Book contents
- Multiple Sclerosis Therapeutics
- Multiple Sclerosis Therapeutics
- Copyright page
- Contents
- Contributors
- Abbreviations list
- Foreword
- Preface
- Section I Introduction
- Section II Clinical trial methodology
- Section III Clinical trials of multiple sclerosis therapies
- Section IV Therapy in clinical practice
- 51 Disease-modifying therapy for multiple sclerosis in clinical practice
- 52 Treatment for patients with primary progressive multiple sclerosis
- 53 Diagnosis, pathogenesis, and treatment of neuromyelitis optica (NMO) spectrum disorders
- Chapter 54 Management of pediatric multiple sclerosis
- 55 Use of MRI in the clinical management of multiple sclerosis
- 56 Multiple sclerosis-associated fatigue
- 57 Management of spasticity
- 58 Management of bladder and sexual dysfunction in multiple sclerosis
- 59 Depression in multiple sclerosis
- 60 Assessment and treatment of pain disorders in multiple sclerosis
- 61 Management of medical comorbidities in patients with multiple sclerosis
- 62 Rehabilitation in multiple sclerosis
- Index
- Plate Section
52 - Treatment for patients with primary progressive multiple sclerosis
from Section IV - Therapy in clinical practice
Published online by Cambridge University Press: 05 December 2011
Book contents
- Multiple Sclerosis Therapeutics
- Multiple Sclerosis Therapeutics
- Copyright page
- Contents
- Contributors
- Abbreviations list
- Foreword
- Preface
- Section I Introduction
- Section II Clinical trial methodology
- Section III Clinical trials of multiple sclerosis therapies
- Section IV Therapy in clinical practice
- 51 Disease-modifying therapy for multiple sclerosis in clinical practice
- 52 Treatment for patients with primary progressive multiple sclerosis
- 53 Diagnosis, pathogenesis, and treatment of neuromyelitis optica (NMO) spectrum disorders
- Chapter 54 Management of pediatric multiple sclerosis
- 55 Use of MRI in the clinical management of multiple sclerosis
- 56 Multiple sclerosis-associated fatigue
- 57 Management of spasticity
- 58 Management of bladder and sexual dysfunction in multiple sclerosis
- 59 Depression in multiple sclerosis
- 60 Assessment and treatment of pain disorders in multiple sclerosis
- 61 Management of medical comorbidities in patients with multiple sclerosis
- 62 Rehabilitation in multiple sclerosis
- Index
- Plate Section
Summary
The atypical characteristics of primary progressive multiple sclerosis (PPMS) have presented problems in the recruitment to and design of therapeutic trials. The problem areas in the implementation of therapeutic trials are: diagnostic criteria, sample size calculations, and choice of outcome measures. Although there is no definitively proven disease-modifying treatment available for PPMS, several randomized controlled trials have now been specifically designed for this group. The clinical trials in PPMS are based on glatiramer acetate and rituximab. The planned clinical trials in PPMS are based on fingolimod (FTY720) and cladribine. The smaller trials in PPMS are based on Interferon beta-1a, Interferon beta-1b, mitoxantrone and riluzole. A retrospective open-label study of intravenous cyclophosphamide and methylprednisolone in progressive MS included 128 patients with PPMS. PPMS may be the ideal model to investigate disease progression and neuronal protection, and is becoming an important focus for treatment trials in these areas.
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- Information
- Multiple Sclerosis Therapeutics , pp. 604 - 613Publisher: Cambridge University PressPrint publication year: 2011