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Immunosuppressive treatments in multiple sclerosis.

Darin T Okuda1

  • 1Clinical Center for Multiple Sclerosis, Department of Neurology and Neurotherapeutics, UT Southwestern Medical Center, Dallas, TX, USA.

Handbook of Clinical Neurology
|February 11, 2014
PubMed
Summary

Immunosuppressive therapies remain crucial for managing aggressive or treatment-intolerant multiple sclerosis (MS) cases. This review covers key agents like cyclophosphamide and mitoxantrone, detailing their efficacy and safety in MS treatment.

Keywords:
aggressive diseaseazathioprinecomplications of therapycyclophosphamidemethotrexatemitoxantronemycophenolate mofetilprogressive disease

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Area of Science:

  • Neurology
  • Immunology
  • Pharmacology

Background:

  • Multiple sclerosis (MS) is a complex autoimmune CNS disorder.
  • Historically, immunosuppressants were primary MS treatments before modern therapies.
  • These agents are still vital for specific patient groups and aggressive disease courses.

Purpose of the Study:

  • To review the role of key immunosuppressive agents in multiple sclerosis management.
  • To discuss the efficacy, safety, and mechanisms of action of these treatments.
  • To explore implications for therapeutic intervention in MS.

Main Methods:

  • Review of seminal data and contemporary studies on immunosuppressive treatments for MS.
  • Focus on cyclophosphamide, methotrexate, azathioprine, mycophenolate mofetil, and mitoxantrone.
  • Analysis of mechanisms of action, efficacy, and safety profiles.

Main Results:

  • Immunosuppressive agents are used as monotherapy or combination treatment for suboptimal responders or aggressive MS.
  • Specific agents like mitoxantrone are FDA-approved for MS treatment.
  • Efficacy and safety data for these agents in MS are critically reviewed.

Conclusions:

  • Immunosuppressive therapies remain an important therapeutic option in managing multiple sclerosis.
  • Understanding the mechanisms, efficacy, and safety of these agents is crucial for optimal patient care.
  • These treatments offer valuable options for patients with aggressive or refractory MS.