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Practice Guideline
. 2025 Apr 21;222(7):356-364.
doi: 10.5694/mja2.52578. Epub 2025 Feb 9.

Consensus recommendations on multiple sclerosis management in Australia and New Zealand: part 1

Jessica Shipley  1   2 , James Beharry  3 , Wei Yeh  1   2 , Nabil Seery  1   2 , Yi Chao Foong  2   4 , Darshini Ayton  2 , Pakeeran Siriratnam  1   2 , Tracie Tan  1   2 , Heidi Beadnall  5 , Joshua Barton  6 , Francesca Bridge  1   2 , Robb Wesselingh  1   2 , Lisa Taylor  7 , Louise Rath  1 , Jodi Haartsen  8 , Mohammad Gadi  9   10 , Cassie Nesbitt  1   2   11 , Michael Zhong  1   2 , Victoria Cushing  1 , Fiona McKay  12 , Julia Morahan  12 , Benjamin Peter Trewin  13   14 , Izanne Roos  7   15 , Mark Marriott  7   16 , Ai-Lan Nguyen  7   15 , Emma Downey  1 , Joanne Crosby  1 , Julian Bosco  1   2 , Jennifer Taylor  17 , Lauren Giles  18 , Nevin John  2   19 , Ernest Butler  20 , Anneke van der Walt  1   2 , Helmut Butzkueven  1   2 , Stefan Blum  21 , Marion Simpson  22 , Mark Slee  23 , Sudarshini Ramanathan  14   24 , Todd Hardy  24 , Richard A L Macdonell  22 , Katherine Buzzard  7   25 , Deborah F Mason  3   26 , Jeannette Lechner-Scott  27   28 , Trevor J Kilpatrick  7   29 , Tomas Kalincik  7   15 , Bruce V Taylor  4   30 , Simon A Broadley  31   32 , Stephen Reddel  5   24 , Douglas Johnson  33   34 , Mastura Monif  1   2 ; MS Interest Group, Australian and New Zealand Association of Neurologists
Affiliations
Practice Guideline

Consensus recommendations on multiple sclerosis management in Australia and New Zealand: part 1

Jessica Shipley et al. Med J Aust. .

Abstract

Introduction: Multiple sclerosis (MS) is a chronic inflammatory demyelinating and degenerative disease of the central nervous system. There were 33 335 people with MS in Australia in 2021 and 2917 in New Zealand in 2006 and the prevalence and incidence are increasing with time. Although new treatments have substantially improved outcomes in recent decades, the treatment landscape has become increasingly complex due to the expanding number of disease-modifying therapies (DMTs) and associated safety considerations.

Main recommendations: A total of 80 consensus recommendations were developed on the current best-practice management of MS in Australia and New Zealand. Part 1 of these guidelines outlines the consensus recommendations covering domains including DMT counselling and selection, pre-DMT assessments, monitoring disease activity on DMT, switching DMT, and discontinuing DMT. The remaining recommendations are outlined in Part 2, encompassing risk mitigation strategies during treatment with DMT, managing DMT in special situations (including pregnancy, postpartum, breastfeeding, active infection including COVID-19, and malignancy), general lifestyle measures, acute MS relapses, and symptomatic treatments for MS.

Changes in management as a result of the guidelines: This two-part position statement provides a practical resource for clinicians on current best-practice consensus recommendations for managing adults (≥ 18 years old) with MS in the Australian and New Zealand health care settings. It outlines the 14 DMTs currently available through the Australian Pharmaceutical Benefits Scheme and eight through the New Zealand Pharmaceutical Schedule, including the unique efficacy, safety and monitoring considerations of each. Through these guidelines, we aim to support safe, timely and effective management of patients with MS in Australia and New Zealand.

Keywords: Multiple sclerosis.

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References

    1. Campbell J, van der Mei I, Taylor B, Palmer A. Health economic impact of multiple sclerosis in Australia in 2021: an interim update of prevalence, costs and cost of illness from 2017 to 2021. Sydney: Multiple Sclerosis Australia, 2023. https://www.msaustralia.org.au/wp‐content/uploads/2023/02/health‐economi... (viewed July 2023).
    1. Taylor BV, Pearson JF, Clarke G, et al. MS prevalence in New Zealand, an ethnically and latitudinally diverse country. Mult Scler 2010; 16: 1422‐1431.
    1. Multiple Sclerosis International Federation. Atlas of MS, 3rd edition. Part 1: mapping multiple sclerosis around the world, key epidemiology findings. London: MSIF, 2020. https://www.msif.org/wp‐content/uploads/2020/12/Atlas‐3rd‐Edition‐Epidem... (viewed July 2023).
    1. Browne P, Chandraratna D, Angood C, et al. Atlas of multiple sclerosis 2013: a growing global problem with widespread inequity. Neurology 2014; 83: 1022‐1024.
    1. Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018; 17: 162‐173.

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