Relapsing-remitting MS

Efficacy Patients with relapsing remitting MS A meta-analysis of all beta interferons determined that treated patients were 27% and 19% less likely to have a relapse during the first and second years of treatment, respectively, than those who had... 

Betaseron (rIFN-P-lb, differs from Berlex Laboratories and Relapsing-remitting MS... 

Rebif (tradename) is an rIFN-P-la first approved for medical use in the EU in 1998 and subsequently in the USA in 2002. It is indicated for the treatment of patients with relapsing-remitting MS, to decrease the frequency of clinical exacerbations and delay the accumulation of physical disability. 

Opinions vary on when to initiate treatment with interferon-p. According to the National Multiple Sclerosis Society, these agents should be considered in patients with relapsing-remitting MS who have had recent relapses. Some neurologists delay treatment until there is a more prolonged history of recurrent relapses, because, in their experience, patients may have a benign early course. 

Borras C, Rio J, Porcel J, Barrios M, Tintore M, Montalban X. Emotional state of patients with relapsing-remitting MS treated with interferon beta-lb. Neurology 1999 52(8) 1636-9. 

The FDA approved therapy for relapsing remitting MS with the smallest % reduction in relapses at 12 months by the Johnson Class I data... 

Tills approved therapy for relapsing remitting MS included a warning to monitor depression because of a suicide duiing the phase III tiial. 

Cytokines themselves may also be used for MS therapy. IFN-P has been in clinical nse as an immunomodulatory drug for the treatment of MS for more than 10 years. Administration of IFN-P decreases the relapse rates and new MRI lesions in patients with relapsing/remitting MS (The IFN-p Multiple Sclerosis Study Group, 1993) or delay disease progression in patients with secondary progressive MS (Jacobs et al., 1996 ... 

Rio J (1998) Low-dose steroids reduce flu-like symptoms at the initiation of lEN beta-lb in relapsing remitting MS. Neurology 50(6) 1910-1912. 

Zivadinov R, Rudick RA, De Masi R, et al. Effects of IV methylpred-nisolone on brain atrophy in relapsing-remitting MS. Nemology 2001 57 1239-1247. 

Betaseron (rIFN-j81b, differs from human protein in that Cysl7 is replaced by Ser produced in E. coli) Berlex Laboratories and Chiron relapsing/remitting MS 1993 (US)... 

Rebif (rh IFN- la produced in CHO cells) Ares-Serono relapsing/remitting MS 1998 (EU), 2002 (US)... 

Glatiramer is an immunosuppressive agent that modifies the immune processes thought to be responsible for multiple sclerosis (MS). It is indicated in reducing the frequency of relapses in patients with relapsing-remitting MS. 

IFN, interferon IM, intramuscularly RRMS, relapsing-remitting MS SC, subcutaneously SPMS, secondary progressive MS IV, intravenously. Gd, gadolinium, used in Gd-enhanced MRI to assess number and size of inflammatory brain lesions EDSS, Expanded Disability Status Scale, a neurologic assessment scale for MS pathology MMP, matrix... 

GA, administered subcutaneously to patients with relapsing-remitting MS, decreased the rate of exacerbations by -30%. In vivo administration of GA induces highly cross-reactive CD4+ T cells that are immune-deviated to secrete Th2 cytokines and prevents the appearance of new lesions detectable by MRI. This represents one of the first successful uses of an agent that ameliorates autoimmune disease by altering signals through the T-ceU receptor complex. 

Correale J, Rush C, Amengual A, et al. Mitoxantrone as rescue therapy in worsening relapsing-remitting MS patients receiving IFN-(3. J Neuroimmunol 2005 162 173-183. 

A 23-year-old man with ethanol abuse, brain injury and diagnosed with relapsing-remitting MS was treated with natalizumab for 39 months before treatment was interrupted when he was hospitalised with pneumonia. MRI and PCR for cerebrospinal fluid JC virus showed findings consistent with PML-IRIS. It was concluded that new enhancing white matter lesions can be manifestations of PML-IRIS rather than MS exacerbation and H-MRS may help clinicians determine the need for corticosteroids and anticipate continuing recovery of patients with PML-IRIS... 

In a case report, a 52-year-old man with psoriasis and relapsing-remitting MS developed an injection site cutaneous necrosis that involved both subcutaneous and muscular tissue with massive oedema 21 months after GA treatment. Three days later he developed radial nerve palsy. After a few days another similar lesion appeared at another injection site [26 ]. 

In a randomised, double-blind, placebo-controlled trial comparing GA 40 mg administered 3 times weekly with placebo in patients with relapsing-remitting MS, the most common adverse events in the GA group were injection site reactions (35.5%) [27 ]. 

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