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DOI: 10.1055/s-0038-1628185
Immuntherapie heute
Multiple Sklerose und Myasthenia gravisImmunotherapy todayMultiple sclerosis and myasthenia gravisPublication History
Eingegangen am:
07 August 2012
angenommen am:
15 August 2012
Publication Date:
23 January 2018 (online)
Zusammenfassung
Das Verständnis immunpathogenetischer Zusammenhänge neurologischer Erkrankungen und die sich daraus ergebenden Möglichkeiten in der Therapie haben sich maßgeblich verändert. Das Krankheitsbild mit der größten Dynamik auf dem Therapiesektor in den vergangenen Jahren ist die Multiple Sklerose (MS). Inzwischen gibt es verschiedene Immuntherapien zur Behandlung der schubförmigen MS. Die Immuntherapie der Myasthenia gravis (MG) ist ein wichtiger Bestandteil einer effektiven Therapie, die therapeutischen Möglichkeiten sind im Vergleich zur MS limitierter, was am Fehlen entsprechender Studiendaten liegt.
In dieser Übersichtsarbeit werden die aktuellen Empfehlungen zur Immuntherapie der MS, mit den gängigen Immuntherapeutika zusammengefasst und diskutiert sowie der Stellenwert der Immuntherapie der MG dargestellt.
Summary
Our understanding of immune-mediated disorders in neurology has changed dramatically with clinical consequences in the way how these diseases are currently being treated. The disease with the greatest dynamic in the therapeutic field is multiple sclerosis (MS). Nowadays, there is a variety of different immunotherapies for the treatment of MS available, most of which are being used already early in the course of the disease. In mysthenia gravis (MG) immunotherapy is a relevant part of the overall treatment concept. However, given the lack of larger clinical trials, the field is not as dynamic.
The present article provides an overview on the current value of immunotherapy in MS and MG.
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Literatur
- 1 Noseworthy JH. et al. Multiple sclerosis. N Engl J Med 2000; 343: 938-52.
- 2 Kieseier BC, Hemmer B, Hartung HP. Multiple sclerosis – novel insights and new therapeutic strategies. Curr Opin Neurol 2005; 18: 211-20.
- 3 Gold R, Buttgereit F, Toyka KV. Mechanism of action of glucocorticosteroid hormones: possible implications for therapy of neuroimmunological disorders. J Neuroimmunol 2001; 117: 1-8.
- 4 Keegan M. et al. Plasma exchange for severe attacks of CNS demyelination: predictors of response. Neurology 2002; 58: 143-6.
- 5 Mao-Draayer Y. et al. Treatment of steroid unresponsive tumefactive demyelinating disease with plasma exchange. Neuro-logy 2002; 59: 1074-7.
- 6 Ruprecht K. et al. Plasma exchange for severe optic neuritis: treatment of 10 patients. Neurology 2004; 63: 1081-3.
- 7 Weinshenker BG. et al. A randomized trial of plasma exchange in acute central nervous system inflammatory demyelinating disease. Ann Neurol 1999; 46: 878-86.
- 8 Schilling S. et al. Plasma exchange therapy for steroid unresponsive multiple sclerosis relapses: clinical experience with 16 patients. Nervenarzt 2006; 77: 430-8.
- 9 Keegan M. et al. Relation bet-ween humoral pathological changes in multiple sclerosis and response to therapeutic plasma exchange. Lancet 2005; 366: 579-82.
- 10 Interferon beta-1b is effective in relapsing-remitting multiple sclerosis.. I. Clinical results of a multi-center, randomized, double-blind, placebo-controlled trial. The IFNB Multiple Sclerosis Study Group. Neurology 1993; 43: 655-61.
- 11 Randomised double-blind placebo-controlled study of interferon beta-1a in relapsing/remitting multiple sclerosis.. PRISMS (Prevention of Relapses and Disability by Interferon beta-1a Subcutaneously in Multiple Sclerosis) Study Group. Lancet 1998; 352: 1498-504.