Freedom from disease activity in multiple sclerosis

Neurology. 2010 Apr 27;74 Suppl 3:S3-7. doi: 10.1212/WNL.0b013e3181dbb51c.

Abstract

Background: Multiple sclerosis (MS) shares many pathologic features with other immune-mediated inflammatory diseases, such as rheumatoid arthritis, Crohn disease, and psoriasis. The development of effective biologic agents for rheumatoid arthritis has resulted in a treatment paradigm shift such that disease remission is now an explicit goal.

Expert clinical opinion: The traditional immunomodulatory disease-modifying therapies for MS (interferon beta and glatiramer acetate) delay disease progression and reduce activity on brain MRI to varying degrees; however, they have not been demonstrated to induce disease remission. Therefore, the concept of disease remission or freedom from disease activity in MS has received little attention from the neurology community. We discuss some potential definitions of disease remission in MS and whether freedom from disease activity can become an increasingly useful measure of therapeutic response.

Future directions: Future research should be directed at determining the long-term significance of freedom from disease activity during a short-term clinical trial in relapsing-remitting MS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / drug therapy
  • Arthritis, Rheumatoid / physiopathology
  • Expert Testimony
  • Humans
  • Immunologic Factors / therapeutic use
  • Multiple Sclerosis / drug therapy*
  • Multiple Sclerosis / physiopathology
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy
  • Natalizumab
  • Remission Induction
  • Severity of Illness Index

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antirheumatic Agents
  • Immunologic Factors
  • Natalizumab