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Management of multiple sclerosis: current trials and future options.
1Department of Neurology, Mayo Medical School, Clinic and Foundation, Rochester, Minnesota 55905, USA. Noseworthy.john@mayo.edu
Current Opinion in Neurology
|July 15, 2003
Summary
Advances in multiple sclerosis (MS) treatment show promise, with some trials demonstrating efficacy for beta interferons and mitoxantrone. However, key questions remain regarding long-term disease progression and optimal treatment strategies for MS.
Area of Science:
- Neurology
- Immunology
- Clinical Trials
Background:
- Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
- Therapeutic advancements are crucial for managing MS progression and improving patient outcomes.
Purpose of the Study:
- To review multiple sclerosis (MS) therapeutic trials published in 2002.
- To inform healthcare providers about the latest advances in MS patient care.
Main Methods:
- Review of pivotal and preliminary reports from 2002.
- Analysis of head-to-head comparison trials in relapsing/remitting MS.
- Evaluation of phase 3 trials for secondary progressive MS.
Main Results:
- Beta interferons (interferon-beta-1a) showed partial efficacy in secondary progressive MS (IMPACT trial).
- Mitoxantrone demonstrated apparent partial efficacy in active and progressive MS.
- Several large trials reported disappointing results, including oral glatiramer acetate and intravenous immunoglobulin (unpublished).
Conclusions:
- The relationship between early inflammatory phases and late clinical deterioration in MS requires further investigation.
- Optimal research designs are needed to determine if early treatments impact long-term disability in MS.