Emerging multiple sclerosis disease-modifying therapies.
OBJECTIVE
We focus on emerging therapies for the treatment of multiple sclerosis (MS) whose progress through late-phase clinical trials has furthered our understanding of MS pathophysiology.


RESULTS
A promising array of potential new therapies for MS is targeting a broadening range of pathophysiologic mechanisms. Essentially all emerging therapies in late-phase clinical trials continue to focus on peripheral immune mechanisms that predominate early in the illness. The success of some of these, with varying mechanisms of action, has contributed to an evolution in our conceptual framework of MS.


CONCLUSIONS
Several of the emerging therapies focusing on immune-mediated disease mechanisms seem to offer stronger efficacy than the currently approved immune modulators for MS, although with potential for serious adverse effects. These therapies have also broadened our understanding of MS pathophysiology by demonstrating that significant decreases in new disease activity can be achieved through targeting of distinct cell types and mechanisms.
Giacomini
Paul S
PS
Multiple Sclerosis Clinic, Montreal Neurological Institute and Hospital, McGill University Health Centre, Quebec, Canada.
Darlington
Peter J
PJ
Bar-Or
Amit
A
D000818:Animals; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D006801:Humans; D007108:Immune Tolerance; D007155:Immunologic Factors / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007249:Inflammation / Q000378:metabolism; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D009419:Nerve Tissue Proteins / Q000276:immunology; D011993:Recombinant Fusion Proteins / Q000235:genetics / Q000276:immunology
D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D009419:Nerve Tissue Proteins; D011993:Recombinant Fusion Proteins