Approved and future pharmacotherapy for multiple sclerosis.
BACKGROUND
Pharmacotherapy for relapsing-remitting multiple sclerosis (MS) advanced with the demonstration that interferon beta and glatiramer acetate improve the clinical course of this disease. Mitoxantrone is the first drug approved by the Food and Drug Administration for treatment of secondary progressive MS. Despite this progress, the agents presently available are only partially effective, are difficult to administer, and may have significant side effects. Several orally administered immunomodulatory agents are presently being evaluated for treatment of MS. One class of drugs, HMG CoA inhibitors (statins), is safe and well-tolerated and could become another mainstay of MS therapy.


RESULTS
This article reviews the clinical evidence for approved MS therapies and discusses their mechanisms of action. Furthermore, the clinical and laboratory data suggesting a potential role for statins in MS therapy are discussed.


CONCLUSIONS
Although treatment with interferon beta, glatiramer acetate, and mitoxantrone, the approved therapies, provide important treatment options for patients with relapsing-remitting MS and secondary progressive MS, the potential benefits of other medications, including statins, should be explored in controlled clinical trials.
Stüve
Olaf
O
Department of Neurology, University of California, San Francisco 94143-0114, USA. ostuve@itsa.ucsf.edu
Cree
Bruce C
BC
von Büdingen
Hans-Christian
HC
Yousef
Sawsan
S
Bowen
James D
JD
Genain
Claude P
CP
Hauser
Stephen L
SL
Steinman
Lawrence
L
Zamvil
Scott S
SS