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Chapter 7 - Disease-Modifying Therapies

Published online by Cambridge University Press:  10 February 2021

Carlos A. Perez ,
Andrew Smith  and
Flavia Nelson
By
Carlos A. Pérez
Carlos A. Perez
Affiliation:
University of Texas, Houston
Andrew Smith
Affiliation:
OhioHealth Riverside Methodist Hospital in Columbus, Ohio, USA
Flavia Nelson
Affiliation:
University of Minnesota, Minneapolis
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Summary

With the ongoing expansion of the therapeutic armamentarium, treatment strategies for multiple sclerosis (MS) have undergone profound changes in the last few years. Several treatment options are available at this time, and the effects of these drugs appear to be greater when treatment is initiated early, soon after the onset of symptoms. This chapter reviews currently used disease-modifying agents (Figure 7.1) in addition to several promising therapies in various phases of development.

Type
Chapter
Information
Multiple Sclerosis
A Practical Manual for Hospital and Outpatient Care
 , pp. 121 - 144
Publisher: Cambridge University Press
Print publication year: 2021

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References

Cross, AH, Naismith, RT. Established and novel disease-modifying treatments in multiple sclerosis. J Intern Med. 2014;275(4):350–63. doi:10.1111/joim.12203Google Scholar
Tillery, EE, Clements, JN, Howard, Z. What’s new in multiple sclerosis? Ment Heal Clin. 2017;7(5):213–20. doi:10.9740/mhc.2017.09.213Google ScholarPubMed
Rae-Grant, A, Day, GS, Marrie, RA, et al. Practice guideline recommendations summary: disease-modifying therapies for adults with multiple sclerosis. Neurology. 2018;90(17):777–88. doi:10.1212/WNL.0000000000005347Google ScholarPubMed
Kappos, L, Freedman, MS, Polman, CH, et al. Long-term effect of early treatment with interferon beta-1b after a first clinical event suggestive of multiple sclerosis: 5-year active treatment extension of the phase 3 BENEFIT trial. Lancet Neurol. 2009;8(11):987–97. doi:10.1016/S1474-4422(09)70237-6Google Scholar
Marcus, JF, Waubant, EL. Updates on clinically isolated syndrome and diagnostic criteria for multiple sclerosis. Neurohospitalist. 2013;3(2):65–80. doi:10.1177/1941874412457183CrossRefGoogle ScholarPubMed
Eriksson, I, Komen, J, Piehl, F, et al. The changing multiple sclerosis treatment landscape: impact of new drugs and treatment recommendations. Eur J Clin Pharmacol. 2018;74:663–70. doi:10.1007/s00228-018-2429-1CrossRefGoogle ScholarPubMed
Wingerchuk, DM, Carter, JL. Multiple sclerosis: current and emerging disease-modifying therapies and treatment strategies. Mayo Clin Proc. 2014;89(2):225–40. doi:10.1016/j.mayocp.2013.11.002Google Scholar
Olek, MJ. Differential diagnosis, clinical features, and prognosis of multiple sclerosis. Curr Clin Neurol Mult Scler. 2005:15–53.CrossRefGoogle Scholar
Jones, DE. Early relapsing multiple sclerosis. Continuum (Minneap Minn). 2016;22(3):744–60. doi:10.1212/CON.0000000000000329Google Scholar
Ciotti, JR, Cross, AH. Disease-modifying treatment in progressive multiple sclerosis.Curr Treat Options Neurol. 2018;20(5):12. doi:10.1007/s11940-018-0496-3Google Scholar
Dumitrescu, L, Constantinescu, CS, Tanasescu, R. Siponimod for the treatment of secondary progressive multiple sclerosis. Expert Opin Pharmacother. 2018;20(2):143–50.Google ScholarPubMed
Food and Drug Administration. FDA approves new oral treatment for multiple sclerosis.Google Scholar
Neema, M, Stankiewicz, J, Arora, A, et al. MRI in multiple sclerosis: what’s inside the toolbox? Neurotherapeutics. 2007;4:602–17. doi:10.1016/j.nurt.2007.08.001CrossRefGoogle ScholarPubMed
Rocca, MA, Messina, R, Filippi, M. Multiple sclerosis imaging: recent advances. J Neurol. 2013;260(3):929–35. doi:10.1007/s00415-012-6788-8CrossRefGoogle ScholarPubMed
Feinstein, A, Freeman, J, Lo, AC. Treatment of progressive multiple sclerosis: what works, what does not, and what is needed. Lancet Neurol. 2015;14(2):194–207.Google Scholar
Ching, B, Mohamed, A, Khoo, T, Ismail, H. Multiphasic disseminated encephalomyelitis followed by optic neuritis in a child with gluten sensitivity. Mult Scler J. 2015;21(9):1209–11. doi:10.1177/CrossRefGoogle Scholar
Wingerchuk, DM. Immune-mediated myelopathies. Continuum (Minneap Minn). 2018;24(2):497–522. doi:10.1212/CON.0000000000000582Google ScholarPubMed
Freedman, MS, Rush, CA. Severe, highly active, or aggressive multiple sclerosis. Continuum (Minneap Minn). 2016;22(3):761–84. doi:10.1212/CON.0000000000000331Google ScholarPubMed
Hacohen, Y, Wong, YY, Lechner, C, et al. Disease course and treatment responses in children with relapsing myelin oligodendrocyte glycoprotein antibody–associated disease. JAMA Neurol. 2018;75(4):478–87. doi:10.1001/jamaneurol.2017.4601Google Scholar
Thompson, AJ, Baranzini, SE, Geurts, J, et al. Multiple sclerosis. Lancet Neurol. 2018;391:1622–36. doi:10.1016/B978-0-7234-3748-2.00015-3Google Scholar
Hauser, SL, Bar-Or, A, Cohen, J, et al. Ofatumumab versus teriflunomide in relapsing MS: adaptive design of two Phase 3 studies (ASCLEPIOS I and ASCLEPIOS II) (S16.005). Neurology. 2017;88(16 suppl):S16.005. http://n.neurology.org/content/88/16_Supplement/S16.005.abstract.CrossRefGoogle Scholar
Fox, E, Wray, S, Shubin, R, et al. Open label extension (OLE) of Phase 2 multicenter study of ublituximab (UTX), a novel glycoengineered anti-CD20 monoclonal antibody (mAb), in patients with relapsing forms of multiple sclerosis (RMS) (P3.2-048). Neurology. 2019;92(15 suppl):P3.2-048. http://n.neurology.org/content/92/15_Supplement/P3.2-048.abstract.CrossRefGoogle Scholar
Comi, G, Kappos, L, Selmaj, KW, et al. Safety and efficacy of ozanimod versus interferon beta-1a in relapsing multiple sclerosis (SUNBEAM): a multicentre, randomised, minimum 12-month, phase 3 trial. Lancet Neurol. 2019;18(11):1009–20. doi:10.1016/S1474-4422(19)30239-XCrossRefGoogle ScholarPubMed
Cohen, JA, Comi, G, Selmaj, KW, et al. Safety and efficacy of ozanimod versus interferon beta-1a in relapsing multiple sclerosis (RADIANCE): a multicentre, randomised, 24-month, phase 3 trial. Lancet Neurol. 2019;18(11):1021–33. doi:10.1016/S1474-4422(19)30238-8Google Scholar
Vermersch, P, Benrabah, R, Schmidt, N, et al. Masitinib treatment in patients with progressive multiple sclerosis: a randomized pilot study. BMC Neurol. 2012;12:36. doi:10.1186/1471-2377-12-36CrossRefGoogle ScholarPubMed
Willis, M, Fox, R. Progressive multiple sclerosis. Continuum (Minneap Minn). 2016;22(3):785–98.Google Scholar
Eriksson, M, Andersen, O, Runmarker, B. Long-term follow up of patients with clinically isolated syndromes, relapsing-remitting and secondary progressive multiple sclerosis. Mult Scler. 2003;9:260–74.Google Scholar
Cree, BAC, Gourraud, PA, Oksenberg, JR, et al. Long-term evolution of multiple sclerosis disability in the treatment era. Ann Neurol. 2016;80(4):499–510. doi:10.1002/ana.24747Google ScholarPubMed
Granberg, T, Martola, J, Kristoffersen-Wiberg, M, et al. Radiologically isolated syndrome: incidental magnetic resonance imaging findings suggestive of multiple sclerosis, a systematic review. Mult Scler J. 2013;19(3):271–80. doi:10.1177/1352458512451943Google Scholar
Montalban, X, Arnold, DL, Weber, MS, et al. Placebo-controlled trial of an oral BTK inhibitor in multiple sclerosis. N Engl J Med. 2019;380(25):2406–17. doi:10.1056/NEJMoa1901981Google Scholar
Sorensen, PS, Lisby, S, Grove, R, et al. Safety and efficacy of ofatumumab in relapsing-remitting multiple sclerosis. Neurology. 2014;82(7):573–81. doi:10.1212/WNL.0000000000000125CrossRefGoogle ScholarPubMed
Kish, T. Promising multiple sclerosis agents in late-stage development. PT. 2018;43(12):750–72. www.ncbi.nlm.nih.gov/pubmed/30559588.Google ScholarPubMed

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