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Oral disease-modifying therapies for multiple sclerosis.

Woojun Kim1, Manuella Edler Zandoná2, Su-Hyun Kim3

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New oral multiple sclerosis (MS) drugs offer improved patient compliance over injectables. This review analyzes the efficacy and safety of approved oral MS therapies and promising candidates.

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Area of Science:

  • Neurology
  • Immunology
  • Pharmacology

Background:

  • Traditional injectable therapies for multiple sclerosis (MS) face challenges with patient adherence and effectiveness.
  • Recent advancements include the approval of oral medications for MS, enhancing patient satisfaction and compliance.
  • However, oral MS treatments necessitate a careful evaluation of their safety and tolerability profiles.

Purpose of the Study:

  • To review the mechanisms of action, safety, and efficacy of currently approved oral multiple sclerosis (MS) drugs.
  • To evaluate two additional oral agents, cladribine and laquinimod, which have shown positive results in Phase III clinical trials.

Main Methods:

  • Literature review of approved and investigational oral therapies for multiple sclerosis (MS).
  • Analysis of published data on efficacy, safety, tolerability, and mechanisms of action.
  • Comparison of oral agents with traditional injectable MS treatments.

Main Results:

  • Fingolimod, teriflunomide, and dimethyl fumarate are approved oral MS treatments with distinct mechanisms.
  • Cladribine and laquinimod have demonstrated efficacy in Phase III trials, suggesting potential future therapeutic options.
  • Oral administration generally improves patient compliance and satisfaction compared to injectables.

Conclusions:

  • Oral therapies represent a significant advancement in multiple sclerosis (MS) management, improving patient adherence.
  • A comprehensive risk-benefit assessment is crucial for each oral MS drug due to potential safety and tolerability concerns.
  • Further research and post-marketing surveillance are essential to fully understand the long-term impact of these novel oral MS treatments.