Therapeutic approaches to disease modifying therapy for multiple sclerosis in adults: an Australian and New Zealand perspective: part 2 new and emerging therapies and their efficacy. MS Neurology Group of the Australian and New Zealand Association of Neurologists

J Clin Neurosci. 2014 Nov;21(11):1847-56. doi: 10.1016/j.jocn.2014.01.018. Epub 2014 Jun 28.

Abstract

In Part 2 of this three part review of multiple sclerosis (MS) treatment with a particular focus on the Australian and New Zealand perspective, we review the newer therapies that have recently become available and emerging therapies that have now completed phase III clinical trial programs. We go on to compare the relative efficacies of these newer and emerging therapies alongside the existing therapies. The effectiveness of β-interferon in the treatment of different stages and the different disease courses of MS is critically reviewed with the conclusion that the absolute level of response in term of annualised relapse rates (where relapses occur) and MRI activity are similar, but are disappointing in terms of sustained disability progression for progressive forms of the disease. Finally we review the controversial area of combination therapy for MS. Whilst it remains the case that we have no cure or means of preventing MS, we do have a range of effective therapies that when used appropriately and early in the disease course can have a significant impact on short term and longer term outcomes.

Keywords: Evidence-based medicine; Guideline; Multiple sclerosis; Review; Treatment.

Publication types

  • Comparative Study
  • Consensus Development Conference
  • Practice Guideline
  • Review

MeSH terms

  • Adult
  • Alemtuzumab
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antigens, CD20 / immunology
  • Antioxidants / therapeutic use
  • Australia / epidemiology
  • Clinical Trials, Phase III as Topic
  • Crotonates / adverse effects
  • Crotonates / therapeutic use
  • Daclizumab
  • Dimethyl Fumarate
  • Disease Management
  • Disease Progression
  • Drug Therapy, Combination
  • Evidence-Based Medicine
  • Fumarates / therapeutic use
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Immunoglobulin G / therapeutic use
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / therapeutic use*
  • Interferon-beta / therapeutic use
  • Magnetic Resonance Imaging
  • Multiple Sclerosis / drug therapy*
  • Multiple Sclerosis / epidemiology
  • Multiple Sclerosis / pathology
  • Multiple Sclerosis / therapy
  • New Zealand / epidemiology
  • Quinolones / therapeutic use
  • Randomized Controlled Trials as Topic
  • Therapies, Investigational / trends*
  • Toluidines / adverse effects
  • Toluidines / therapeutic use
  • Transplantation, Autologous
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antigens, CD20
  • Antioxidants
  • Crotonates
  • Fumarates
  • Immunoglobulin G
  • Immunosuppressive Agents
  • Quinolones
  • Toluidines
  • teriflunomide
  • Alemtuzumab
  • Interferon-beta
  • laquinimod
  • Daclizumab
  • Dimethyl Fumarate