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Current disease-modifying treatment of multiple sclerosis.
- Source :
-
The Mount Sinai journal of medicine, New York [Mt Sinai J Med] 2011 Mar-Apr; Vol. 78 (2), pp. 161-75. - Publication Year :
- 2011
-
Abstract
- The treatment era for multiple sclerosis began in 1993 with the approval of the first disease-modifying therapy. This changed the management of multiple sclerosis from treating acute exacerbations to focusing on preventive therapeutic options that lessen the risk for exacerbations, changes on magnetic resonance imaging, and disability as measured by the Expanded Disability Status Scale. Currently, there are 8 therapies approved to treat multiple sclerosis: beta-interferons (Avonex, Betaseron, Extavia, and Rebif), fingolimod (Gilenya), glatiramer acetate (Copaxone), mitoxantrone (Novantrone), and natalizumab (Tysabri). These agents will be reviewed including the pivotal trial data, mechanisms of action, and side effects. The timing of beginning therapy and selection of these agents must be individualized for each patient depending upon patient preference, tolerability, clinical and magnetic resonance imaging disease activity, and disease course. All of the current treatments are approved for relapsing disease. To date only the injectable agents, including interferons and glatiramer acetate, have been shown to be of benefit when started after an initial demyelinating event referred to as clinically isolated syndrome. Mitoxantrone was approved for progressive relapsing and secondary progressive multiple sclerosis, although its use is limited by potential risks such as cardiotoxicity and leukemia. Although these agents have made a significant impact on the treatment of multiple sclerosis, they are often only partially effective, so patients may continue to have disease activity. Multiple new agents are currently being tested in clinical trials and it is likely our treatment paradigms will change as more effective therapies become available.<br /> (© 2011 Mount Sinai School of Medicine.)
- Subjects :
- Antibodies, Monoclonal administration & dosage
Antibodies, Monoclonal adverse effects
Antibodies, Monoclonal, Humanized
Antineoplastic Agents administration & dosage
Antineoplastic Agents adverse effects
Clinical Trials as Topic
Disease Progression
Fingolimod Hydrochloride
Glatiramer Acetate
Humans
Immunosuppressive Agents administration & dosage
Immunosuppressive Agents adverse effects
Interferon-beta administration & dosage
Interferon-beta adverse effects
Magnetic Resonance Imaging
Mitoxantrone administration & dosage
Mitoxantrone adverse effects
Natalizumab
Peptides administration & dosage
Peptides adverse effects
Propylene Glycols administration & dosage
Propylene Glycols adverse effects
Secondary Prevention
Sphingosine administration & dosage
Sphingosine adverse effects
Sphingosine analogs & derivatives
Multiple Sclerosis physiopathology
Multiple Sclerosis therapy
Patient Selection
Subjects
Details
- Language :
- English
- ISSN :
- 1931-7581
- Volume :
- 78
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The Mount Sinai journal of medicine, New York
- Publication Type :
- Academic Journal
- Accession number :
- 21425262
- Full Text :
- https://doi.org/10.1002/msj.20239