Immunmodulierende Therapiestrategien bei der multiplen Sklerose: Übersicht und aktueller Stand klinischer Studien

Zusammenfassung

Die Therapie der multiplen Sklerose (MS) hat sich über die letzten Jahre dramatisch verändert. Neue Erkenntnisse über die Pathogenese und die Entwicklung neuer pathogenetischer Konzepte haben zusammen mit Verbesserungen bei der Durchführung klinischer Studien und der Magnetresonanztomographie zu einem deutlichen Fortschritt der Behandlung der MS geführt. Immunmodulierende Medikamente wie Interferon-β, Glatiramerazetat und - seit kurzem - Mitoxantron haben eine Effektivität in randomisierten, doppelgeblindeten, plazebokontrollierten Phase-III-Studien gezeigt. Dieser Artikel gibt eine Übersicht über die wichtigsten klinischen Studien der derzeit verfügbaren immunmodulierenden und immunsuppressiven Substanzen in der Behandlung der MS unter besonderer Berücksichtigung der Empfehlungen der trinationalen deutschsprachigen Multiple-Sklerose-Therapie-Konsensus-Gruppe.

Abstract

The therapeutic approach to multiple sclerosis (MS) has changed dramatically over the past decade. Novel insights in the pathogenesis and development of pathophysiological concepts together with improvements in clinical trial design and magnetic resonance imaging have led to significant advances in the management of MS through a variety of immunomodulatory therapies. Interferons, glatiramer acetate and - recently - mitoxantrone showed effectiveness in the treatment of MS in randomized, double-blind, placebo-controlled phase III trials. This review analyses the most important clinical trials with the currently available immunomodulatory and immunosuppressive treatments considering the recommendations of the German/Austrian/Swiss Multiple Sclerosis Therapy Consensus Group.

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