Against
ECTRIMS Online Library. Zakaria M. 09/11/19; 279424; 102
Magd Zakaria
Magd Zakaria
Contributions
Abstract

Abstract: 102

Type: Scientific Session

Abstract Category: Burning Debate: It is inappropriate to prescribe interferon-beta and

M.F. Zakaria

Neurology, Ain-Shams University, Cairo, Egypt

First line therapies ( interferon-beta, glatiramer acetate, teriflunomide, and dimethyl fumarate ) are often prescribed when newly diagnosed active multiple sclerosis (MS) patients have good prognostic signs and are early in the window of opportunity. As regards efficacy, only head to head trials can compare between the efficacy of the different first line therapies because a common misleading error is to compare the relative risk reduction of a drug in one trial with that of another drug in a different trial. The available head to head trials showed that first line injectables are, as effective as, newer oral first line therapies. As regards safety, the first line injectables have the best safety profile in all the available treatments for MS and their monitoring burden is minimal. As regards pregnancy data, no wash out period is required and the label of many of these injectables are currently being re evaluated to be used during pregnancy.
As regards long term benefit, the results of the largest, prospective, long term(10 years), observational UK trial showed that first line injectables had a clinically significant effect on the expanded disability status scale (EDSS) progression. Perhaps, the main problem is the convenience, compliance and adherence, nevertheless, there are many clinical situations in which the first line injectables are the best choice of all first line therapies.
Disclosure: The author declares that there is no conflict of interest or funding as regards this presentation. However, the author has received honoraria for previous presentations or advisory boards from Novartis, Merck Serono, Bayer Schering, Roche and Biologix.

Abstract: 102

Type: Scientific Session

Abstract Category: Burning Debate: It is inappropriate to prescribe interferon-beta and

M.F. Zakaria

Neurology, Ain-Shams University, Cairo, Egypt

First line therapies ( interferon-beta, glatiramer acetate, teriflunomide, and dimethyl fumarate ) are often prescribed when newly diagnosed active multiple sclerosis (MS) patients have good prognostic signs and are early in the window of opportunity. As regards efficacy, only head to head trials can compare between the efficacy of the different first line therapies because a common misleading error is to compare the relative risk reduction of a drug in one trial with that of another drug in a different trial. The available head to head trials showed that first line injectables are, as effective as, newer oral first line therapies. As regards safety, the first line injectables have the best safety profile in all the available treatments for MS and their monitoring burden is minimal. As regards pregnancy data, no wash out period is required and the label of many of these injectables are currently being re evaluated to be used during pregnancy.
As regards long term benefit, the results of the largest, prospective, long term(10 years), observational UK trial showed that first line injectables had a clinically significant effect on the expanded disability status scale (EDSS) progression. Perhaps, the main problem is the convenience, compliance and adherence, nevertheless, there are many clinical situations in which the first line injectables are the best choice of all first line therapies.
Disclosure: The author declares that there is no conflict of interest or funding as regards this presentation. However, the author has received honoraria for previous presentations or advisory boards from Novartis, Merck Serono, Bayer Schering, Roche and Biologix.

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