Management of Relapsing-Remitting Multiple Sclerosis

The Canadian Agency for Drugs and Technologies in Health (CADTH) has examined the comparative efficacy and safety of drug therapies for relapsing-remitting multiple sclerosis (RRMS).

The review included drugs that are currently available in Canada, and those that are newly emerging and not yet approved in Canada.

The project comprised several key components:

• A comparison of the efficacy and safety of drug therapies for RRMS and an assessment of their cost-effectiveness
• The development of recommendations from the Canadian Drug Expert Committee (CDEC).

The impending entry of new oral and injectable agents for the treatment of RRMS will have a significant impact on evolving treatment strategies. By reviewing the evidence and developing reports and tools, CADTH is providing health care decision-makers with the evidence-based resources they need to make informed decisions.

Patient Input

The Canadian Agency for Drugs and Technologies in Health is piloting the inclusion of patient group input in its process for the therapeutic review of drug therapies for relapsing-remitting multiple sclerosis (RRMS). 

The submitted patient group input identifies health outcomes and issues of importance to patients, and their unmet needs in managing RRMS. The patient input is systematically incorporated into this therapeutic review, beginning with informing the project protocol through to informing the Canadian Drug Expert Committee in making its recommendation(s) based on this therapeutic review. 

Below is a link to the patient group input that was submitted for this project. It has not been summarized, edited, or critically appraised — it is posted in the format in which it was received. 

• Patient Group Input – Multiple Sclerosis Society of Canada

Key Messages

CADTH's work on this project resulted in the following key messages:

• For patients newly diagnosed with RRMS, start with glatiramer acetate or interferon beta-1b.
• For patients who do not respond to or are unable to take one of the recommended initial drugs, switch to the other recommended drug.
• For patients who do not respond to or are unable to take both glatiramer acetate or interferon beta-1b, choose one of dimethyl fumarate, fingolimod, and natalizumab, based on safety and cost considerations.
• Combination therapy should not be used.