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Managing MS in a changing treatment landscape

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Abstract

Increasing options are dictating the development of new algorithms to provide guidance in the treatment of people with multiple sclerosis (MS). There is a wealth of evidence on the safety and efficacy of interferon-beta and glatiramer acetate, which have been used in Europe and in the United States for more than 10 years. The spectrum of approved indications for these conventional disease modifying therapies includes the treatment of relapsing-remitting MS, secondary progressive MS, and the clinically isolated syndrome. Beyond these therapies we already have the recently introduced antibody natalizumab and, in some countries, the immunosuppressive agent mitoxantrone. Oral therapies are expected in the near future, with the sphingosin-1-phosphate receptor modulator fingolimod approved in the US and the EU and the purine nucleoside analogue cladribine in Australia and Russia. The evidence on all of these conventional and novel therapeutics is reviewed in this paper to provide an overview of the changing landscape of MS treatment.

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Notes

  1. Evidence for Interferon Dose–Response: European-North American Comparative Efficacy.

  2. Independent comparison of interferon.

  3. International MS secondary Progressive Avonex Controlled Trial.

  4. Betaferon efficacy yielding outcomes of a new dose.

  5. Betaseron versus Copaxone in MS with triple-dose gadolinium and 3T MRI endpoints.

  6. Rebif versus Glatiramer acetate in relapsing MS disease.

  7. Controlled High-Risk Subjects Avonex Multiple Sclerosis Prevention Study.

  8. Early treatment of Multiple Sclerosis.

  9. Betaferon in newly emerging Multiple Sclerosis for initial treatment.

  10. Early glatiramer acetate treatment in delaying conversion to clinically definite Multiple Sclerosis in subjects presenting with a clinically isolated syndrome.

  11. Mitoxantrone in Multiple Sclerosis.

  12. Fertility and Mitoxantrone in MS.

  13. Natalizumab safety and efficacy in relapsing remitting Multiple Sclerosis.

  14. Safety and efficacy of natalizumab in combination with Avonex.

  15. FTY720 research evaluating effects of daily oral therapy in Multiple Sclerosis.

  16. Trial assessing injectable interferon versus FTY720 oral in RRMS.

  17. Cladribine tablets treating MS orally.

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Acknowledgments

This review includes data presented by the authors during an expert meeting sponsored by Bayer Schering Pharma AG (Berlin, Germany) in Berlin, Germany on June 26, 2010. Editorial and medical writing support was provided by Physicians World Europe GmbH, (Mannheim, Germany), funded by Bayer Schering Pharma AG (Berlin, Germany). Bayer Schering Pharma AG had no role in data collection, data interpretation or writing the manuscript.

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Authors and Affiliations

  1. Department of Neurology, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK

    Martin Duddy

  2. Department of Neurology, St. Josef-Hospital/Ruhr-University Bochum, Gudrunstrasse 56, 44791, Bochum, Germany

    Aiden Haghikia & Ralf Gold

  3. Multiple Sclerosis Centre, Department of Cardiovascular and Neurological Science, University of Cagliari, Cagliari, Italy

    Eleonora Cocco

  4. Department of Neurology, Krankenhaus der Barmherzigen Brüder, Linz, Austria

    Christian Eggers

  5. Clinic of Neurology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    Jelena Drulovic

  6. Neurology Department, Hospital de Figueres, Girona, Spain

    Olga Carmona

  7. Department of Neurology, Hôpital R. Salengro, Lille, France

    Helene Zéphir

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  1. Martin Duddy
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  2. Aiden Haghikia
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  8. Ralf Gold
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Correspondence to Ralf Gold.

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Duddy, M., Haghikia, A., Cocco, E. et al. Managing MS in a changing treatment landscape. J Neurol 258, 728–739 (2011). https://doi.org/10.1007/s00415-011-6009-x

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  • DOI: https://doi.org/10.1007/s00415-011-6009-x

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