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Determining Immune System Suppression versus CNS Protection for Pharmacological Interventions in Autoimmune Demyelination
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Disease-modifying agents in multiple sclerosis.

Paul W O'Connor1, Jiwon Oh2

  • 1Multiple Sclerosis Clinic, St. Michael's Hospital, Toronto, Canada.

Handbook of Clinical Neurology
|February 11, 2014
PubMed
Summary
This summary is machine-generated.

Major advances in multiple sclerosis (MS) treatments have led to new disease-modifying agents (DMAs). This review examines the efficacy and safety of established and novel DMAs for MS management.

Keywords:
alemtuzumabcladribineclinical trialscyclophosphamidedaclizumabdimethyl fumaratefingolimodglatiramer acetateinterferon-betaintravenous immunoglobulinlaquinimodmitoxantronenatalizumabocrelizumabteriflunomidetherapy

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Area of Science:

  • Neurology
  • Immunology
  • Pharmacology

Background:

  • Significant progress in developing disease-modifying agents (DMAs) for multiple sclerosis (MS) over the last 20 years.
  • Nine DMAs are currently approved for MS treatment in the United States.
  • Ongoing research shows promising results for investigational agents in clinical trials.

Purpose of the Study:

  • To review the efficacy and safety of established disease-modifying agents for multiple sclerosis.
  • To evaluate the efficacy and safety of investigational agents for multiple sclerosis.
  • To inform clinical decisions regarding the use of novel versus established DMAs in MS treatment.

Main Methods:

  • Review of clinical trial data for established and investigational disease-modifying agents in multiple sclerosis.
  • Analysis of efficacy based on clinical and radiographic measures of disease activity.
  • Assessment of safety and tolerability profiles of various DMAs.

Main Results:

  • Established DMAs offer proven long-term safety and tolerability.
  • Investigational agents demonstrate beneficial effects on clinical and radiographic disease activity.
  • Limited long-term data exists for novel DMAs, necessitating cautious use.

Conclusions:

  • The range of available DMAs for MS is expected to grow.
  • While established DMAs are safe, potent novel agents may be suitable for some patients.
  • Careful consideration of long-term efficacy and safety is crucial when initiating novel DMAs in MS patients.