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Related Concept Videos

Multiple Sclerosis l: Introduction01:19

Multiple Sclerosis l: Introduction

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Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...
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Related Experiment Video

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Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
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New management algorithms in multiple sclerosis.

Per Soelberg Sorensen1

  • 1Danish Multiple Sclerosis Center, Department of Neurology, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.

Current Opinion in Neurology
|April 25, 2014
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Summary
This summary is machine-generated.

New oral therapies like dimethyl fumarate and teriflunomide are now recommended for initial relapsing-remitting multiple sclerosis treatment, potentially replacing older injectables. Alemtuzumab is suggested for second-line therapy.

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Area of Science:

  • Neurology
  • Immunology
  • Pharmacology

Background:

  • Current multiple sclerosis (MS) treatment algorithms rely on first-line injectables (interferon-beta [IFN-β], glatiramer acetate) and second-line therapies (natalizumab, fingolimod).
  • The increasing number of approved MS drugs in Europe and the US complicates therapeutic choices.

Purpose of the Study:

  • To develop updated management algorithms for relapsing-remitting multiple sclerosis (RRMS).
  • To incorporate newly approved oral therapies and monoclonal antibodies into treatment strategies for RRMS.

Main Methods:

  • Review of recent large placebo-controlled trials in RRMS.
  • Analysis of efficacy and safety data for new oral disease-modifying drugs (teriflunomide, dimethyl fumarate) and monoclonal antibodies (alemtuzumab).

Main Results:

  • New oral disease-modifying drugs (teriflunomide, dimethyl fumarate) demonstrate comparable or superior efficacy to injectable therapies (IFN-β, glatiramer acetate) in RRMS.
  • These oral agents appear to have a favorable safety profile.
  • Alemtuzumab shows superior efficacy to subcutaneous IFN-β 1a and is approved in Europe as a second-line therapy.

Conclusions:

  • Dimethyl fumarate and teriflunomide are poised to replace IFN-β and glatiramer acetate as first-line treatments for de novo RRMS patients.
  • Patients stable on current injectable therapies with minimal side effects may continue their treatment.
  • Alemtuzumab is recommended for second-line treatment in RRMS.