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Related Experiment Video

Updated: Apr 19, 2026

Determining Immune System Suppression versus CNS Protection for Pharmacological Interventions in Autoimmune Demyelination
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[Disease modifying therapies in multiple sclerosis].

Hikoaki Fukaura

    Nihon Rinsho. Japanese Journal of Clinical Medicine
    |December 19, 2014
    PubMed
    Summary
    This summary is machine-generated.

    Disease-modifying therapies like natalizumab and immunosuppressants are available for multiple sclerosis (MS) in Japan. Glatiramer acetate may soon be available, offering options for relapsing MS and potentially progressive forms.

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    Area of Science:

    • Neurology
    • Immunology

    Context:

    • Multiple Sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system.
    • Immunosuppressive therapies have been utilized for over three decades, targeting the T-cell mediated autoimmune hypothesis of MS.
    • Current treatment landscape in Japan includes natalizumab and various immunosuppressive agents.

    Purpose:

    • To review the clinical utility of disease-modifying agents for multiple sclerosis (MS) in Japan.
    • To discuss the role of immunosuppressive therapies and glatiramer acetate in MS management.
    • To provide guidance on the appropriate use of natalizumab, considering its efficacy and risks.

    Summary:

    • Immunosuppressive drugs (azathioprine, cyclophosphamide, methotrexate, mitoxantrone) and glatiramer acetate are most effective in inflammatory stages of MS, characterized by relapses or MRI gadolinium-enhancing lesions.
    • These agents lack efficacy in primary progressive MS and later stages of secondary progressive MS.
    • Natalizumab is recommended for selected relapsing-remitting MS (RRMS) patients who have failed other treatments or have aggressive disease, due to the risk of progressive multifocal leukoencephalopathy (PML).

    Impact:

    • Informs clinical decision-making for MS treatment in Japan.
    • Highlights the importance of disease stage and inflammatory activity in selecting appropriate therapies.
    • Emphasizes a cautious approach to natalizumab use, reserving it for specific patient populations.