues such as pregnancy, lactation, elderly population, and vaccination. Well-defined national consensus protocols may facilitate dialogue between policymakers and healthcare professionals and thus contribute to better patient care in the long run.

Keywords: Consensus; Multiple sclerosis; Recommendation; Treatment.

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Conflict of interest statement

CR participated as clinical investigator and/or received consultation and/or speaker fees and/or conference travel grants from: Biogen, Merck, Novartis, Sanofi Genzyme, Roche, Teva. IZ has served on scientific advisory boards, received support for congress participation, speaker honoraria, or for being member of clinical endpoint committees in clinical trials, and received research support for his laboratory from Biogen, Merck, Roche, Sanofi Genzyme, Novartis, Alexion, and Bristol Myers Squibb. CsR received speaker fees, conference honoraria from Biogen, Novartis, Merck, Roche, Sanofi.

AM participated as clinical investigator and/or received consultation and/or speaker fees and/or conference travel grants from Biogen, Merck, Novartis, Sanofi Genzyme, Roche, Teva. GL received speaker fees and honoraria form Biogen, Novartis, Merck, Roche, Sanofi. ZM received speaker fees and conference/travel grants from: Biogen, Merck, Novartis, Roche and Sanofi Genzyme. ÁP received received investigator and speaker fees from: Sanofi Genzyme, Roche. GJ, GR, AT, KM and ID reported no conflict of interest. MS participated as clinical investigator and received consultation / speaker fees and conference travel grants from: Biogen, Merck, Novartis, Sanofi Genzyme, Roche, Teva. ZJ received consultation fees, speaker fees and conference travel grants from: Biogen, Merck, Novartis, Sanofi Genzyme, Roche. ZB received congress support from Biogen, Merck, Novartis, Sanofi-Genzyme and Roche. IP participated as clinical investigator, and received consultation, and speaker fees, and conference travel grants from: Biogen, Merck, Novartis, Sanofi Genzyme. TC has received personal honoraria for speaking, advisory boards and travel expenses from Biogen, Novartis, Roche, Sanofi-Genzyme, Teva.

Figures

Fig. 1
Fig. 1
The number of medication prescription of pwMS on HET between 2016 and 2021 -based on the data from the National Health Insurance Fund [18]. The DMTs are shown in the order of their approval by the national authorities. Cladribine has been accepted since January 2020 without restriction. The reimbursement of anti-CD20 therapies are available with restriction, the only exception is ocrelizumab for primary progressive MS with unrestricted availability since January 2022. Data on DMTs n < 10, e.g. rituximab are not shown
See this image and copyright information in PMC

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