Optimizing therapy early in multiple sclerosis: An evidence-based view

Multiple Sclerosis and Related Disorders
Tjalf ZiemssenBernd C Kieseier

Abstract

Therapies that target the underlying pathology of multiple sclerosis (MS), including focal and diffuse damage, may improve long-term disease control. Focal damage (inflammatory lesions) manifests clinically mainly as relapses, whereas diffuse damage (neurodegeneration and brain volume loss) has been more closely associated with disability progression and cognitive decline. Given that first-line therapies such as beta-interferon and glatiramer acetate, which are primarily directed against inflammation, might fail to adequately control disease activity in some patients, it has been recommended to switch these patients early to a therapy of higher efficacy, possibly targeting both components of MS pathology more rigorously. This review provides an overview of the efficacy of EU-approved disease-modifying therapies on conventional MS outcome measures (relapses, disability progression and paraclinical magnetic resonance imaging endpoints) in addition to brain volume loss, a measure of diffuse damage in the brain. In addition, the evidence supporting early treatment optimization in patients with high disease activity despite first-line therapy will be reviewed and an algorithm for optimal disease control will be presented.

Associated Clinical Trials

References

Apr 29, 1998·Brain : a Journal of Neurology·D H MillerH F McFarland
May 30, 2001·Lancet·G ComiUNKNOWN Early Treatment of Multiple Sclerosis Study Group
Jan 5, 2002·Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society·L J Balcer
Mar 20, 2002·Current Neurology and Neuroscience Reports·S Markovic-Plese, H F McFarland
Oct 22, 2003·Lancet·Per Soelberg SorensenUNKNOWN Danish Multiple Sclerosis Study Group
Jul 13, 2005·Neurology·L KapposUNKNOWN European Interferon Beta-1a IM Dose-Comparison Study Investigators
Sep 10, 2005·Journal of Neurology·Valentina TomassiniCarlo Pozzilli
Oct 19, 2005·Brain : a Journal of Neurology·Alexandra KutzelniggHans Lassmann
Oct 29, 2005·Journal of Neurology·Massimo Filippi, Maria Assunta Rocca
Jan 24, 2006·Lancet Neurology·Robert A Bermel, Rohit Bakshi
Mar 3, 2006·The New England Journal of Medicine·Chris H PolmanUNKNOWN AFFIRM Investigators
Mar 3, 2006·The New England Journal of Medicine·Richard A RudickUNKNOWN SENTINEL Investigators
May 26, 2006·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·C CaonO Khan
Mar 22, 2007·Radiographics : a Review Publication of the Radiological Society of North America, Inc·James G SmirniotopoulosJason W Schroeder
Apr 25, 2007·Neurology·D H MillerUNKNOWN AFFIRM Investigators
May 8, 2007·Expert Opinion on Drug Safety·Marcelo KremenchutzkyCarolina Rush
Dec 14, 2007·Journal of Neurology, Neurosurgery, and Psychiatry·A MinnebooJ A Castelijns
Oct 17, 2008·Multiple Sclerosis : Clinical and Laboratory Research·A GajofattoE Waubant
Nov 14, 2008·Journal of Neurology·UNKNOWN Multiple Sclerosis Therapy Consensus Group (MSTCG)R Hohlfeld
Feb 4, 2009·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·N PutzkiV Limmroth
Jun 23, 2009·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·L ProsperiniC Pozzilli
Jul 21, 2009·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·N PutzkiV Limmroth
Oct 2, 2009·Nature Reviews. Neurology·Jordi RíoXavier Montalban
Oct 9, 2009·CNS & Neurological Disorders Drug Targets·Oleksandra KatrychShaker A Mousa
Jan 12, 2010·Clinical Neuropharmacology·Jerold Chun, Hans-Peter Hartung
Jan 22, 2010·The New England Journal of Medicine·Ludwig KapposUNKNOWN FREEDOMS Study Group
Jan 22, 2010·The New England Journal of Medicine·Jeffrey A CohenUNKNOWN TRANSFORMS Study Group
Apr 29, 2010·Brain : a Journal of Neurology·Emmanuelle LerayGilles Edan
Jun 10, 2010·Neurology·A T RederUNKNOWN Investigators of the 16-Year Long-Term Follow-Up Study
Jun 22, 2010·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·S BelachewM Vokaer
Jun 22, 2010·Journal of Neurology, Neurosurgery, and Psychiatry·G C EbersUNKNOWN Investigators of the 16-year Long-Term Follow-Up Study
Aug 26, 2010·Annals of Neurology·Leonid GorelikMeena Subramanyam
Oct 16, 2010·Progress in Neurobiology·Ranjan Dutta, Bruce D Trapp
Dec 24, 2010·Therapeutic Advances in Neurological Disorders·Ralf GoldGiancarlo Comi
Feb 10, 2011·PloS One·Tamara Castillo-TrivinoEmmanuelle Waubant
Mar 3, 2011·Nature Reviews. Neurology·Joep Killestein, Chris H Polman
Mar 30, 2011·Neurology·M S A DeloireB Brochet

❮ Previous
Next ❯

Citations

Dec 26, 2015·Journal of Neurology·Tjalf ZiemssenSven Schippling
Jun 18, 2016·Seminars in Hematology·Cindy NeunertEllis Neufeld
Sep 7, 2016·Expert Opinion on Pharmacotherapy·Nikolaos GrigoriadisGünther F L Hofbauer
Oct 22, 2016·Expert Review of Neurotherapeutics·Catalina CoclituRadu Tanasescu
Dec 3, 2016·Expert Review of Molecular Diagnostics·Matteo GastaldiDiego Franciotta
Feb 7, 2017·Expert Review of Clinical Immunology·Tjalf Ziemssen, Katja Thomas
Oct 14, 2017·Journal of the American Association of Nurse Practitioners·Cortnee Roman, Kara Menning
Nov 24, 2017·Neurological Research·Przemyslaw PuzAleksandra Karuga-Pierścieńska
Feb 6, 2018·Therapeutic Advances in Neurological Disorders·Veit BeckerTjalf Ziemssen
Jun 5, 2019·Continuum : Lifelong Learning in Neurology·Robert H Gross, John R Corboy
Jul 30, 2019·Neurology. Neuroimmunology and Neuroinflammation·Itay LotanIsrael Steiner
Mar 13, 2019·Neurology. Clinical Practice·Edward J FoxAaron Boster
Mar 19, 2019·Neurology. Neuroimmunology and Neuroinflammation·Tjalf ZiemssenUNKNOWN PANGAEA study group
Jul 7, 2017·Neurology. Neuroimmunology and Neuroinflammation·Maria Pia SormaniNicola De Stefano
Aug 29, 2017·Expert Opinion on Pharmacotherapy·Katja ThomasTjalf Ziemssen
Oct 21, 2017·Multiple Sclerosis Journal - Experimental, Translational and Clinical·Mark S FreedmanFernando Dangond
Sep 11, 2018·Journal of Clinical Neurology·Ricardo AlonsoOrlando Garcea
Jun 14, 2017·Multiple Sclerosis Journal - Experimental, Translational and Clinical·J NicholasV Herrera
Dec 14, 2018·Frontiers in Immunology·Maxi KaufmannKatja Akgün
Aug 28, 2019·Neurology. Neuroimmunology and Neuroinflammation·Itay LotanIsrael Steiner
Dec 25, 2019·Journal of Neuroinflammation·Tjalf ZiemssenWolfgang Brück
Jul 3, 2020·Frontiers in Neurology·Tjalf ZiemssenRocco Haase
May 12, 2018·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Robert ZivadinovUNKNOWN MS-MRIUS investigators
Jan 10, 2017·Frontiers in Immunology·Catharina C GrossAlice Laroni
Aug 31, 2020·Multiple Sclerosis and Related Disorders·L NovakovaJ Lycke
Aug 11, 2020·Revue neurologique·V PantazouM Théaudin
Nov 17, 2020·Frontiers in Neuroscience·Katrin TrentzschTjalf Ziemssen
Feb 25, 2021·Multiple Sclerosis and Related Disorders·Inge M W VerberkClaire Bridel
Mar 28, 2021·Magnetic Resonance Imaging·Claudia E WeberPhilipp Eisele

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.