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New disease-modifying therapies and new challenges for MS.
Curr Neurol Neurosci Rep 2012; 12(5):489-91CN

Abstract

The availability of the second-generation therapies for relapsing multiple sclerosis (MS), natalizumab and fingolimod, provides new treatment options for MS but also presents new challenges. Both natalizumab and fingolimod appear to be more effective than the interferon beta products and glatiramer acetate, but both have more safety problems than do the first-generation therapies. Treatment with natalizumab is associated with a significant risk of patients developing progressive multifocal leukoencephalopathy (PML), which the JC virus causes. We now are able to risk stratify MS patients into high- and low-risk groups for developing PML on the basis of the presence or absence of antibodies to the JC virus, history of prior use of immunosuppressants, and duration of therapy with natalizumab. Fingolimod appears to be associated with a risk of asystole and sudden death. It may also increase the risk of serious herpes infections and paradoxical activation of MS. More information is needed about these serious side effects from fingolimod to allow us to use it safely in patients.

Authors+Show Affiliations

Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, L226, Portland, OR 97239, USA. yadavv@ohsu.eduNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22760478

Citation

Yadav, Vijayshree, and Dennis Bourdette. "New Disease-modifying Therapies and New Challenges for MS." Current Neurology and Neuroscience Reports, vol. 12, no. 5, 2012, pp. 489-91.
Yadav V, Bourdette D. New disease-modifying therapies and new challenges for MS. Curr Neurol Neurosci Rep. 2012;12(5):489-91.
Yadav, V., & Bourdette, D. (2012). New disease-modifying therapies and new challenges for MS. Current Neurology and Neuroscience Reports, 12(5), pp. 489-91. doi:10.1007/s11910-012-0295-2.
Yadav V, Bourdette D. New Disease-modifying Therapies and New Challenges for MS. Curr Neurol Neurosci Rep. 2012;12(5):489-91. PubMed PMID: 22760478.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - New disease-modifying therapies and new challenges for MS. AU - Yadav,Vijayshree, AU - Bourdette,Dennis, PY - 2012/7/5/entrez PY - 2012/7/5/pubmed PY - 2013/4/4/medline SP - 489 EP - 91 JF - Current neurology and neuroscience reports JO - Curr Neurol Neurosci Rep VL - 12 IS - 5 N2 - The availability of the second-generation therapies for relapsing multiple sclerosis (MS), natalizumab and fingolimod, provides new treatment options for MS but also presents new challenges. Both natalizumab and fingolimod appear to be more effective than the interferon beta products and glatiramer acetate, but both have more safety problems than do the first-generation therapies. Treatment with natalizumab is associated with a significant risk of patients developing progressive multifocal leukoencephalopathy (PML), which the JC virus causes. We now are able to risk stratify MS patients into high- and low-risk groups for developing PML on the basis of the presence or absence of antibodies to the JC virus, history of prior use of immunosuppressants, and duration of therapy with natalizumab. Fingolimod appears to be associated with a risk of asystole and sudden death. It may also increase the risk of serious herpes infections and paradoxical activation of MS. More information is needed about these serious side effects from fingolimod to allow us to use it safely in patients. SN - 1534-6293 UR - https://www.unboundmedicine.com/medline/citation/22760478/New_disease_modifying_therapies_and_new_challenges_for_MS_ L2 - https://dx.doi.org/10.1007/s11910-012-0295-2 DB - PRIME DP - Unbound Medicine ER -