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    ABSTRACT: 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.
    No preview · Article · Apr 2013 · Current Treatment Options in Neurology
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    ABSTRACT: In MS, we've advanced from a state in which essentially nothing could be done for our patients to a new challenge: how to select the best medication for an individual patient from among nine FDA-approved choices, with more expected soon to launch. Clinical progress has occurred in part because MS is a more tractable problem than, for example, a classical neurodegenerative disease. In MS progress was achieved almost exclusively by developing immunotherapies that kill, attenuate, or disable overactive autoreactive lymphocytes. An unsolved challenge in MS is how to protect against late neurodegeneration, the major cause of chronic disability in this disease. One noteworthy feature of the MS success story is that, despite progress, we still do not have a coherent model of pathogenesis. We do not know the primary trigger or triggers, the specificity of the culprit pathogenic immune cells, or the mechanism underlying progressive disability in longstanding disease. MS also remains one of the most compelling mysteries in modern medicine. Why has it increased in frequency over the past century and why may have this increase occurred mostly in women? What is the cause of progression? And why in 15% of patients does the disease manifest only as gradual, primary progression [primary progressive MS (PPMS)], with focal areas of inflammation and gliosis visible on MRI presenting as a gradual accumulation of disability rather than as clinical relapses? This selective overview will highlight recent progress, and outline a few areas that are particularly ripe for meaningful advances in the near future. ANN NEUROL 2013. © 2013 American Neurological Association.
    Preview · Article · Aug 2013 · Annals of Neurology
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    ABSTRACT: Multiple sclerosis is the leading nontraumatic cause of neurologic disability in young adults. The need to prevent neurodegeneration and promote repair in multiple sclerosis (MS) has gained increasing interest in the last decade leading to the search and development of pharmacological agents and non-pharmacologic strategies able to target not only the inflammatory but also the neurodegenerative component of the disease. This paper will provide an overview of the therapeutics currently employed in MS, with a focus on their potential neuroprotective effects and on the MRI methods employed to detect and monitor in-vivo neuroprotection and repair and the relevance of this information to schizophrenia investigation and treatment.
    Full-text · Article · May 2014 · Schizophrenia Research
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