title: Therapeutic approaches to disease modifying therapy for multiple sclerosis in adults: an Australian and New Zealand perspective: part 1 historical and established therapies. MS Neurology Group of the Australian and New Zealand Association of Neurologists.
abstract: Multiple sclerosis (MS) is a potentially life-changing immune mediated disease of the central nervous system. Until recently, treatment has been largely confined to acute treatment of relapses, symptomatic therapies and rehabilitation. Through persistent efforts of dedicated physicians and scientists around the globe for 160 years, a number of therapies that have an impact on the long term outcome of the disease have emerged over the past 20 years. In this three part series we review the practicalities, benefits and potential hazards of each of the currently available and emerging treatment options for MS. We pay particular attention to ways of abrogating the risks of these therapies and provide advice on the most appropriate indications for using individual therapies. In Part 1 we review the history of the development of MS therapies and its connection with the underlying immunobiology of the disease. The established therapies for MS are reviewed in detail and their current availability and indications in Australia and New Zealand are summarised. We examine the evidence to support their use in the treatment of MS.
authors.affiliation: School of Medicine, Griffith University, Gold Coast Campus, QLD 4222, Australia; Department of Neurology, Gold Coast University Hospital, Southport, QLD, Australia. Electronic address: simon.broadley@griffith.edu.au.
authors.forename: Simon A
authors.initials: SA
authors.lastname: Broadley
authors.affiliation: Brain and Mind Research Institute, University of Sydney, Camperdown, NSW, Australia.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Barnett
authors.affiliation: Department of Neurology, The Townsville Hospital, Douglas, QLD, Australia.
authors.forename: Mike
authors.initials: M
authors.lastname: Boggild
authors.affiliation: Department of Neurology and St Vincent's Centre for Applied Medical Research, St Vincent's Hospital, University of New South Wales, Darlinghurst, NSW, Australia.
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Brew
authors.affiliation: Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia.
authors.forename: Helmut
authors.initials: H
authors.lastname: Butzkueven
authors.affiliation: Westmead Clinical School, University of Sydney, NSW, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Heard
authors.affiliation: South Western Sydney Clinical School, University of New South Wales, NSW, Australia.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Hodgkinson
authors.affiliation: Centre for Neuromuscular and Neurological Disorders, University of Western Australia, WA, Australia; Institute of Immunology and Infectious Diseases, Murdoch University, WA, Australia.
authors.forename: Allan G
authors.initials: AG
authors.lastname: Kermode
authors.affiliation: Hunter Medical Research Institute, The University of Newcastle, New Lambton, NSW, Australia.
authors.forename: Jeannette
authors.initials: J
authors.lastname: Lechner-Scott
authors.affiliation: Department of Neurology, Austin Health, Heidelberg, VIC, Australia.
authors.forename: Richard A L
authors.initials: RA
authors.lastname: Macdonell
authors.affiliation: Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Marriott
authors.affiliation: Department of Neurology, Christchurch Hospital, Christchurch, New Zealand.
authors.forename: Deborah F
authors.initials: DF
authors.lastname: Mason
authors.affiliation: Central Clinical School, University of Sydney, NSW, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Parratt
authors.affiliation: Brain and Mind Research Institute, University of Sydney, Camperdown, NSW, Australia.
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Reddel
authors.affiliation: School of Medicine, Deakin University, VIC, Australia.
authors.forename: Cameron P
authors.initials: CP
authors.lastname: Shaw
authors.affiliation: Centre for Neuroscience and Flinders Medical Centre, Flinders University, SA, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Slee
authors.affiliation: Brain and Mind Research Institute, University of Sydney, Camperdown, NSW, Australia.
authors.forename: Judith
authors.initials: J
authors.lastname: Spies
authors.affiliation: Menzies Research Institute, University of Tasmania, TAS, Australia.
authors.forename: Bruce V
authors.initials: BV
authors.lastname: Taylor
authors.affiliation: Centre for Neuromuscular and Neurological Disorders, University of Western Australia, WA, Australia.
authors.forename: William M
authors.initials: WM
authors.lastname: Carroll
authors.affiliation: Menzies Research Institute, University of Tasmania, TAS, Australia.
authors.forename: Trevor J
authors.initials: TJ
authors.lastname: Kilpatrick
authors.affiliation: Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia.
authors.forename: John
authors.initials: J
authors.lastname: King
authors.affiliation: University of Queensland Centre for Clinical Research, QLD, Australia.
authors.forename: Pamela A
authors.initials: PA
authors.lastname: McCombe
authors.affiliation: Brain and Mind Research Institute, University of Sydney, Camperdown, NSW, Australia.
authors.forename: John D
authors.initials: JD
authors.lastname: Pollard
authors.affiliation: Department of Neurology, Auckland City Hospital, Auckland, New Zealand.
authors.forename: Ernest
authors.initials: E
authors.lastname: Willoughby
mesh_terms: D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D001315:Australia / Q000453:epidemiology; D002986:Clinical Trials as Topic; D019468:Disease Management; D018450:Disease Progression; D019317:Evidence-Based Medicine; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016899:Interferon-beta / Q000627:therapeutic use; D008942:Mitoxantrone / Q000627:therapeutic use; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000453:epidemiology / Q000628:therapy; D000069442:Natalizumab; D009520:New Zealand / Q000453:epidemiology; D035703:Therapies, Investigational / Q000639:trends; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D007166:Immunosuppressive Agents; D000069442:Natalizumab; D016899:Interferon-beta; D008942:Mitoxantrone
keywords: Evidence-based medicine; Guideline; Multiple sclerosis; Review; Treatment