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[Treatment of remitting forms of multiple sclerosis]
1Fédération de Neurologie, INSERM U-495, Hôpital de la Salpêtrière, 75013 Paris. catherine.lubetzki@psl.ap-hop-paris.fr
Abstract:
Disease-modifying treatments in multiple sclerosis emerged during the last few years, concerning mainly relapsing-remitting forms of the disease. They are essentially represented by beta-interferons. beta-interferons reduce relapse rate, achieving about 30 p. cent, and have an effect on brain lesions detected on MRI. They are indicated for use in ambulatory patients with relapsing-remitting multiple sclerosis characterized by at least 2 attacks of neurological dysfunction over the preceding 2 (or 3)-year period. Questions and controversies still remain concerning dose-response effect, early initiation and duration of treatment. Copolymer, which has a different mechanism of action, also decreases frequency of relapses, and the magnitude of the clinical effect is similar to beta-interferon. Copolymer is indicated for use in patients with relapsing-remitting multiple sclerosis, having either an intolerance or a contra-indication to beta-interferon.
Insights
New disease-modifying treatments for multiple sclerosis, primarily beta-interferons, reduce relapse rates by 30% and impact MRI-detected brain lesions. Copolymer offers similar relapse reduction for patients intolerant to beta-interferons.
Area of Science:
- Neurology
- Immunology
Background:
- Disease-modifying treatments for multiple sclerosis (MS) have recently emerged, primarily targeting relapsing-remitting MS.
- Beta-interferons are a key treatment, reducing relapse rates and affecting MRI-detected brain lesions.
Purpose of the Study:
- To review the efficacy and indications of beta-interferons in relapsing-remitting multiple sclerosis.
- To introduce copolymer as an alternative treatment for patients with intolerance or contraindications to beta-interferons.
Main Methods:
- Review of existing clinical data on beta-interferons and copolymer for multiple sclerosis.
- Analysis of treatment effects on relapse rates and magnetic resonance imaging (MRI) findings.
Main Results:
- Beta-interferons reduce relapse rates by approximately 30% and demonstrate an effect on brain lesions visible on MRI.
- Copolymer exhibits a similar magnitude of clinical effect in decreasing relapse frequency compared to beta-interferon.
Conclusions:
- Beta-interferons are indicated for ambulatory patients with relapsing-remitting MS experiencing at least two neurological attacks in 2-3 years.
- Copolymer serves as an alternative for patients with relapsing-remitting MS who cannot tolerate or are contraindicated for beta-interferon therapy.
- Ongoing research is needed to address questions regarding dose-response, early initiation, and treatment duration for these therapies.