title: Treatment and treatment trials in multiple sclerosis.
abstract: 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.
authors.affiliation: Department of Neurology, Heinrich-Heine-University, Duesseldorf, Germany.
authors.forename: Bernd C
authors.initials: BC
authors.lastname: Kieseier
authors.forename: Heinz
authors.initials: H
authors.lastname: Wiendl
authors.forename: Bernhard
authors.initials: B
authors.lastname: Hemmer
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Hartung
mesh_terms: 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
chemical_list: D000911:Antibodies, Monoclonal; D007155:Immunologic Factors; D010455:Peptides; D000068717:Glatiramer Acetate; D016899:Interferon-beta