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Immunosuppression: promises and failures
1Division of Neurology, Department of Medicine, Multiple Sclerosis Clinic and Brain Research Centre, The University of British Columbia, Vancouver, BC, Canada. joel.oger@ubc.ca
The author participated very early in the use of immunosuppressors in the treatment of multiple sclerosis. He reviews evidence which support their use. IV Methylprednisolone, azathioprine and mitoxantrone are supported in their use by evidence of a level appropriate to the date of their generation while Cyclosporine A and Cyclophosphamide are not. The author also reviews the benefits and side effects of each of these medications, insisting on a practical approach to their use. The author concludes that since immunomodulators have been approved, the use of the immunosuppressors has been reduced, however there is a strong possibility that their use will be rekindled in association with immunomodulatory medications.
The author participated very early in the use of immunosuppressors in the treatment of multiple sclerosis. He reviews evidence which support their use. IV Methylprednisolone, azathioprine and mitoxantrone are supported in their use by evidence of a level appropriate to the date of their generation while Cyclosporine A and Cyclophosphamide are not. The author also reviews the benefits and side effects of each of these medications, insisting on a practical approach to their use. The author concludes that since immunomodulators have been approved, the use of the immunosuppressors has been reduced, however there is a strong possibility that their use will be rekindled in association with immunomodulatory medications.
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