title: Multiple sclerosis--new treatment modalities.
abstract: Ever since the introduction of the first disease modifying therapies, the concept of multiple sclerosis treatment algorithms developed ceaselessly. The increasing number of available drugs is paralleled by impelling issue of ensuring the most appropriate treatment to the right patient at the right time. The purpose of this review is to describe novel agents recently approved for multiple sclerosis treatment, namely teriflunomide, alemtuzumab and dimethylfumarate, focusing on mechanism of action, efficacy data in experimental setting, safety and tolerability. The place in therapy of newer treatment implies careful balancing of risk-benefit profile as well as accurate patient selection. Hence the widening of therapeutic arsenal provides greater opportunity for personalized therapy but also entails a complex trade-off between efficacy, tolerability, safety and eventually patient preference.
authors.affiliation: Multiple Sclerosis Center, Department of Neurology, San Salvatore Hospital, L'Aquila, Italy.
authors.forename: Rocco
authors.initials: R
authors.lastname: Totaro
authors.forename: Caterina
authors.initials: C
authors.lastname: Di Carmine
authors.forename: Carmine
authors.initials: C
authors.lastname: Marini
authors.forename: Antonio
authors.initials: A
authors.lastname: Carolei
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006801:Humans; D009103:Multiple Sclerosis / Q000188:drug therapy*
chemical_list: D000911:Antibodies, Monoclonal
references.citation: J Clin Invest. 2014 May;124(5):2188-92
references.pmid: 24691444
references.citation: Brain. 1996 Feb;119 ( Pt 1):225-37
references.pmid: 8624684
references.citation: N Engl J Med. 2006 Mar 2;354(9):911-23
references.pmid: 16510745
references.citation: Neurol Ther. 2015 Dec;4(2):93-104
references.pmid: 26662361
references.citation: BMC Neurol. 2015 Jul 08;15:108
references.pmid: 26152311
references.citation: Neurol Sci. 2005 Dec;26 Suppl 4:S179-82
references.pmid: 16388354
references.citation: Eur J Neurol. 2006 Jun;13(6):604-10
references.pmid: 16796584
references.citation: Lancet. 2012 Nov 24;380(9856):1829-39
references.pmid: 23122650
references.citation: Mult Scler. 2014 May;20(6):705-16
references.pmid: 24126064
references.citation: Mult Scler. 2015 Jan;21(1):57-66
references.pmid: 24990854
references.citation: Int J Mol Sci. 2015 Jun 29;16(7):14669-76
references.pmid: 26132570
references.citation: J Neurol. 2006 Jan;253(1):98-108
references.pmid: 16044212
references.citation: Clin Immunol. 2006 Sep;120(3):247-59
references.pmid: 16797237
references.citation: N Engl J Med. 2012 Sep 20;367(12):1098-107
references.pmid: 22992073
references.citation: Lancet. 2012 Nov 24;380(9856):1819-28
references.pmid: 23122652
references.citation: Mult Scler. 2015 Oct;21(11):1476-7
references.pmid: 26199352
references.citation: Neurol Ther. 2014 Nov 20;3(2):133-8
references.pmid: 26000229
references.citation: N Engl J Med. 2015 Apr 9;372(15):1476-8
references.pmid: 25853765
references.citation: N Engl J Med. 2013 Apr 25;368(17):1658-9
references.pmid: 23614604
references.citation: Mult Scler Int. 2015;2015:763418
references.pmid: 26266049
references.citation: N Engl J Med. 2008 Oct 23;359(17):1786-801
references.pmid: 18946064
references.citation: N Engl J Med. 2010 Feb 4;362(5):402-15
references.pmid: 20089954
references.citation: Lancet Neurol. 2014 Mar;13(3):247-56
references.pmid: 24461574
references.citation: Br J Pharmacol. 1999 Aug;127(7):1589-96
references.pmid: 10455314
references.citation: Biochem J. 1998 Dec 1;336 ( Pt 2):299-303
references.pmid: 9820804
references.citation: N Engl J Med. 2006 Mar 2;354(9):899-910
references.pmid: 16510744
references.citation: Neurology. 2011 Aug 9;77(6):573-9
references.pmid: 21795656
references.citation: Arthritis Rheum. 2005 Sep;52(9):2730-9
references.pmid: 16142756
references.citation: J Neurol Neurosurg Psychiatry. 2015 Feb;86(2):208-15
references.pmid: 24849515
references.citation: N Engl J Med. 2013 Apr 25;368(17):1657-8
references.pmid: 23614603
references.citation: J Neurol. 2009 Jan;256(1):89-103
references.pmid: 19169851
references.citation: Nat Rev Neurol. 2014 Apr;10(4):183-4
references.pmid: 24638132
references.citation: N Engl J Med. 2015 Apr 9;372(15):1474-6
references.pmid: 25853764
references.citation: N Engl J Med. 2012 Sep 20;367(12):1087-97
references.pmid: 22992072
references.citation: N Engl J Med. 2010 Feb 4;362(5):387-401
references.pmid: 20089952
references.citation: Ther Clin Risk Manag. 2015 Mar 31;11:525-34
references.pmid: 25848299
references.citation: J Immunol. 2013 Dec 15;191(12):5867-74
references.pmid: 24198283
references.citation: Lancet Neurol. 2014 Oct;13(10):977-86
references.pmid: 25192851
references.citation: Int J Immunopathol Pharmacol. 2014 Apr-Jun;27(2):147-54
references.pmid: 25004826