Journal
EUROPEAN JOURNAL OF NEUROLOGY
Volume 30, Issue 8, Pages 2144-2176Publisher
WILEY
DOI: 10.1111/ene.15809
Keywords
consensus; disease-modifying therapy; infections; multiple sclerosis; vaccination
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This study developed a European consensus on vaccination strategies for people with multiple sclerosis (pwMS) who are candidates for disease-modifying therapies (DMTs). A multidisciplinary working group used formal consensus methodology to formulate recommendations based on the quality of evidence and risk-benefit balance. A total of 53 recommendations were agreed upon, aiming to homogenize immunization practices in pwMS.
Background and purpose: With the new highly active drugs available for people with multiple sclerosis (pwMS), vaccination becomes an essential part of the risk management strategy. We aimed to develop a European evidence-based consensus for the vaccination strategy of pwMS who are candidates for disease-modifying therapies (DMTs).Methods: This work was conducted by a multidisciplinary working group using formal consensus methodology. Clinical questions (defined as population, interventions and outcomes) considered all authorized DMTs and vaccines. A systematic literature search was conducted and quality of evidence was defined according to the Oxford Centre for Evidence-Based Medicine Levels of Evidence. The recommendations were formulated based on the quality of evidence and the risk-benefit balance.Results: Seven questions, encompassing vaccine safety, vaccine effectiveness, global vaccination strategy and vaccination in subpopulations (pediatric, pregnant women, elderly and international travelers) were considered. A narrative description of the evidence considering published studies, guidelines and position statements is presented. A total of 53 recommendations were agreed by the working group after three rounds of consensus.Conclusion: This first European consensus on vaccination in pwMS proposes the best vaccination strategy according to current evidence and expert knowledge, with the goal of homogenizing the immunization practices in pwMS.
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