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      New approaches in the management of multiple sclerosis

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          Abstract

          Multiple sclerosis (MS) is a central nervous system chronic inflammatory disease that is characterized by an extensive and complex immune response. Scientific advances have occurred in immunology, pathophysiology, and diagnostic and clinical assessment tools, and recent discovery of unique therapeutic targets has spurred numerous Phase II and Phase III clinical trials. Reductions in MS relapse rates and improvements in T 2 or gadolinium-enhancing lesion burdens have been reported from Phase III trials that include fingolimod, alemtuzumab, cladribine, and rituximab. Promising Phase II trial data exist for teriflunomide, daclizumab, laquinimod, and fumarate. The optimism created by these favorable findings must be tempered with evaluation of the adverse effect profile produced by these new agents. Given the discovery of progressive multifocal leukoencephalopathy with the use of natalizumab, ongoing vigilance for rare and life-threatening reactions due to new agents should be paramount. Patients with MS often experience difficulty with ambulation, spasticity, and cognition. Recent clinical trial data from two Phase III dalfampridine-SR trials indicate certain patients receive benefits in ambulation. This article provides an overview of data from clinical trials of newer agents of potential benefit in MS.

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          Author and article information

          Journal
          Drug Des Devel Ther
          Drug Design, Development and Therapy
          Drug Design, Development and Therapy
          Dove Medical Press
          1177-8881
          2010
          24 November 2010
          : 4
          : 343-366
          Affiliations
          [1 ] The University of Montana and Community Medical Center, Missoula, MT, USA;
          [2 ] The University of Montana School of Pharmacy, Missoula, MT, USA
          Author notes
          Correspondence: Douglas R Allington, The University of Montana and Community Medical Center, Missoula, MT, USA, Email douglas.allington@ 123456umontana.edu
          Article
          dddt-4-343
          10.2147/DDDT.S9331
          2998807
          21151622
          © 2010 Barten et al, publisher and licensee Dove Medical Press Ltd.

          This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

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