[New treatments and strategy in multiple sclerosis]

New treatments and strategy in multiple sclerosis. Currently, ten drugs are approved for the relapsing-remitting form of multiple sclerosis (MS). Since 2007, 4 new disease-modifying therapies (DMT) have been approved and several DMT will soon be commercialized including new galenic forms of self-injectable DMTs (pegylated interferon beta 1a and glatiramer acetate). Although these self-injectable DMT have moderate efficacy they have proved to be safe on long term and able to delay disability progression and the entry in the secondary progressive phase of the disease. Some of the new DMT have similar efficacy to the first DMT, other are more efficient but carry the risk of serious adverse events. We report the efficacy and safety of these new drugs in reference to their pivotal study. The current therapeutic strategy is sequential: a first DMT is initiated, then in case of intolerance or failure an other DMT with a different mode of action or second line DMT is proposed. Others strategies may be proposed according to the patient's evolution such as an induction by an aggressive immunotherapy followed by a maintenance with a first line DMT. Whatever the strategy used the most important goal is to reach a shared decison between the patient and his or her neurologist which guarantee the best adherence to DMTs.