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New management algorithms in multiple sclerosis.
- Source :
-
Current opinion in neurology [Curr Opin Neurol] 2014 Jun; Vol. 27 (3), pp. 246-59. - Publication Year :
- 2014
-
Abstract
- Purpose of Review: Our current treatment algorithms include only IFN-β and glatiramer as available first-line disease-modifying drugs and natalizumab and fingolimod as second-line therapies. Today, 10 drugs have been approved in Europe and nine in the United States making the choice of therapy more complex. The purpose of the review has been to work out new management algorithms for treatment of relapsing-remitting multiple sclerosis including new oral therapies and therapeutic monoclonal antibodies.<br />Recent Findings: Recent large placebo-controlled trials in relapsing-remitting multiple sclerosis have shown efficacy of new oral disease-modifying drugs, teriflunomide and dimethyl fumarate, with similar or better efficacy than the injectable disease-modifying drugs, IFN-β and glatiramer acetate. In addition, the new oral drugs seem to have a favorable safety profile. Further, the monoclonal antibody alemtuzumab, which in clinical trials has shown superiority to subcutaneous IFN-β 1a, has been approved in Europe, but not yet in the United States.<br />Summary: In de novo-treated patients, the injectables, IFN-β and glatiramer acetate, will to a great extent be replaced by the new orals, dimethyl fumarate and teriflunomide. However, patients who are stable on an injectable with no or minor side-effects could continue their current therapy. Alemtuzumab should be used as a second-line therapy.
- Subjects :
- Alemtuzumab
Antibodies, Monoclonal, Humanized therapeutic use
Clinical Protocols
Crotonates therapeutic use
Dimethyl Fumarate
Fingolimod Hydrochloride
Fumarates therapeutic use
Glatiramer Acetate
Humans
Hydroxybutyrates
Interferon-beta therapeutic use
Natalizumab
Nitriles
Peptides therapeutic use
Propylene Glycols therapeutic use
Sphingosine analogs & derivatives
Sphingosine therapeutic use
Toluidines therapeutic use
Algorithms
Immunologic Factors therapeutic use
Immunosuppressive Agents therapeutic use
Multiple Sclerosis, Relapsing-Remitting drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1473-6551
- Volume :
- 27
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Current opinion in neurology
- Publication Type :
- Academic Journal
- Accession number :
- 24759080
- Full Text :
- https://doi.org/10.1097/WCO.0000000000000096