Multiple sclerosis secondary-progressive

States, Canada, and Europe. The Food and Drug Administration has also approved Novantrone, a cytotoxic agent with associated anti-inflammatory activities, for the treatment of patients with secondary progressive multiple sclerosis based on a phase III trial that provided clinical and MRI evidence of reduced disease activity. 

G. Other applications Treatment with interferon beta-lb has demonstrated therapeutic effect in patients with secondary progressive multiple sclerosis by delaying sustained neurological deterioration. It may also be effective in the treatment of Kaposi s sarcoma and malignant glioma. 

Karussis DM, et al. (1996) Treatment of secondary progressive multiple sclerosis with the immunomodulator linomide a double-blind, placebo-controlled pilot study with monthly magnetic resonance imaging evaluation. Neurology 47(2) 341-346... 

Lindberg RL, DeGroot CJ, Certa U, Raviol T, Hoffmann F, Kappos L, Leppert D (2004) Multiple sclerosis as a generalized CNS disease—comparadvemicroarTay analysis of normal appearing white matter and lesions in secondary progressive multiple sclerosis. J Neuroimmunol 152 154—167. 

Interferon beta is used in the form of natural fibroblast or recombinant preparations (interferon beta-la and interferon beta-lb) and exerts antiviral and antiproliferative properties similar to those of interferon alfa. Although its efficacy has been debated (1), interferon beta has been approved for the treatment of relapsing-remitting multiple sclerosis, and more recently for secondary progressive multiple sclerosis. 

European Study Group on Interferon Beta-lb in Secondary Progressive MS. Placebo-controlled multicentre randomised trial of interferon beta-lb in treatment of secondary progressive multiple sclerosis. Lancet 1998 352(9139) 1491-7. 

Dubois B, D Hooghe MB, De Lepeleire K, Ketelaer P, Opdenakker G, Carton H. Toxicity in a double-blind, placebo-controlled pilot trial with D-penicillamine and meta-cycline in secondary progressive multiple sclerosis. Mult Scler 1998 4(2) 74-8. 

Kappos L, Weinshenker B, Pozzilli C, Thompson AJ, Dahike F, Beckmann K, Polman C, McFarland H, and for the European and North American Interferon beta-lb in Secondary Progressive Multiple Sclerosis Trial Steering Committees and Independent Advisory Boards. Interferon beta-1 b in secondary progressive MS A combined analysis of the two trials. Neurology 63 1779-1787, 2004. 

Forbes, R. Lees, A. Waugh, N. Swingler, R. Population based cost utility study of interferon beta-lb in secondary progressive multiple sclerosis. Br. Med. J. 1999. 319 (7224), 1529-1533. 

SPMS secondary-progressive multiple sclerosis SSPE subacute sclerosing panencephalitis TGF-/S transforming growth factor /3 TLI total lymphoid irradiation TNF-a tumor necrosis factor alpha WHO World Health Organization... 

Mitoxantrone (Novantrone) is supplied for intravenous infusion. To induce remission in acute nonlymphocytic leukemia in adults, the drug is given in a daily dose of 12 mg/m for 3 days as a component of a regimen that also includes cytosine arabinoside. Mitoxantrone also is used in advanced hormone-resistant prostate cancer in a dose of 12 to 14 mg/m every 21 days. Mitoxantrone has been approved by the FDA for the treatment of late-stage, secondary progressive multiple sclerosis. 

Gl. Galboiz, Y., Shapiro, S., Lahat, N., Rawashdeh, H., and Miller, A., Matrix metalloproteinases and their tissue inhibitors as markers of disease subtype and response to interferon-beta therapy in relapsing and secondary-progressive multiple sclerosis patients. Ann. Neurol. 50, 443-451 (2001). 

Sorensen TL, Sellebjerg F (2001) Distinct chemokine receptor and cytokine expression profile in secondary progressive MS. Neurology 57 1371-1376 Sorensen TL, Tani M, Jensen J, Pierce V, Lucchinetti C, Folcik VA, Qin S, Rottman J, Sellebjerg F, Strieter RM, Frederiksen JL, Ransohoff RM (1999) Expression of specific chemokines and chemokine receptors in the central nervous system of multiple sclerosis patients. J Clin Invest 103 807-815... 

The clinical course of multiple sclerosis has been described in four basic patterns relapsing remitting, secondary progressive, primary progressive, and progressive relapsing. 

In contrast to T cells, in different immunopathologies, the brain provides a fostering envkonment to B cells. Primary central nervous system (CNS) lymphomas are usually of B cell origin. The cerebrospinal fluid (CSF) of patients with chronic infections and autoimmune diseases of the CNS typically contains remarkably stable oligoclonal Ig bands. In the CNS of multiple sclerosis patients, clonally expanded B cells and plasma cells persist. Ectopic B cell follicles develop in the meninges of patients with secondary progressive MS, and B cell differentiation may be recapitulated in the CNS of MS patients (Krumbholz et al., 2006) (see Chapters 18-24). 

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 ... 

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