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2017;32(2):113119
NEUROLOGA
www.elsevier.es/neurologia
REVISIN
a
Hospital Puerta de Hierro, Majadahonda, Madrid, Espana
b
Hospital Miguel Servet, Zaragoza, Espana
c
Complejo Hospitalario de Mlaga, Mlaga, Espana
d
Hospital Dr. Peset, Valencia, Espana
e
Hospital Moiss Broggi, Sant Joan Desp, Barcelona, Espana
f
Hospital de Basurto, Bilbao, Vizcaya, Espana
PALABRAS CLAVE Resumen La incorporacin de nuevos medicamentos para modicar el curso de la esclerosis
Esclerosis mltiple; mltiple y la complejidad de su uso plantea la conveniencia de utilizar consensos teraputicos.
Consenso; El consenso actual ha sido elaborado por el grupo de enfermedades desmielinizantes de la
Medicamentos para el Sociedad Espanola de Neurologa y actualiza consensos previamente publicados.
curso de la Se enumeran los medicamentos aprobados para la esclerosis mltiple con sus indicaciones
enfermedad; ociales. Se analizan aspectos relacionados con el tratamiento, como la presencia de actividad,
Lneas teraputicas; la precocidad, el mantenimiento teraputico, el seguimiento, el fallo teraputico, los cambios
Cambios de de medicacin y el tratamiento en situaciones especiales.
medicacin; Se elaboran indicaciones de tratamiento desde el sndrome desmielinizante aislado a las
Algoritmo distintas formas de esclerosis mltiple detallando recomendaciones de tratamiento inicial,
cambios de medicacin, con consideraciones sobre terapia combinada e induccin y aspectos
prcticos del uso de medicamentos.
2016 Sociedad Espanola de Neurologa. Publicado por Elsevier Espana, S.L.U. Este es un
artculo Open Access bajo la licencia CC BY-NC-ND (http://creativecommons.org/licenses/by-
nc-nd/4.0/).
KEYWORDS Consensus statement on the treatment of multiple sclerosis by the Spanish Society
Multiple sclerosis; of Neurology in 2016
Consensus statement;
Disease-modifying Abstract With the advent of new disease-modifying drugs, the treatment of multiple sclero-
drugs; sis is becoming increasingly complex. Using consensus statements is therefore advisable. The
Lines of therapy; present consensus statement, which was drawn up by the Spanish Society of Neurologys study
group for demyelinating diseases, updates previous consensus statements on the disease.
http://dx.doi.org/10.1016/j.nrl.2016.02.026
0213-4853/ 2016 Sociedad Espanola de Neurologa. Publicado por Elsevier Espana, S.L.U. Este es un artculo Open Access bajo la licencia
CC BY-NC-ND (http://creativecommons.org/licenses/by-nc-nd/4.0/).
114 A. Garca Merino et al.
The present study lists the medications currently approved for multiple sclerosis and their
Changes in ofcial indications, and analyses such treatment-related aspects as activity, early treatment,
medication; maintenance, follow-up, treatment failure, changes in medication, and special therapeutic
Algorithm situations.
This consensus statement includes treatment recommendations for a wide range of demye-
linating diseases, from isolated demyelinating syndromes to the different forms of multiple
sclerosis, as well as recommendations for initial therapy and changes in drug medication, and
additional comments on induction and combined therapy and practical aspects of the use of
these drugs.
2016 Sociedad Espanola de Neurologa. Published by Elsevier Espana, S.L.U. This is an open
access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/
4.0/).
Respuesta inadecuada a segunda lnea. Considerar otros Siz Hinarejos, Albert, Hospital Clnic, Barcelona.
frmacos de segunda lnea.
Fracaso de los anteriores: opciones no aprobadas: rituxi-
mab, ciclofosfamida, autotrasplante.
Suspensin de natalizumab: terapia alternativa entre 8 y
12 semanas de la suspensin
Bibliografa
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