Subscribe to RSS
DOI: 10.1055/s-2002-33045
Alphabet Soup: A Personal, Evolving, Mostly Evidence-Based and Logical, Sequential Approach to the "ABCNR" Drugs in Multiple Sclerosis
Publication History
Publication Date:
12 August 2002 (online)
![](https://www.thieme-connect.de/media/sin/200201/lookinside/thumbnails/10.1055-s-2002-33045-1.jpg)
ABSTRACT
With the development of multiple options for immunotherapy in multiple sclerosis, the clinician is faced with the challenge of keeping pace with the literature, acquiring familiarity with the various treatment options and opinions, and then offering the patients the most current and appropriate management. Given the inherent nature of a multifocal and unpredictable disease such as multiple sclerosis, along with the availability of multiple treatment options, it behooves the clinician to develop an evidence-based rationale for how to best manage patients. This article reflects the common questions that arise from referring neurologists regarding my personal approach to the management of patients with multiple sclerosis.
KEYWORDS
Multiple sclerosis - immunotherapy - demyelinating disease
REFERENCES
- 1 McFarlin D E, McFarland H F. Multiple sclerosis. N Engl J Med . 1982; 307 1183-1252
- 2 Rudick R A, Cohen J A, Guttman-Weinstock B. Management of multiple sclerosis. New Engl J Med . 1997; 337 1604-1611
- 3 Goodin D S, Frohman E M, Garmany G P. Disease modifying therapies in multiple sclerosis. Neurology . 2002; 58 169-178
- 4 Lublin F D, Reingold S C. Defining the clinical course of multiple sclerosis: results of an international survey. Ann Neurol . 1996; 46 907-911
- 5 Weinshenker B G, Bass B, Rice G PA. The natural history of multiple sclerosis: a geographic based study. I. Clinical course and disability. Brain . 1989; 112 133-146
- 6 Weinshenker B G, Bass B, Rice G PA. The natural history of multiple sclerosis: a geographically based study. II. Predictive value of the early clinical course. Brain . 1989; 112 1419-1428
- 7 Khoury S J, Guttman C RG, Orav E J. Longitudinal MRI in multiple sclerosis: correlation between disability and lesion burden. Neurology . 1994; 44 2120-2124
- 8 Beck R, for the Optic Neuritis Study Group. The 5-year risk of MS after optic neuritis. Experience of the Optic Neuritis Treatment Trial. Neurology . 1997; 49 1404-1413
- 9 Miller D H, Ormerod I EC, Rudge P, Kendall R E, Moseley I F, McDonald W I. The early risk of multiple sclerosis following isolated acute syndromes of the brainstem and spinal cord. Ann Neurology . 1989; 26 635-639
- 10 Paolino E, Fainardi E, Ruppi P. A prospective study on the predictive value of CSF oligoclonal bands and MRI in acute isolated neurological syndromes for subsequent progression to multiple sclerosis. J Neurol Neurosurg Psych . 1996; 60 572-575
- 11 Filippi M, Horsfield M A, Morrissey S P. Quantitative brain MRI lesion load predicts the course of clinically isolated syndromes suggestive of multiple sclerosis. Neurology . 1994; 44 635-641
- 12 McDonald W I, Compston A, Edan G. Recommended diagnostic criteria for multiple sclerosis: guidelines from the international panel on the diagnosis of multiple sclerosis. Ann Neurol . 2001; 50 121-127
- 13 The IFNB Multiple Sclerosis Study Group. Interferon beta-1b is effective in relapsing remitting multiple sclerosis. I. Clinical results of a multi-center, randomized, double-blinded, placebo-controlled trial. Neurology . 1993; 43 665-661
- 14 Lublin F D, Whitaker J N, Eidelman B H, Miller A E, Arnason B GW, Burks J S. Management of patients receiving interferon beta-1b for multiple sclerosis: report of a consensus conference. Neurology . 1996; 46 12-18
- 15 Jacobs L D, Cookfair D L, Rudick R A. Intramuscular interferon beta-1a for disease progression in relapsing multiple sclerosis. Ann Neurol . 1996; 39 285-294
- 16 The PRISMS study group. PRISMS-4: long-term efficacy of interferon-beta-1a in relapsing MS. Neurology . 2001; 56 1628-1636
- 17 Rice G. The significance of neutralizing antibodies in patients with multiple sclerosis treated with interferon beta. Neurology . 2001; 58 1297-1298
- 18 Johnson K P, Brooks B R, Cohen J A. Copolymer 1 reduces relapse rate and improves disability in relapsing-remitting multiple sclerosis: results of phase III multicenter, double-blind, placebo-controlled trial. Neurology . 1995; 45 1268-1276
- 19 Millefiorini E, Gasperini C, Pozzilli C. Randomized placebo-controlled trial of mitoxantrone in relapsing-remitting multiple sclerosis: 24-month clinical and MRI outcome. J Neurol . 1997; 244 153-159
- 20 Jacobs L D, Beck R W, Simon J H. Intramuscular interferon Beta-1a therapy initiated during a first demyelinating event in multiple sclerosis. NEJM . 2000; 343 898-904
- 21 European Study Group on Interferon-beta-1b in secondary progressive MS. Placebo-controlled multicentre randomized trial of interferon B-1b in treatment of secondary progressive multiple sclerosis. Lancet . 1998; 352 1491-1497