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Neurological Review
March 1999

Multiple Sclerosis: Therapeutic Update

Author Affiliations

From the Department of Neurology, Division of Neuroimmunology, Wayne State University School of Medicine, Detroit Medical Center, Detroit, Mich.



Arch Neurol. 1999;56(3):277-280. doi:10.1001/archneur.56.3.277

Therapy for multiple sclerosis (MS) is undergoing rapid changes. We discuss recent developments in the therapy of MS, failures as well as successes, and consider some newer approaches. Multiple sclerosis, a multifocal, initially remitting-relapsing, and in some cases primarily progressive, inflammatory central nervous system immune-mediated demyelinating disease, with some axonal involvement, is currently the most common disabling neurologic disease of young people in North America and Europe. Although much is known about the pathogenesis, there is no cure and the disease must be managed long-term. Recently, there have been a number of advances in the treatment of MS.

There are several dimensions to the therapy of MS: treatment of the underlying disease (treatment of relapses, prevention or modulation of relapses, and prevention of progression) and treatment of the effects of the disease (treatment of symptoms and provision of support). Since there is limited information available about what determines the tempo of the underlying disease, advances in the prevention of relapses and progression have been few, and most have occurred recently. Given that there are a series of pathogenetic steps in the formation of an inflammatory demyelinating plaque, there are several approaches to treating and preventing relapses. We concentrate on the therapy of the underlying disease in this article rather than symptom management.