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Advances in Multiple Sclerosis and Experimental Demyelinating Diseases (Current Topics in Microbiology and Immunology)

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The past decade has witnessed significant advances in the understanding of the pathophysiology of MS and in the development of novel disease-modifying agents (DMA). The use of DMA in the treatment of patients with MS has drastically increased not only in the United States but throughout the rest of the world.

Currently, in the United States, most patients given a diagnosis of relapsing-remitting MS are commenced on a DMA. Controversy still exists regarding how early DMA should be commenced and whether all patients with relapsing-remitting MS should in fact be treated [21, 54]. To answer these questions, it is important to know the natural history of the disease.

The public associates a diagnosis of MS with the need for a wheelchair and certain disability. This misinformation may motivate many patients with a recent diagnosis of MS or a clinically isolated syndrome to initiate long-term DMA. In order for the patient and physician to make the best therapeutic decision for the patient, both parties must study DMA efficacy, the side effects, mode of administration, and costs, and review the natural history of the disease.

In this chapter, we will describe the natural history of MS and review the controversies regarding the entity of benign MS. We will review the indications, efficacy, mode of action and side effect profiles of the currently available FDA approved DMA. We will discuss the importance of evidence-based medicine and natural history studies in treatment decision making. We will review the arguments for and against treating all patients. We will discuss a possible change from the blockbuster to a more individualized patient care approach.
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Never Apply for a Job Again!: Break the Rules, Cut the Line, Beat the Rest
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Learning Ext JS 4
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Rang & Dale's Pharmacology: With STUDENT CONSULT  Online Access
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A straightforward way to master a complex subject! This bestselling textbook presents all the knowledge you need to get through your pharmacology course and beyond-using a clear and accessible approach that makes the material easy and interesting to learn. Progressing logically from a molecular understanding of receptors and drug actions to the...
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