title: Definitions of breakthrough disease and second-line agents.
abstract: Conventional disease-modifying agents are only moderately effective, so breakthrough disease activity is commonly seen. The evidence from randomized clinical trials and real-world observational data supporting the use of the second-line agents natalizumab, mitoxantrone, and cyclophosphamide are reviewed. Potential future treatment options are also discussed. Management algorithms for breakthrough disease are outlined.
authors: Section of Neurology, University of Manitoba, GF-543 Health Sciences Centre, 820 Sherbrook Street, Winnipeg, MB, Canada, R3A 1R9.
authors: James J
authors: JJ
authors: Marriott
authors: Paul W
authors: PW
authors: O'Connor
mesh_terms: D017277:Drug Approval / Q000706:statistics & numerical data; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy*; D016896:Treatment Outcome; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D007155:Immunologic Factors