Current Treatment Options in Neurology

, Volume 15, Issue 3, pp 241–258

Management of Secondary Progressive Multiple Sclerosis: Prophylactic Treatment—Past, Present, and Future Aspects

Authors

    • Department of NeurologyMedical University of Vienna
  • Olaf Stüve
    • Department of Neurology and NeurotherapeuticsUniversity of Texas Southwestern Medical Center at Dallas
    • Neurology Section, VA North Texas Health Care SystemDallas VA Medical Center
MULTIPLE SCLEROSIS AND RELATED DISORDERS (BM SEGAL, SECTION EDITOR)

DOI: 10.1007/s11940-013-0233-x

Cite this article as:
Rommer, P.S. & Stüve, O. Curr Treat Options Neurol (2013) 15: 241. doi:10.1007/s11940-013-0233-x

Opinion statement

Whereas the number of treatment options in relapsing-remitting multiple sclerosis (RRMS) is growing constantly, alternatives are rare in the case of secondary-progressive multiple sclerosis (SPMS). Besides mitoxantrone in North America and Europe, interferon beta-1b and beta-1a are approved for treatment in Europe. Glucocorticosteroids, azathioprine, intravenous immunoglobulins (IVIG) and cyclophosphamide (CYC), although not approved, are commonly utilized in SPMS. Currently monoclonal antibodies (mab), and masitinib are under examination for treatment for SPMS. Hematopoietic stem cell transplantation and immunoablative stem cell transplantation are therapies with the aim of reconstitution of the immune system. This review gives information on the different therapeutics and the trials that tested them. Pathophysiological considerations are presented in view of efficacy of the therapeutics. In addition, therapeutics that showed no efficacy in trials or with unacceptable side effects are topics of this review.

Keywords

Secondary progressive multiple sclerosisInterferon beta-1bInterferon beta-1aMitoxantroneGlucocorticosteroidsAzathioprineIntravenous immunoglobulinsCyclophosphamideMasitinibDaclizumabRituximabLinomideTreatmentProphylactic treatmentManagement

Copyright information

© Springer Science+Business Media New York 2013