Therapeutic Decision-Making for Relapsing MS - Flowchart
Therapeutic Decision-Making for Relapsing MS - Flowchart
«Flowchart»

POSSIBLE THERAPEUTIC ALGORITHM FOR RELAPSING MS

POSSIBLE THERAPEUTIC ALGORITHM FOR RELAPSING MS

POSSIBLE THERAPEUTIC ALGORITHM FOR RELAPSING MS

POSSIBLE THERAPEUTIC ALGORITHM FOR RELAPSING MS

Treatment naïve

Treatment naïve

Treatment naïve

Active MS on treatment with IFN, GA, TER

Active MS on treatment with IFN, GA, TER

Active MS on treatment with IFN, GA, TER

Active MS on treatment with FNG, DMF

Active MS on treatment with FNG, DMF

Active MS on treatment with FNG, DMF

On NTZ

On NTZ

On NTZ

End

End

End

NTZ1 
FNG
DMF
IFN
GA
TER2 

NTZ1 
FNG
DMF
IFN
GA
TER2 

NTZ1 
FNG
DMF
IFN
GA
TER2 

1  1




2  2

JCV (+)

JCV (+)

JCV (+)

OCR
ALEM5 
MITO6 

OCR
ALEM5 
MITO6 

OCR
ALEM5 
MITO6 


5  5
6  6

OCR
FNG
DMF
ALEM5 

OCR
FNG
DMF
ALEM5 

OCR
FNG
DMF
ALEM5 




5  5

JCV (+)

JCV (+)

JCV (+)

JCV (-)

JCV (-)

JCV (-)

OCR
FNG3 
DMF4 
IFN
GA
TER

OCR
FNG3 
DMF4 
IFN
GA
TER

OCR
FNG3 
DMF4 
IFN
GA
TER


3  3
4  4


JCV (+)

JCV (+)

JCV (+)

JCV (-)

JCV (-)

JCV (-)

OCR
NTZ
FNG
DMF

OCR
NTZ
FNG
DMF

OCR
NTZ
FNG
DMF




JCV (+)

JCV (+)

JCV (+)

JCV (-)

JCV (-)

JCV (-)

OCR
NTZ
ALEM5 

OCR
NTZ
ALEM5 

OCR
NTZ
ALEM5 



5  5

OCR
DMF
FNG
ALEM5 
MITO6 

OCR
DMF
FNG
ALEM5 
MITO6 

OCR
DMF
FNG
ALEM5 
MITO6 




5  5
6  6

1. Restricted to treatment naïve pts with high disease activity in some areas

1. Restricted to treatment naïve pts with high disease activity in some areas

1. Restricted to treatment naïve pts with high disease activity in some areas

2. Carries low but unpredictable risk of toxic epidermal necrolysis

2. Carries low but unpredictable risk of toxic epidermal necrolysis

2. Carries low but unpredictable risk of toxic epidermal necrolysis

3. Has low but unpredictable risk of PML

3. Has low but unpredictable risk of PML

3. Has low but unpredictable risk of PML

4. Has low risk of PML that may be possible to mitigate

4. Has low risk of PML that may be possible to mitigate

4. Has low risk of PML that may be possible to mitigate

5. Has risk of de novo autoimmunity

5. Has risk of de novo autoimmunity

5. Has risk of de novo autoimmunity

6. Carries risk of cardiomyopathy and promyelocytic leukemia

6. Carries risk of cardiomyopathy and promyelocytic leukemia

6. Carries risk of cardiomyopathy and promyelocytic leukemia