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HOT TOPICS IN NEUROLOGY AND PSYCHIATRY: Issue 9, 2010
Multiple sclerosis: current and prospective therapies
Upcoming treatment options in relapsing-remitting multiple sclerosis
Volker Limmroth, Norman Putzki
Correspondence to:
Norman Putzki - MD
Head of Multiple Sclerosis Outpatient Clinic at Dept. of Neurology
MS Center
University of Duisburg-Essen
Cantonal Hospital St. Gallen, Switzerland
University Clinic Essen, Germany
St. Gallen, Switzerland / Essen, Germany
E-mail: Norman.putzki@kssg.ch
DOI: 10.4147/HTN-100923

Abstract


Background: Several disease modifying treatments (DMT) are licensed for the treatment of relapsing-remitting multiple sclerosis (RRMS). Current first line DMT (interferon beta and glatiramer acetate), require frequent injections, and discontinuation rates are high. Also, not all patients show adequate disease control with these agents. These aspects underline the need for agents that are less invasive which may improve adherence and patient satisfaction. Furthermore, agents with alternative modes of action may also improve disease control.
Discussion: This review introduces promising new agents that are currently under investigation for the treatment of RRMS in phase II/III trials. Oral drugs with distinct modes of action are reviewed in the first part while the second part focuses on new monoclonal antibodies. The introduction of some of these new agents may have important implications for current treatment algorithms.

Summary


  • ORAL AGENTS
  • Cladribine
  • Mechanism of action
  • Efficacy
  • Adverse events
  • Phase III trial of oral cladribine
  • Fingolimod (FTY720)
  • Mechanism of action
  • Efficacy
  • Adverse events
  • Teriflunomide
  • Mechanism of action
  • Efficacy
  • Adverse events
  • Phase III trial
  • Laquinimod
  • Mechanism of action
  • Efficacy
  • Adverse events
  • Phase III trial
  • Fumaric acid esters (BG00012)
  • Mechanism of action
  • Efficacy
  • Adverse events
  • Phase III trials
  • Oral alpha-4-beta-1-integrin antagonists
  • Conclusions
  • NEW MONOCLONAL ANTIBODIES
  • Rituximab
  • Mode of action
  • Efficacy
  • Adverse events
  • Other anti-B cell approaches under investigation
  • Daclizumab
  • Mode of action
  • Efficacy
  • Adverse events
  • Alemtuzumab
  • Mode of action
  • Efficacy
  • Adverse events
  • Conclusions
  • REFERENCES

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