title: Effectiveness of multiple sclerosis treatment with current immunomodulatory drugs.
abstract: BACKGROUND
  Multiple sclerosis (MS) is a chronic inflammatory disease of the CNS of a putative autoimmune origin characterized by neurologic dysfunction disseminated in space and time due to demyelination and axonal loss that results in progressive disability. Recent advances in understanding the immune pathogenesis of the disease resulted in the introduction of numerous effective immunomodulatoty drugs having diverse mechanisms of action, modes of administration and risk-benefit profiles. This results in more complex albeit more promising treatment selection and choices.
  
  
  METHODS
  The epidemiology, clinical features, pathogenesis and diagnosis of the disease are discussed. The mode of action and main characteristics of current immunomodulatory drugs for MS and their place in the therapeutic algorithm of the disease based on evidence from clinical trials are described. Speculation on new paradigms, treatment goals and outcome measures aimed at improving the landscape of MS treatment is presented.
  
  
  CONCLUSIONS
  Multiple disease, drug and patient-related factors should be taken into consideration when selecting the appropriate drug and treatment strategy to the appropriate patient, thus paving the road for personalized medicine in MS.
authors.affiliation: Ben-Gurion University of the Negev, Barzilai Medical Center, Department of Neurology, Faculty of Health Sciences , Ashkelon , Israel +972 8 674 5117 ; +972 8 674 5463 ; rmilo@barzi.health.gov.il.
authors.forename: Ron
authors.initials: R
authors.lastname: Milo
mesh_terms: D002908:Chronic Disease; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology
chemical_list: D007155:Immunologic Factors
keywords: MRI; disability; disease activity; disease-modifying therapy; multiple sclerosis; no evidence of disease activity; prognostic factors; risk–benefit; therapy