Outcomes and Cost-Effectiveness of Autologous Hematopoietic Cell Transplant for Multiple Sclerosis
| Autor: | Dunn-Pirio, Anastasie M, Heyman, Benjamin M, Kaufman, Dan S, Kinkel, Revere P |
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| Rok vydání: | 2019 |
| Předmět: |
Comparative Effectiveness Research
Transplantation Multiple Sclerosis Clinical Trials and Supportive Activities Neurosciences Evaluation of treatments and therapeutic interventions Outcomes Neurodegenerative Autoimmune Disease Brain Disorders Autologous stem cell transplant Good Health and Well Being Clinical Research 6.1 Pharmaceuticals Neurological Cost-effectiveness |
| Zdroj: | Current treatment options in neurology, vol 21, iss 10 |
| Popis: | PURPOSE OF REVIEW:This review presents a critical appraisal of the use of autologous hematopoietic cell transplant (AHCT) for the treatment of multiple sclerosis. We present the reader with a brief review on the AHCT procedure, its immunomodulatory mechanism of action in MS, the most recent evidence in support of its use in patients with relapsing-remitting multiple sclerosis (RRMS), as well as its cost considerations. RECENT FINDINGS:The first meta-analysis of clinical trials of AHCT for patients with MS demonstrated durable 5-year progression-free survival rates and low treatment-related mortality. Recently, the first randomized controlled phase III clinical trial demonstrated AHCT to be superior to best available therapy for a subset of patients with RRMS. This led to the American society for transplant and cellular therapies (ASTCT) to recommend AHCT "for patients with relapsing forms of MS who have prognostic factors that indicate a high risk of future disability." AHCT should be considered for patients with RRMS with evidence of clinical activity who have failed 2 lines of therapy or at least one highly active disease-modifying therapy. |
| Databáze: | OpenAIRE |
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