PT -期刊文章盟亚历山大Rae-Grant盟安-格雷戈里·s .天盟露丝上非盟- Alejandro Rabinstein AU -布鲁斯交流克里族盟-加里·s . Gronseth AU -迈克尔Haboubi盟- 6月哈珀盟乔纳森·p·Hosey AU -大卫·e·琼斯盟罗伯特Lisak AU -丹尼尔·佩尔蒂埃盟Sonja Potrebic盟辛西娅Sitcov AU -里克Sommers盟-朱莉Stachowiak AU -托马斯。爱Getchius AU -香农a Merillat盟Tamara Pringsheim TI -实践指南建议总结:疾病修饰治疗- 10.1212 / WNL成年人罹患多发性硬化症的援助。0000000000005347 DP - 2018年4月24日TA -神经病半岛投注体育官网学第六PG - 777 - 788 - 90 IP - 17 4099 - //www.ebmtp.com/content/90/17/777.short 4100 - //www.ebmtp.com/content/90/17/777.full所以Neurology2018 4月24日;90 AB -目的制定疾病修饰治疗建议(DMT)多发性硬化症(MS)。方法多学科小组开发了DMT建议,整合研究结果从一个系统回顾;跟着一个Medicine-compliant研究所的过程以确保透明度和病人参与;关于开始和发展修改Delphi一致同意的建议,切换、和停止与儿童相关的女士患有复发缓和,次要进步女士,女士主要进步,临床孤立综合征脱髓鞘。建议由结构化的基本原理,结合证据从一个或多个来源:系统回顾,相关证据(证据而不是系统回顾),保健的原则,从证据和推理。结果三十的建议是:17从儿童开始,包括建议他们应该开始;10开关与儿童如果突破疾病发展;阻止儿童和3。建议包含病人参与策略和个性化的治疗,包括依从性监测和疾病发病率评估。该小组还讨论了DMT风险,包括咨询关于渐进多焦点的脑白质病风险的人使用natalizumab女士fingolimod,以美罗华ocrelizumab,富马酸二甲酯; and made suggestions for future research to evaluate relative merits of early treatment with higher potency DMTs vs standard stepped-care protocols, DMT comparative effectiveness, optimal switching strategies, long-term effects of DMT use, definitions of highly active MS, and effects of treatment on patient-specified priority outcomes. This guideline reflects the complexity of decision-making for starting, switching, or stopping MS DMTs. The field of MS treatment is rapidly changing; the Academy of Neurology development process includes planning for future updates.AAN=American Academy of Neurology; AE=adverse effect; CIS=clinically isolated syndrome; DMT=disease-modifying therapy; EDSS=Expanded Disability Status Scale; FDA=Food and Drug Administration; IFN-β=interferon-β; JCV=John Cunningham virus; MS=multiple sclerosis; PML=progressive multifocal leukoencephalopathy; PPMS=primary progressive multiple sclerosis; RCT=randomized controlled trial; REMS=risk evaluation and mitigation strategies; RRMS=relapsing-remitting multiple sclerosis; SPMS=secondary progressive multiple sclerosis