Drug Safety

pp 1–15 | Cite as

Managing Risks with Immune Therapies in Multiple Sclerosis

  • Moritz Förster
  • Patrick Küry
  • Orhan Aktas
  • Clemens Warnke
  • Joachim Havla
  • Reinhard Hohlfeld
  • Jan Mares
  • Hans-Peter HartungEmail author
  • David KremerEmail author
Review Article


Since the introduction of the interferons in the 1990s, a multitude of different immunomodulatory and immunosuppressant disease-modifying therapies for multiple sclerosis (MS) have been developed. They have all shown positive effects on clinical endpoints such as relapse rate and disease progression and are a heterogeneous group of therapeutics comprising recombinant pegylated and non-pegylated interferon-β variants, peptide combinations, monoclonal antibodies, and small molecules. However, they have relevant side effect profiles, which necessitate thorough monitoring and straightforward patient education. In individual cases, side effects can be severe and potentially life-threatening, which is why knowledge about (neurological and non-neurological) adverse drug reactions is essential for prescribing neurologists as well as general practitioners. This paper aims to provide an overview of currently available MS therapies, their modes of action and safety profiles, and the necessary therapy monitoring.


Compliance with Ethical Standards

Conflict of interest

Moritz Förster, Patrick Küry, and Jan Mares declare that they have no competing interests. Orhan Aktas received grant support from Bayer, Biogen, Novartis, and Sanofi and consultancy or speaking fees from Bayer, Biogen, Novartis, Roche, Sanofi, and Teva. Hans-Peter Hartung received consultancy fees and fees for serving on steering or data monitoring committees and advisory boards from Bayer Healthcare, Biogen, GeNeuro, Genzyme, MedDay, Merck, Novartis, Celgene Receptos, Roche, and Teva. Joachim Havla received grant support for OCT (optical coherence tomography) research from the Friedrich-Baur Foundation in Munich, and personal fees and non-financial support from Merck, Novartis, Roche, Bayer, Biogen, Sanofi, Santhera, and Genzyme. Reinhard Hohlfeld received grant support from Biogen, Genzyme-Sanofi, Merck-Serono, Novartis, and Teva and personal fees from Actelion, Biogen, Genzyme-Sanofi, MedDay, Merck-Serono, Novartis, Roche, and Teva. David Kremer received travel grants from GeNeuro and Merck, refund of congress participation fees from GeNeuro, Merck, and Servier, consulting fees from Grifols, payment for lectures from Grifols, and support for research projects from Teva. Clemens Warnke received support from the Hertie foundation (P1150063) and has received personal fees from Novartis, Bayer, Biogen, and Teva.


None of the authors received funding for preparation of this manuscript.


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Neurology, Medical FacultyHeinrich-Heine-UniversityDüsseldorfGermany
  2. 2.Department of NeurologyUniversity Hospital CologneCologneGermany
  3. 3.Institute of Clinical Neuroimmunology, Biomedical Center and University HospitalLudwig-Maximilian-Universität MünchenMunichGermany
  4. 4.The Munich Cluster for Systems Neurology (SyNergy)MunichGermany
  5. 5.Department of NeurologyUniversity Hospital and Faculty of Medicine and Dentistry, Palacky UniversityOlomoucCzech Republic

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