Multiple Sclerosis Therapy
The history of multiple sclerosis therapy is generally one of futility, consisting of many far-fetched remedies, some of which have been painful or harmful or both. This is not surprising given the variability of the disease among patients, and even within the same patients, and considering the relative inability of current therapy to reverse the disease. However, significant advances have been made in MS therapy, which have made McAlpine’s pessimistic statement in 1965 outdated. The pessimism of previous times has been replaced by a flurry of attempts to optimize modern clinical trial design to identify effective treatments. These attempts, which have come from a massive amount of investment by pharmaceutical companies and the extensive efforts of neurologists and allied health care workers, have led to the discovery of many effective therapies. These therapies can be divided into two general categories. This chapter first covers “disease-modifying drugs (DMDs),” therapies which affect the underlying disease process. Next “symptomatic therapies” are discussed, including life-style changes which can benefit the patient.
KeywordsFatigue Corticosteroid Interferon Caffeine Methotrexate
- 16.Casetta I, Iuliano G, Filippini G. Azathioprine for multiple sclerosis. Cochrane Database Syst Rev. 2007;(4):CD003982.Google Scholar
- 20.Marriott JJ, Miyasaki JM, Gronseth G, O’Connor PW. Evidence Report: The efficacy and safety of mitoxantrone (Novantrone) in the treatment of multiple sclerosis: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2010;74(18):1463–70.PubMedCrossRefGoogle Scholar