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Related Experiment Videos

Immunotherapy in multiple sclerosis, Part 2

C C Becker1, B E Gidal, J O Fleming

  • 1Department of Pharmacy, St. Francis Hospital, Milwaukee, WI 53215, USA.

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
|October 1, 1995
PubMed
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This review examines immunotherapies for multiple sclerosis (MS), an inflammatory CNS disease. While some treatments like corticosteroids and interferon beta-1b can manage relapses, none reverse disease progression, and some have serious side effects.

Area of Science:

  • Neurology
  • Immunology
  • Pharmacology

Background:

  • Multiple sclerosis (MS) is an inflammatory, demyelinating disease of the central nervous system (CNS) affecting young adults.
  • Various immune mechanisms are implicated in MS, suggesting the utility of immunomodulating therapies.
  • Treatment goals in MS vary by disease stage, including symptom management, relapse reduction, and slowing progression.

Purpose of the Study:

  • To review the efficacy of various immunotherapies for multiple sclerosis (MS).
  • To assess the benefits and risks of corticosteroids, azathioprine, cyclophosphamide, immune globulin, cyclosporine, interferons, copolymer 1, and cladribine in MS patients.
  • To inform treatment decisions based on clinical stage and disease activity.

Main Methods:

  • Systematic review of existing clinical trial data on immunotherapies for MS.

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  • Analysis of drug efficacies in relation to disease exacerbations, relapse rates, and progression.
  • Evaluation of adverse effects and cost-effectiveness of different treatment options.

    • Main Results:

    • Corticosteroids and corticotropin accelerate recovery from exacerbations; long-term use is not recommended.
    • Azathioprine offers modest benefits for relapse rates but is not advised for aggressive MS.
    • Interferon beta-1b reduces relapse frequency and severity in relapsing-remitting MS; copolymer 1 and cladribine show early promise. Cyclophosphamide and cyclosporine have significant drawbacks.
    • Intravenous immune globulin's efficacy for severe relapses remains unproven.

    Conclusions:

    • Current immunotherapies for MS can provide symptomatic relief and manage relapses but do not reverse disease progression.
    • Some treatments carry significant risks and adverse effects, necessitating careful patient selection.
    • Further understanding of MS immunopathogenesis is crucial for developing more targeted and effective therapies with lasting benefits.