Consensus recommendations on multiple sclerosis management in Australia and New Zealand: part 2
Shipley J., Beharry J., Yeh W., Seery N., Foong YC., Ayton D., Siriratnam P., Tan T., Beadnall H., Barton J., Bridge F., Wesselingh R., Taylor L., Rath L., Haartsen J., Gadi M., Nesbitt C., Zhong M., Cushing V., McKay F., Morahan J., Trewin BP., Roos I., Marriott M., Nguyen A., Downey E., Crosby J., Bosco J., Taylor J., Giles L., John N., Butler E., van der Walt A., Butzkueven H., Blum S., Simpson M., Slee M., Ramanathan S., Hardy T., Macdonell RAL., Buzzard K., Mason DF., Lechner‐Scott J., Kilpatrick TJ., Kalincik T., Taylor BV., Broadley SA., Reddel S., Johnson D., Monif M.
AbstractIntroductionMultiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system with rapidly evolving treatment options and strategies. An iterative modified Delphi process was used to develop 80 consensus recommendations for the management of MS in Australia and New Zealand. Part 1 of these guidelines includes recommendations related to selection of initial disease‐modifying therapy (DMT) for MS, assessments before commencing DMT, monitoring disease activity on DMT, switching DMT, and discontinuing DMT.Main recommendationsThis article, Part 2, covers recommendations related to risk mitigation during treatment with DMT, managing DMT in special situations (including pregnancy, postpartum, breastfeeding, active infection including COVID‐19, and malignancy), general lifestyle measures for MS, acute MS relapses, and symptomatic treatments.Changes in management as a result of the guidelinesTogether with Part 1, this consensus statement provides practical guidance for clinicians involved in the care of adults (≥ 18 years old) with MS in Australia and New Zealand. A safe, effective and comprehensive approach to managing MS is crucial for improving long term outcomes and quality of life in individuals affected by MS.