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Immunosuppression in clinical practice: approaches to individualized therapy

Andrew Chan1, Olaf Stüve, Nicolas von Ahsen

  • 1Department of Neurology, Ruhr University Bochum, St. Josef Hospital, Gudrunstr. 56, 44791 Bochum, Germany. Andrew.Chan@rub.de

Journal of Neurology
|March 21, 2009
PubMed

Despite novel immunoactive agents, immunosuppressants still play a considerable role in the treatment of MS, especially in rapidly progressive cases. Given the limited tolerability and potentially severe side effects of most immunosuppressive drugs, identification of patients with a favorable benefit-risk profile is essential. A narrow therapeutic index, with sometimes high interindividual variability in terms of response and side effects may partially be explained by genetic factors affecting different metabolic pathways. Here, we will review practical aspects in the clinical use of immunosuppressants in MS and discuss approaches to individualized treatment schemes, including novel pharmacogenetic strategies.

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