Update on disease-modifying treatments for multiple sclerosis

Clin Ther. 2014 Dec 1;36(12):1938-1945. doi: 10.1016/j.clinthera.2014.08.006. Epub 2014 Sep 15.

Abstract

Purpose: The purpose of this review is to discuss the selection and use of disease- modifying treatments for patients with relapsing forms of multiple sclerosis (MS).

Methods: PubMed was searched (1966-2014) using the terms multiple sclerosis, treatment, interferon, glatiramer acetate, dimethyl fumarate, fingolimod, teriflunomide, natalizumab, rituximab, and alemtuzumab.

Findings: MS is a chronic neurological disorder that can cause a substantial degree of disability. Because of its usual onset in young adults, patients may require treatment for several decades. Currently available agents include platform injectable therapies, newer oral agents, and second-line monoclonal antibody treatments. Treatment decisions have become more complex with the introduction of new approaches, and a major goal is to balance perceived efficacy and tolerability in a specific patient with the relative impact of disease activity and adverse events on quality of life. Here the options for disease-modifying treatments for relapsing forms of MS are reviewed, and current and future challenges are discussed.

Implications: An evidence-based approach can be used for the selection of disease-modifying treatments based on disease phenotype and severity, adverse events, and perceived efficacy.

Keywords: fumarate; glatiramer; immune therapy; interferon; multiple sclerosis; natalizumab.

Publication types

  • Review

MeSH terms

  • Alemtuzumab
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Crotonates / therapeutic use
  • Dimethyl Fumarate
  • Fingolimod Hydrochloride / therapeutic use
  • Glatiramer Acetate / therapeutic use
  • Humans
  • Immunologic Factors / therapeutic use*
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy*
  • Natalizumab / therapeutic use
  • Quality of Life
  • Rituximab / therapeutic use
  • Toluidines / therapeutic use
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Crotonates
  • Immunologic Factors
  • Natalizumab
  • Toluidines
  • teriflunomide
  • Alemtuzumab
  • Rituximab
  • Glatiramer Acetate
  • Dimethyl Fumarate
  • Fingolimod Hydrochloride