Treatment and treatment trials in multiple sclerosis.
OBJECTIVE
This review focuses on advances in current and novel treatment approaches in multiple sclerosis.


RESULTS
New therapeutic approaches in multiple sclerosis are emerging. Orally available treatment strategies are more acceptable for patients and may improve adherence to therapy. An oral formulation of glatiramer acetate failed to demonstrate efficacy in a clinical trial, but other promising compounds are on the horizon, such as FTY720. Advances are currently being made in use of therapeutic monoclonal antibodies that specifically target key molecules involved in the immunopathogenesis of multiple sclerosis. Natalizumab directed against the adhesion molecule very late antigen-4 represents the first specific antibody to be added to our therapeutic armamentarium for multiple sclerosis. Further evidence that immunomodulation should be initiated as early as possible has been reported.


CONCLUSIONS
Treatment of multiple sclerosis has changed dramatically over the past decade. Enhanced understanding of the immunopathological processes that underlie the disease, advances in biotechnology and development of powerful magnetic resonance imaging technologies, together with improvements in clinical trial design have led to a variety of valuable therapeutic approaches, which are currently being studied in detail.
Kieseier
Bernd C
BC
Department of Neurology, Heinrich-Heine-University, Duesseldorf, Germany.
Wiendl
Heinz
H
Hemmer
Bernhard
B
Hartung
Hans-Peter
HP
D000818:Animals; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D002986:Clinical Trials as Topic / Q000592:standards / Q000639:trends*; D000068717:Glatiramer Acetate; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007167:Immunotherapy / Q000379:methods / Q000639:trends*; D016899:Interferon-beta / Q000627:therapeutic use; D009103:Multiple Sclerosis / Q000628:therapy*; D010455:Peptides / Q000627:therapeutic use; D010956:Plasmapheresis / Q000706:statistics & numerical data / Q000639:trends
D000911:Antibodies, Monoclonal; D007155:Immunologic Factors; D010455:Peptides; D000068717:Glatiramer Acetate; D016899:Interferon-beta