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Newer Versus Older Treatments for Relapsing-Remitting Multiple Sclerosis

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Summary

Multiple sclerosis (MS) is a chronic disease with an unpredictable clinical course and several distinct clinical patterns. Recent developments in immunology, molecular biology and genetics have improved our understanding of the pathophysiology of MS. Further, advances in trial methodology, including the availability of magnetic resonance imaging (MRI) as a surrogate outcome measure, have led to the identification of several new therapeutic options for relapsing-remitting (RR) MS. These therapies include corticosteroids, recombinant interferon-β-1b (rIFNβ-1b), recombinant interferon-β-1a (rIFNβ-1a) and copolymer-1 (Cop-1).

Corticosteroids have been shown to accelerate the recovery from acute exacerbations, but there are still conflicting data on their effect on outcome and long term course. rIFNβ-1b, rIFNB-1a and Cop-1 all effectively alter the natural history of RR-MS. These 3 agents all decrease the relapse rate by approximately one-third, but differ in their adverse effect profiles and administration regimens. Further trials are required to define the optimal treatment of RR-MS.

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References

  1. Weinshenker BG, Bass B, Rice GPA, et al. The natural history of multiple sclerosis: a geographically based study. 1 Clinical course and disability. Brain 1989; 112: 113–46.

    Article  Google Scholar 

  2. Raine C. The Dale E McFarlin Memorial lecture: the immunology of the multiple sclerosis lesion. Ann Neurol 1994; 36: S61–72.

    Article  PubMed  CAS  Google Scholar 

  3. Almawi WY, Sewell KL, Hadro ET, et al. Mode of action of the glucocorticosteroids as immunosuppressive agents. In: Molecular and cellular biology of cytokines. New York: Wiley-Liss, 1990: 321–6.

    Google Scholar 

  4. Troiano R, Cook SD, Dowling PC. Steroid therapy in multiple sclerosis: point of view. Arch Neurol 1987; 44: 803–7.

    Article  PubMed  CAS  Google Scholar 

  5. Barnes MP, Bateman DE, Clelenad PG, et al. Intravenous methylprednisolone for multiple sclerosis in relapse. J Neurol Neurosurg Psychiatry 1985; 48: 157–9.

    Article  PubMed  CAS  Google Scholar 

  6. Beck RW, Cleary PA, Anderson Jr MM, et al. A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis: the Optic Neuritis Study Group. N Engl J Med 1992; 326: 581–8.

    Article  PubMed  CAS  Google Scholar 

  7. Beck RW, Cleary PA, Trobe JD, et al. The effect of corticosteroids for acute optic neuritis on the subsequent development of multiple sclerosis. N Engl J Med 1993; 329: 1764–9.

    Article  PubMed  CAS  Google Scholar 

  8. Weinstock-Guttman B, Ransohoff RM, Kinkel RP, et al. Ann Neurol 1995; 37: 7–13.

    Article  PubMed  CAS  Google Scholar 

  9. Panitch HS, Hirsch RL, Schindler J, et al. Exacerbations of multiple sclerosis in patients treated with gamma interferon. Lancet 1987; 1: 893–5.

    Article  PubMed  CAS  Google Scholar 

  10. Panitch HS, Hirsch RL, Schindler J, et al. Treatment of multiple sclerosis with gamma interferon: exacerbations associated with activation of the immune system. Neurology 1987; 37: 1097–102.

    Article  PubMed  CAS  Google Scholar 

  11. Johnson KP, Knobler RL, Greenstein JI, et al. Recombinant human interferon beta treatment of relapsing-remitting multiple sclerosis: pilot study results. Neurology 1990; 40 (1): 261.

    Google Scholar 

  12. IFNB multiple Sclerosis Study Group. Interferon beta-1b is effective in relapsing-remitting multiple sclerosis: I. Clinical results of a multicenter, randomized, double-blind, placebocontrolled trial. Neurology 1993; 43: 655–61.

    Article  Google Scholar 

  13. Pliskin N, Towle V, Hamer D. The effects of interferon-beta on cognitive function in multiple sclerosis. Ann Neurol 1994; 36 (2): 326.

    Google Scholar 

  14. Paty DW, Li DKB, UBC MS/MRI Study Group, et al. Interferon beta-1b is effective in relapsing-remitting multiple sclerosis. Neurology 1993; 43: 662–7.

    Article  PubMed  CAS  Google Scholar 

  15. IFNB Multiple Sclerosis Study group and University of British Columbia MS/MRI analysis group. Interferon beta 1-b in the treatment of multiple sclerosis: final outcome of the randomized controlled trial. Neurology 1995; 45: 1277–85.

    Article  Google Scholar 

  16. Jacobs L, Cookfair D, Rudick R, et al. Results of a phase III trial of IM recombinant beta interferon as treatment for multiple sclerosis. Ann Neurol 1994; 36 (2): 259.

    Article  Google Scholar 

  17. Teitelbaum D, Webb C, Bree M, et al. Suppression of experimental allergic encephalomyelitis in rhesus monkeys by a synthetic basic copolymer. Clin Immunol Immunopathol 1974; 3: 256–62.

    Article  PubMed  CAS  Google Scholar 

  18. Webb C, Teitelbaum D, Arnon R, et al. In vivo and in vitro immunological cross-reactions between basic encephalitogen and synthetic basic polypeptides capable of suppressing experimental allergic encephalomyelitis. Eur J Immunol 1973; 3: 279–86.

    Article  PubMed  CAS  Google Scholar 

  19. Bornstein MB, Miller A, Slagle S, et al. A pilot trial of copolymer 1 in exacerbating-remitting multiple sclerosis. N Engl J Med 1987; 317: 408–14.

    Article  PubMed  CAS  Google Scholar 

  20. Bornstein MB, Miller A, Slagle S, et al. A placebo-controlled, double-blind, randomized two-center, pilot trial of Cop 1 in chronic progressive multiple sclerosis. Neurology 1991; 41: 533–9.

    Article  PubMed  CAS  Google Scholar 

  21. Johnson KP, Brooks BR, Cohen JA, et al. and the Copolymer 1 multiple Sclerosis Study Group. Copolymer 1 reduces relapse rate and improves disability in relapsing-remitting multiple sclerosis: results of a phase III multicenter, doubleblind, placebo-controlled trial. Neurology 1995; 45: 1268–76.

    Article  PubMed  CAS  Google Scholar 

  22. Report of the Quality Standards Subcommittee of the American Academy of Neurology. Practice advisory on selection of patients with multiple sclerosis for treatment with Betaseron. Neurology 1994; 44: 1537–40.

    Article  Google Scholar 

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Authors and Affiliations

  1. The Mellen Center for Multiple Sclerosis Treatment and Research, Department of Neurology, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio, 44195, USA

    Bianca Weinstock-Guttman &  Jeffrey A. Cohen

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  1. Bianca Weinstock-Guttman
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  2. Jeffrey A. Cohen
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Weinstock-Guttman, B., Cohen, J.A. Newer Versus Older Treatments for Relapsing-Remitting Multiple Sclerosis. Drug-Safety 14, 121–130 (1996). https://doi.org/10.2165/00002018-199614020-00006

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  • DOI: https://doi.org/10.2165/00002018-199614020-00006

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