title: A neurologist's guide to safe use of immunomodulatory therapies.
abstract: Increased understanding of the pathogenesis of immune-mediated neurologic conditions with concomitant development of new therapeutic agents modulating various aspects of the immune system has resulted in the use of innovative therapies in the treatment of these diseases. These novel immunomodulatory therapeutic regimens also augment the potential for complications, including severe adverse effects.In this review, the authors address practical issues regarding management of patients with neuroimmunological conditions treated with immunomodulatory therapies, including glucocorticoids, methotrexate, azathioprine, mycophenolate, cyclophosphamide, rituximab, tumor necrosis factor-α inhibitors, and intravenous immunoglobulins. Particular focus is placed on their infectious and noninfectious adverse effects, contraindications, safety monitoring, risk surveillance, and preventive strategies in clinical practice.
authors.affiliation: Harvard Medical School, Boston, Massachusetts.
authors.forename: Ivana
authors.initials: I
authors.lastname: Vodopivec
authors.affiliation: Harvard Medical School, Boston, Massachusetts.
authors.forename: Eli M
authors.initials: EM
authors.lastname: Miloslavsky
authors.affiliation: Harvard Medical School, Boston, Massachusetts.
authors.forename: Camille N
authors.initials: CN
authors.lastname: Kotton
authors.affiliation: Harvard Medical School, Boston, Massachusetts.
authors.forename: Tracey A
authors.initials: TA
authors.lastname: Cho
mesh_terms: D020274:Autoimmune Diseases of the Nervous System / Q000188:drug therapy*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use*; D056747:Immunomodulation; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D009462:Neurology
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D007166:Immunosuppressive Agents