title: Metabolic and safety issues for multiple sclerosis pharmacotherapy--opportunities for personalised medicine.
abstract: BACKGROUND
  A number of disease-modifying therapies have become available to treat multiple sclerosis (MS) in recent years. As the effects of these medications are unpredictable and they are generally used for a number of years, the selection of the most appropriate disease-modifying agent must be based on the long-term efficacy and toxicity profile, thus strategies to personalise treatment to optimise responses may be potentially very useful.
  
  
  METHODS
  This review provides an overview of the efficacy and toxicity of disease-modifying agents used in MS and specifically discusses any metabolic side effects and advances in personalising the use of each of these agents. Medline and EMBASE were searched for any articles regarding the efficacy, toxicity and personalised use of the medicines discussed in this review.
  
  
  CONCLUSIONS
  Disease-modifying agents used to treat MS differ substantially in their efficacy and toxicity profile, but metabolic side effects appear to be limited to alemtuzumab, teriflunomide and IFN-β. Although personalised treatment strategies to assist in selection of the most appropriate disease-modifying agent for MS are limited, there is substantial potential to use genetic sub-studies of the many recent trials investigating disease-modifying agents to develop personalised treatment strategies.
authors.affiliation: University of South Australia, School of Pharmacy and Medical Sciences , GPO Box 2471, Adelaide 5001 , Australia +618 8302 2312 ; +618 8302 1010 ; Michael.wiese@unisa.edu.au.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Wiese
authors.forename: Vijayaprakash
authors.initials: V
authors.lastname: Suppiah
authors.forename: Catherine
authors.initials: C
authors.lastname: O'Doherty
mesh_terms: D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000503:physiopathology; D057285:Precision Medicine; D013997:Time Factors
chemical_list: D007166:Immunosuppressive Agents
keywords: adverse drug reaction; metabolic effects; multiple sclerosis; personalised medicine; pharmacotherapy