Beginning of the end of two-stage theory purporting that inflammation then degeneration explains pathogenesis of progressive multiple sclerosis

Curr Opin Neurol. 2016 Jun;29(3):340-4. doi: 10.1097/WCO.0000000000000317.


Purpose of review: The review discusses future directions in research on multiple sclerosis and neuromyelitis optica, as long-held beliefs about these diseases are undermined with data from recent clinical trials.

Recent findings: Results of clinical trials for registration (phase 3) were reported in the last year. Anti-inflammatory approaches, such as daclizumab high-yield process targeting IL-2 receptor, and ocrelizumab targeting CD20 B cells, confirmed a beneficial role of immune suppression in relapsing-remitting disease. And now for the first time achieving the primary end point in primary progressive multiple sclerosis was attained with ocrelizumab.

Summary: The results in the past year challenge the long-held belief that relapsing-remitting disease is inflammatory, whereas progressive forms of the disease are 'less inflammatory' and more 'degenerative.'

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Daclizumab
  • Humans
  • Inflammation / complications
  • Inflammation / drug therapy*
  • Multiple Sclerosis, Chronic Progressive / drug therapy*
  • Multiple Sclerosis, Chronic Progressive / etiology*
  • Neuromyelitis Optica / drug therapy*
  • Neuromyelitis Optica / etiology


  • Antibodies, Monoclonal, Humanized
  • daclizumab HYP
  • ocrelizumab
  • Daclizumab