Minocycline for Relapsing-Remitting Multiple Sclerosis and Clinically Isolated Syndrome: A Review of Clinical Effectiveness and Guidelines Minocycline for Relapsing-Remitting Multiple Sclerosis and Clinically Isolated Syndrome: A Review of Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Minocycline for Relapsing-Remitting Multiple Sclerosis and Clinically Isolated Syndrome: A Review of Clinical Effectiveness and Guidelines Minocycline for Relapsing-Remitting (...) Multiple Sclerosis and Clinically Isolated Syndrome: A Review of Clinical Effectiveness and Guidelines Last updated: September 16, 2019 Project Number: RC1183-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of minocycline for relapsing-remitting multiple sclerosis? What is the clinical effectiveness of minocycline for clinically isolated syndrome? What are the evidence-based guidelines regarding

Second-Line Therapy for Patients with Relapsing-Remitting Multiple Sclerosis: A Review of Guidelines Second-Line Therapy for Patients with Relapsing-Remitting Multiple Sclerosis: A Review of Guidelines | CADTH.ca Find the information you need Second-Line Therapy for Patients with Relapsing-Remitting Multiple Sclerosis: A Review of Guidelines Second-Line Therapy for Patients with Relapsing-Remitting Multiple Sclerosis: A Review of Guidelines Last updated: September 26, 2019 Project Number (...) : RC1190-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What are the evidence-based guidelines regarding switching to a second-line therapy in patients with relapsing-remitting multiple sclerosis? Key Message One evidence-based guideline was identified with one strong recommendation regarding switching from an interferon or glatiramer acetate to a second-line therapy in patients with relapsing-remitting multiple sclerosis and evidence

Vaccine-preventable Infections and Immunization in Multiple Sclerosis 1 Practice guideline update: Vaccine-preventable infections and immunization in multiple sclerosis Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology Mauricio F. Farez, MD, MPH, 1 Jorge Correale, MD, 1,2 Melissa J. Armstrong, MD, MSc, 3 Alexander Rae-Grant, MD, 4 David Gloss, MD, 5 Diane Donley, MD, 6 Yolanda Holler-Managan, MD, 7 Norman J. Kachuck, MD, 8 (...) . Department of Pediatrics, Neurology Division, Loma Linda University Health Care, CA 13. American Academy of Neurology, Minneapolis, MN 14. US Centers for Disease Control and Prevention, Atlanta, GA 15. Department of Neurology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA Address correspondence and reprint requests to American Academy of Neurology: guidelines@aan.com This practice guideline was endorsed by the Multiple Sclerosis Association of America on January 11, 2019

Fingolimod (multiple sclerosis in children and adolescents) - Addendum to Commission A18-87 1 Translation of addendum A19-42 Fingolimod (multiple Sklerose bei Kindern und Jugendlichen) – Addendum zum Auftrag A18-87 (Version 1.0; Status: 28 May 2019). Please note: This translation is provided as a service by IQWiG to English-language readers. However, solely the German original text is absolutely authoritative and legally binding. Addendum 28 May 2019 1.0 Commission: A19-42 Version: Status (...) : IQWiG Reports – Commission No. A19-42 Fingolimod (multiple sclerosis in children and adolescents) – Addendum to Commission A18-87 1 Addendum A19-42 Version 1.0 Fingolimod – Addendum to Commission A18-87 28 May 2019 Institute for Quality and Efficiency in Health Care (IQWiG) - i - Publishing details Publisher: Institute for Quality and Efficiency in Health Care Topic: Fingolimod (multiple sclerosis in children and adolescents) – Addendum to Commission A18-87 Commissioning agency: Federal Joint

Long-term disability progression of pediatric-onset multiple sclerosis To evaluate long-term disability progression in pediatric-onset multiple sclerosis (POMS) and compare to adult-onset multiple sclerosis (AOMS).This was a retrospective cohort study using prospectively collected clinical information from the Swedish MS Registry. Clinical features were compared and Kaplan-Meier and Cox proportional hazards regression were used to assess the risk of reaching sustained Expanded Disability Status (...) Scale (EDSS) 3, 4, and 6 in POMS (multiple sclerosis [MS] onset <18 years) and AOMS (MS onset ≥18 years).A total of 12,482 persons were included; 549 (4.4%) were classified as POMS. The POMS cohort took longer to reach all 3 disability milestones from their MS onset, but did so at a younger age than the AOMS cohort. Primary progressive course (hazard ratio [HR] 4.63; 95% confidence interval [CI] 1.46-14.7), higher relapse rate in the first 5 years of disease (HR 5.35; 95% CI 3.37-8.49), and complete

Placebo-Controlled Trial of an Oral BTK Inhibitor in Multiple Sclerosis. Bruton's tyrosine kinase (BTK) regulates the functions of B cells and myeloid cells that are implicated in the pathogenesis of multiple sclerosis. Evobrutinib is a selective oral BTK inhibitor that has been shown to inhibit B-cell activation both in vitro and in vivo.In this double-blind, randomized, phase 2 trial, we assigned patients with relapsing multiple sclerosis to one of five groups: placebo, evobrutinib (at a dose (...) with relapsing multiple sclerosis who received 75 mg of evobrutinib once daily had significantly fewer enhancing lesions during weeks 12 through 24 than those who received placebo. There was no significant difference with placebo for either the 25-mg once-daily or 75-mg twice-daily dose of evobrutinib, nor in the annualized relapse rate or disability progression at any dose. Longer and larger trials are required to determine the effect and risks of evobrutinib in patients with multiple sclerosis. (Funded

Fingolimod (Gilenya) - highly active relapsing remitting multiple sclerosis Final Appraisal Recommendation Advice No: 0719 – May 2019 Fingolimod (Gilenya ® ) 0.25 mg and 0.5 mg hard capsules Limited submission by Novartis Pharmaceuticals UK Ltd Additional note(s): ? Please refer to the Summary of Product Characteristics for the full licensed indication. ? It is the view of AWMSG that treatment for those aged under 16 years should be initiated and supervised by a paediatric neurologist (...) and will be considered for review every three years. Recommendation of AWMSG Fingolimod (Gilenya®) is recommended as an option for use within NHS Wales as a single disease modifying therapy in highly active relapsing remitting multiple sclerosis for the following groups of paediatric patients aged 10 –17 years: patients with highly active disease despite a full and adequate course of treatment with at least one disease modifying therapy; or patients with rapidly evolving severe relapsing remitting multiple sclerosis

Ocrelizumab for treating primary progressive multiple sclerosis Ocrelizumab for treating primary Ocrelizumab for treating primary progressiv progressive multiple sclerosis e multiple sclerosis T echnology appraisal guidance Published: 12 June 2019 www.nice.org.uk/guidance/ta585 © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility The recommendations in this guidance represent (...) inequalities. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Ocrelizumab for treating primary progressive multiple sclerosis (TA585) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 of 21Contents Contents 1 Recommendations 4 2 Information about

Fingolimod (Gilenya) - highly active relapsing remitting multiple sclerosis Published 10 June 2019 1 Product update SMC2154 fingolimod 0.25mg, 0.5mg hard capsules (Gilenya®) Novartis Pharmaceuticals UK Ltd 5 April 2019 (Issued 10 May 2019) The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and advises NHS Boards and Area Drug and Therapeutic Committees (ADTCs) on its use in NHSScotland. The advice is summarised as follows: ADVICE: following an abbreviated (...) submission fingolimod (Gilenya®) is accepted for use within NHSScotland. Indication under review: as a single disease modifying therapy in highly active relapsing remitting multiple sclerosis for the following groups of patients aged 10 to <18 years: - Patients with highly active disease despite a full and adequate course of treatment with at least one disease modifying therapy. or - Patients with rapidly evolving severe relapsing remitting multiple sclerosis defined by two or more disabling relapses

Percutaneous transluminal angioplasty for treatment of chronic cerebrospinal venous insufficiency (CCSVI) in people with multiple sclerosis. Multiple sclerosis (MS) is a leading cause of neurological disability in young adults. The most widely accepted hypothesis regarding its pathogenesis is that it is an immune-mediated disease. It has been hypothesised that intraluminal defects, compression, or hypoplasia in the internal jugular or azygos veins may be important factors in the pathogenesis (...) . This is an update of a review first published in 2012.To assess the benefit and safety of venous PTA in people with MS and CCSVI.We searched the Cochrane Multiple Sclerosis and Rare Diseases of the Central Nervous System Group's Specialised Register up to 30 August 2018, CENTRAL (in the Cochrane Library 2018, issue 8), MEDLINE up to 30 August 2018, Embase up to 30 August 2018, metaRegister of Controlled Trials, ClinicalTrials.gov., the Australian New Zealand Clinical Trials Registry, and the World Health

Siponimod (Mayzent) - To treat adults with relapsing forms of multiple sclerosis Drug Approval Package: Mayzent (siponimod) U.S. Department of Health and Human Services Search FDA Submit search Drug Approval Package: Mayzent (siponimod) Company: Novartis Pharmaceuticals Corporation Application Number: 209884 Approval Date: 03/26/2019 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. FDA Approval Letter and Labeling (PDF) (PDF) FDA

Cladribine (multiple sclerosis) - Benefit assessment according to §35a Social Code Book (SGB) V Extract 1 Translation of Sections 2.1 to 2.6 of the dossier assessment Cladribin (multiple Sklerose) – Nutzenbewertung gemäß § 35a SGB V (Version 1.0; Status: 27 February 2018). Please note: This translation is provided as a service by IQWiG to English-language readers. However, solely the German original text is absolutely authoritative and legally binding. IQWiG Reports – Commission No. A17-62 (...) Cladribine (multiple sclerosis) – Benefit assessment according to §35a Social Code Book V 1 Extract of dossier assessment A17-62 Version 1.0 Cladribine (multiple sclerosis) 27 February 2018 Institute for Quality and Efficiency in Health Care (IQWiG) - i - Publishing details Publisher: Institute for Quality and Efficiency in Health Care Topic: Cladribine (multiple sclerosis) – Benefit assessment according to §35a Social Code Book V Commissioning agency: Federal Joint Committee Commission awarded on: 30

Multiple sclerosis: wasted opportunities Prescrire IN ENGLISH - Spotlight ''Multiple sclerosis: wasted opportunities'', 1 April 2019 {1} {1} {1} | | > > > Multiple sclerosis: wasted opportunities Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |   |   |   |   |   |   |   |   |  Spotlight Multiple sclerosis: wasted opportunities The drugs on the market have been so poorly evaluated (...) that healthcare professionals are not able to make the best use of the available treatments, to the detriment of patients. Numerous drugs have been authorised over the past 15 years for treatment of multiple sclerosis. Eight drugs have been authorised in Europe since the market introduction of interferon beta (Avonex°, Betaferon° or other brands) and glatiramer (Copaxone° or other brands). These eight drugs were granted marketing authorisation on the basis of 16 clinical trials, 11 of which compared the new

Multiple sclerosis Multiple sclerosis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Multiple sclerosis Last reviewed: February 2019 Last updated: February 2019 Summary Demyelinating central nervous system condition clinically defined by two episodes of neurological dysfunction (brain, spinal cord, or optic nerves) that are separated in space and time. Classically presents in white women, aged between 20 to 40 years (...) , but lends greater specificity when present with brain lesions. Treatment of the condition can be divided into three parts: treatment of the acute attack; prevention of future attacks by reducing triggers and use of disease-modifying therapies; and symptomatic treatments of neurological difficulties such as spasticity, pain, fatigue, and bladder dysfunction. Definition Multiple sclerosis (MS) is defined as an inflammatory demyelinating disease characterised by the presence of episodic neurological

Percutaneous venoplasty for chronic cerebrospinal venous insufficiency in multiple sclerosis P Percutaneous v ercutaneous venoplasty for chronic enoplasty for chronic cerebrospinal v cerebrospinal venous insufficiency in multiple enous insufficiency in multiple sclerosis sclerosis Interventional procedures guidance Published: 30 January 2019 nice.org.uk/guidance/ipg640 Y Y our responsibility our responsibility This guidance represents the view of NICE, arrived at after careful consideration (...) 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 1 of 41 1 Recommendations Recommendations 1.1 Current evidence on percutaneous venoplasty for chronic cerebrospinal venous insufficiency in multiple sclerosis shows that there are serious complications and that it provides no benefit. Therefore, this procedure should not be used in the management of multiple sclerosis. 2 2 The condition, current treatments and procedure

Web-based physiotherapy for people affected by multiple sclerosis: a single blind, randomized controlled feasibility study To examine the feasibility of a trial to evaluate web-based physiotherapy compared to a standard home exercise programme in people with multiple sclerosis.Multi-centre, randomized controlled, feasibility study.Three multiple sclerosis out-patient centres.A total of 90 people with multiple sclerosis (Expanded Disability Status Scale 4-6.5).Participants were randomized

Rituximab vs placebo induction prior to glatiramer acetate monotherapy in multiple sclerosis To examine whether rituximab induction followed by glatiramer acetate (GA) monotherapy is more effective than GA alone for the treatment of relapsing multiple sclerosis with active disease.This was a single-center, double-blind, placebo-controlled study. Fifty-five participants were randomly assigned (1:1 ratio) to either rituximab (R-GA) or placebo (P-GA) induction, followed by GA therapy initiated (...) the study period. There were no differences in adverse events.Induction therapy with rituximab followed by GA may provide superior efficacy in the short term than GA alone in relapsing multiple sclerosis, but this benefit appears to wane within the study period. Larger studies are needed to assess sustainability of results.NCT01569451.© 2019 American Academy of Neurology.

Association of Initial Disease-Modifying Therapy With Later Conversion to Secondary Progressive Multiple Sclerosis. Within 2 decades of onset, 80% of untreated patients with relapsing-remitting multiple sclerosis (MS) convert to a phase of irreversible disability accrual termed secondary progressive MS. The association between disease-modifying treatments (DMTs), and this conversion has rarely been studied and never using a validated definition.To determine the association between the use

Effect of Nonmyeloablative Hematopoietic Stem Cell Transplantation vs Continued Disease-Modifying Therapy on Disease Progression in Patients With Relapsing-Remitting Multiple Sclerosis: A Randomized Clinical Trial. Hematopoietic stem cell transplantation (HSCT) represents a potentially useful approach to slow or prevent progressive disability in relapsing-remitting multiple sclerosis (MS).To compare the effect of nonmyeloablative HSCT vs disease-modifying therapy (DMT) on disease

Rehabilitation for people with multiple sclerosis: an overview of Cochrane Reviews. Multiple sclerosis (MS) is a major cause of chronic, neurological disability, with a significant long-term disability burden, often requiring comprehensive rehabilitation.To systematically evaluate evidence from published Cochrane Reviews of clinical trials to summarise the evidence regarding the effectiveness and safety of rehabilitation interventions for people with MS (pwMS), to improve patient outcomes (...) , and to highlight current gaps in knowledge.We searched the Cochrane Database of Systematic Reviews up to December 2017, to identify Cochrane Reviews that assessed the effectiveness of organised rehabilitation interventions for pwMS. Two reviewers independently assessed the quality of included reviews, using the Revised Assessment of Multiple Systematic Reviews (R-AMSTAR) tool, and the quality of the evidence for reported outcomes, using the GRADE framework.Overall, we included 15 reviews published