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J Clin Neurosci. 2014 Nov;21(11):1847-56. doi: 10.1016/j.jocn.2014.01.018. Epub 2014 Jun 28.

Therapeutic approaches to disease modifying therapy for multiple sclerosis in adults: an Australian and New Zealand perspective: part 2 new and emerging therapies and their efficacy. MS Neurology Group of the Australian and New Zealand Association of Neurologists.

Author information

1
School of Medicine, Griffith University, Gold Coast Campus, QLD 4222, Australia; Department of Neurology, Gold Coast University Hospital, Southport, QLD, Australia. Electronic address: simon.broadley@griffith.edu.au.
2
Brain and Mind Research Institute, University of Sydney, Camperdown, NSW, Australia.
3
Department of Neurology, The Townsville Hospital, Douglas, QLD, Australia.
4
Department of Neurology and St Vincent's Centre for Applied Medical Research, St Vincent's Hospital, University of New South Wales, Darlinghurst, NSW, Australia.
5
Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia; Department of Neurology, Eastern Health and Monash University, 2/5 Arnold Street, Box Hill VIC 3128, Australia.
6
Westmead Clinical School, University of Sydney, NSW, Australia.
7
South Western Sydney Clinical School, University of New South Wales, NSW, Australia.
8
Centre for Neuromuscular and Neurological Disorders, University of Western Australia, WA, Australia; Institute of Immunology and Infectious Diseases, Murdoch University, WA, Australia.
9
Hunter Medical Research Institute, The University of Newcastle, New Lambton, NSW, Australia.
10
Department of Neurology, Austin Health, Heidelberg, VIC, Australia.
11
Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia.
12
Department of Neurology, Christchurch Hospital, Christchurch, New Zealand.
13
Central Clinical School, University of Sydney, NSW, Australia.
14
School of Medicine, Deakin University, VIC, Australia.
15
Flinders Medical Centre, Flinders University, SA, Australia.
16
Menzies Research Institute, University of Tasmania, TAS, Australia.
17
Centre for Neuromuscular and Neurological Disorders, University of Western Australia, WA, Australia.
18
Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia.
19
University of Queensland Centre for Clinical Research, QLD, Australia.
20
Department of Neurology, Auckland City Hospital, Auckland, New Zealand.

Abstract

In Part 2 of this three part review of multiple sclerosis (MS) treatment with a particular focus on the Australian and New Zealand perspective, we review the newer therapies that have recently become available and emerging therapies that have now completed phase III clinical trial programs. We go on to compare the relative efficacies of these newer and emerging therapies alongside the existing therapies. The effectiveness of β-interferon in the treatment of different stages and the different disease courses of MS is critically reviewed with the conclusion that the absolute level of response in term of annualised relapse rates (where relapses occur) and MRI activity are similar, but are disappointing in terms of sustained disability progression for progressive forms of the disease. Finally we review the controversial area of combination therapy for MS. Whilst it remains the case that we have no cure or means of preventing MS, we do have a range of effective therapies that when used appropriately and early in the disease course can have a significant impact on short term and longer term outcomes.

KEYWORDS:

Evidence-based medicine; Guideline; Multiple sclerosis; Review; Treatment

PMID:
24986155
DOI:
10.1016/j.jocn.2014.01.018
[Indexed for MEDLINE]

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