Relapsing-remitting multiple sclerosis: What is the potential for combination therapy?

被引：0
作者：
Mäurer M. [1 ]
Rieckmann P. [1 ,2 ]
机构：
[1] Clin. Res. U. Multiple Sclerosis/N., Department of Neurology, Bayerische Julius-Maximilians Univ., Würzburg
[2] Klin. Forschungsgruppe Multiple S., Neurologische Klin./Poliklin. B., 97080 Würzburg
来源：
BioDrugs | 2000年 / 13卷 / 3期
关键词：
Multiple Sclerosis; Major Histocompatibility Complex; Experimental Autoimmune Encephalomyelitis; Myelin Basic Protein; Mitoxantrone;
D O I：
10.2165/00063030-200013030-00001
中图分类号：
学科分类号：
摘要：
Multiple sclerosis is now a treatable disease and several immunomodulating therapies exist, but their clinical efficacy is moderate and treatment failure during the course of the disease is an increasing problem. As agents with different targets are available, the question was raised whether combination of these therapies would: (i) be safe; (ii) result in reduction of adverse effects; and (iii) provide synergistic benefit by additive or complementary modes of action. The areas under clinical investigation are general immunosuppression as well as more targeted approaches that interfere with antigen presentation, immune cell transmigration, release of myelinotoxic factors or even axonal damage. Combination of these immunomodulatory drugs seems to be rational and promising. Nevertheless, combination therapies need to be studied in carefully designed clinical trials in selected patient populations in order to demonstrate additive or synergistic effects. This article will summarize current drug combination strategies in relapsing-remitting multiple sclerosis and provide an overview of the initial clinical trials.
引用
收藏
页码：149 / 158
页数：9
相关论文
共 70 条
[11]  
Yudkin P., Ellison G.W., Ghezzi A., Et al., Overview of azathioprine treatment in multiple sclerosis, Lancet, 338, pp. 1051-1055, (1991)
[12]  
Fazekas J.M., Deisenhammer F., Strasser-Fuchs S., Et al., Randomized placebo-controlled trial of monthly intravenous immunoglobulin therapy in relapsing-remitting multiple sclerosis, Lancet, 349, pp. 589-593, (1997)
[13]  
Achiron A., Gabbay U., Gilad R., Et al., Intravenous immunoglobulin treatment in multiple sclerosis - Effect on relapses, Neurology, 50, pp. 398-402, (1998)
[14]  
Sorensen P.S., Wanscher B., Jensen C.V., Et al., Intravenous immunoglobulin G reduces MRI activity in relapsing remitting multiple sclerosis, Neurology, 50, pp. 1273-1281, (1998)
[15]  
Rieckmann P., Toyka K.V., Escalating immunotherapy of multiple sclerosis, Eur Neurol, 42, pp. 121-127, (1999)
[16]  
Cursiefen S., Fachenecker P., Rieckmann P., Et al., Mitoxantrone (Novantron®) in therapy of severe multiple sclerosis. A retrospective study of 15 patients, Nervenarzt, 70, pp. 723-731, (1999)
[17]  
Hartung H.P., Gonsette R., Mitoxantrone in progressive multiple sclerosis (MS): A placebo-controlled, randomized, observer-blind European phase III multicenter study - Clinical results, Mult Scler, 4, (1998)
[18]  
Pette M., Hartung H.P., Toyka K.V., Cyclophosphamide in therapy of chronic progressive multiple sclerosis. Critical analysis of current studies, Nervenarzt, 65, pp. 271-274, (1994)
[19]  
Weiner H.L., Mackin G.A., Orav E.J., Et al., Intermittent cyclophosphamide pulse therapy in progressive multiple sclerosis: Final report of the Northeast Cooperative Multiple Sclerosis Treatment Group, Neurology, 43, pp. 910-918, (1993)
[20]  
Weilbach F.X., Gold R., Disease modifying treatments for multiple sclerosis: What is on the horizon?, CNS Drugs, 11, 2, pp. 133-157, (1999)
1234567