[Combined therapy in multiple sclerosis].
BACKGROUND
The availability of new drugs has been a significant advance in the therapy of multiple sclerosis over the last years. However, the control of the disease is far from being complete, and some patients respond poorly or not at all to the new drugs.


METHODS
The present paper reviews the approved therapies for multiple sclerosis and examines the advantages of the association of drugs, both with known and possible efficacy, as well as the theoretical basis for such associations and their possible clinical indications. Different designs for clinical trials in combination therapy are analyzed with a consideration of the current difficulties for the use of placebo in multiple sclerosis forms associated with relapses.


CONCLUSIONS
The achievement of a higher efficacy than the present one is a major challenge in multiple sclerosis therapy. Combination therapy appears to be a reasonable option for that purpose.
García-Merino
J A
JA
Servicio de Neurología/Laboratorio de Neuroinmunología, Clínica Puerta de Hierro, Madrid, España. gmerino@meditex.es
Blasco-Quítez
M R
MR
Ortiz-Benítez
P
P
Puerta
C
C
D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016899:Interferon-beta / Q000627:therapeutic use*; D009103:Multiple Sclerosis / Q000188:drug therapy*; D010956:Plasmapheresis; D013256:Steroids / Q000627:therapeutic use
D007136:Immunoglobulins; D007166:Immunosuppressive Agents; D013256:Steroids; D016899:Interferon-beta