Practical Approach To Immune Therapy In Multiple Sclerosis

Because of the absence of a known specific antigen that triggers an immune response in MS, antigen-specific therapies are unavailable. While these treatment avenues are being explored, however, specific immunotherapies have been developed on the basis of observed efficacy (Box 7.1). None of the immune therapies used in MS has been specifically designed for this indication, and their use is more or less derived from experience in transplantation and cancer therapy and applied on the basis of nonscientific evidence. Immunotherapies using corticos-teroids focused at treating relapses are reviewed in Chapter 6. Here, we focus on immunosuppressors themselves and disease-modifying drugs, such as interferons and glatiramer acetate. Immunosuppressors are themselves subdivided into oral drugs such as azathioprine (Imurel/Imuran) and metho-trexate, and into those used intravenously, such as mitoxantrone (Novantrone®) and cyclophosphamide. Disease-modifying agents include drugs such as interferon-ß and glati-ramer acetate (Copaxone®). We also will discuss the risks and benefits of natalizumab (Tysabri®).

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