[Diagnosis and treatment of multiple sclerosis. Update, 2003].
Multiple sclerosis (MS) is the most common demyelinating disease of the central nervous system. The etiology of MS is not yet fully understood. Besides of genetic predisposition and environmental factors autoimmune mechanisms seem to play a major role in the pathogenesis of MS. Therapy of MS therefore comprises mainly immunomodulatory and immuno-suppressive therapeutic concepts. Interferon beta (Avonex, Rebif, Betaferon/Betaseron) and Glatirameracetate (Copaxone) offer effective therapeutic options for the long-term treatment of relapsing-remitting MS. With Mitoxantron (Ralenova) being recently approved by the EMEA for the treatment of secondary-progressive and progressive-relapsing MS an effective therapeutic option is now available also for this group of patients. The standard treatment for acute MS continues to be the intravenous administration of high-dose methylprednisolone. Several promising new agents (Antegren, Statins) are currently under clinical examination and could expand the spectrum of available therapeutic strategies soon. Recent and ongoing trials as well as upcoming studies on MS therapy are summarized in this review.
Jarius
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S
Institut für Klinische Neuroimmunologie und Neurologische Klinik, Klinikum Grosshadern der LMU München.
Hohlfeld
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Voltz
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D000208:Acute Disease; D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000627:therapeutic use; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D001379:Azathioprine / Q000008:administration & dosage / Q000627:therapeutic use; D018849:Controlled Clinical Trials as Topic; D018592:Cross-Over Studies; D000068717:Glatiramer Acetate; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016899:Interferon-beta / Q000008:administration & dosage / Q000627:therapeutic use; D008137:Longitudinal Studies; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D008942:Mitoxantrone / Q000008:administration & dosage / Q000627:therapeutic use; D015337:Multicenter Studies as Topic; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D000069442:Natalizumab; D010455:Peptides / Q000008:administration & dosage / Q000627:therapeutic use; D010865:Pilot Projects; D011446:Prospective Studies; D012008:Recurrence; D013997:Time Factors
D000276:Adjuvants, Immunologic; D000700:Analgesics; D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D000069442:Natalizumab; D010455:Peptides; D000068717:Glatiramer Acetate; D016899:Interferon-beta; D008942:Mitoxantrone; D001379:Azathioprine; D008775:Methylprednisolone