title: Oral drugs in multiple sclerosis therapy: an overview and a critical appraisal.
abstract: Multiple sclerosis (MS) is characterized by demyelination and axonal loss that results in progressive disability. Recent advances in understanding the immune pathogenesis of MS resulted in the introduction of numerous effective drugs with diverse mechanisms of actions, routes of administration and benefit-risk profiles. New oral drugs recently approved for MS treatment has led to significant achievements in MS management. The oral route of administration promotes patient satisfaction and increases therapeutic compliance; but their introduction has raised concerns regarding safety and tolerability; and a thorough analysis of the benefit/risk ratio is required. This article reviews the mechanisms of action, safety and efficacy of the licensed and experimental oral drugs in MS. Moreover, we put into perspective the disease, drug and patient-related factors that should be taken into account when considering the appropriate oral drug and treatment strategy to the appropriate patient, thus paving the road for personalized medicine in MS.
authors.affiliation: Multiple Sclerosis Center, Policlinico G. Rodolico, Rodolico, Catania, 95100, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: D'Amico
authors.forename: Carmela
authors.initials: C
authors.lastname: Leone
authors.forename: Cinzia
authors.initials: C
authors.lastname: Caserta
authors.forename: Francesco
authors.initials: F
authors.lastname: Patti
mesh_terms: D000284:Administration, Oral; D002986:Clinical Trials as Topic; D016207:Cytokines / Q000378:metabolism; D015507:Drugs, Investigational / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D009103:Multiple Sclerosis / Q000188:drug therapy*; D015363:Quinolones / Q000627:therapeutic use
chemical_list: D016207:Cytokines; D015507:Drugs, Investigational; D007166:Immunosuppressive Agents; D015363:Quinolones; C476223:laquinimod
keywords: escalation therapy; induction therapy; multiple sclerosis; oral drugs; safety; therapy