The effectiveness and practicality of immunosuppressive drugs.
Immunosuppression in MS is fundamentally linked to inflammation. Given that the irreversible deficits in MS are the consequence of axonal loss (the impact of other factors, such as neuronal loss, is less well understood), the critical therapeutic issue in MS is the relationship between inflammation and axonal injury. Two hypotheses for this relationship have been suggested: that inflammation and axonal injury are independent pathologies; or that they are dependent. In this latter case, an argument can be made for using an immunosuppressant. The optimal ways of administering immunosuppressive therapy may be early in the disease course, or as part of induction or combination therapy. One immunosuppressant (mitoxantrone) is licensed for the treatment of MS and some treatment efficacy and long-term surveillance data are available. More studies on the efficacy and use of immunosuppressants in MS are needed, however.
Clinique Neurologique, C.H.U. Pontchaillou, Rue Henri Le Guilloux, 35033 Rennes Cedex 9, France. gilles.edan@chu-rennes.fr
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D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008942:Mitoxantrone / Q000627:therapeutic use*; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000503:physiopathology*; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D008942:Mitoxantrone