Definitions of breakthrough disease and second-line agents

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James J Marriott1, Paul W O'Connor

  • 1Section of Neurology, University of Manitoba, GF-543 Health Sciences Centre, 820 Sherbrook Street, Winnipeg, MB, Canada, R3A 1R9.

Neurologic Clinics
|March 29, 2011
PubMed

Insights

Conventional treatments for breakthrough disease activity show moderate effectiveness. This review examines second-line agents like natalizumab and discusses future options and management strategies for improved patient outcomes.

Area of Science:

  • Neurology
  • Immunology
  • Pharmacology

Background:

  • Conventional disease-modifying therapies offer limited efficacy, leading to frequent breakthrough disease activity.
  • Breakthrough disease activity necessitates a review of current and future treatment strategies.

Purpose of the Study:

  • To review evidence for second-line agents in managing breakthrough disease.
  • To discuss potential future therapeutic options and outline management algorithms.

Main Methods:

  • Review of randomized clinical trials.
  • Analysis of real-world observational data.
  • Synthesis of evidence for natalizumab, mitoxantrone, and cyclophosphamide.

Main Results:

  • Evidence supports the use of natalizumab, mitoxantrone, and cyclophosphamide as second-line treatments.
  • Current agents have moderate effectiveness, highlighting the need for advanced therapies.

Conclusions:

  • Second-line agents provide options for managing breakthrough disease activity.
  • Future treatments and structured management algorithms are crucial for optimizing patient care.

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