Alphabet Soup: A Personal, Evolving, Mostly Evidence-Based and Logical, Sequential Approach to the

David H. Mattson

doi:10.1055/s-2002-33045

Seminars in Neurology, Table of Contents

Semin Neurol 2002; 22(1): 017-026
DOI: 10.1055/s-2002-33045

Alphabet Soup: A Personal, Evolving, Mostly Evidence-Based and Logical, Sequential Approach to the "ABCNR" Drugs in Multiple Sclerosis

David H. Mattson

Professor of Neurology, Director, Neuroimmunology and MS Section, Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana

Abstract

ABSTRACT

With the development of multiple options for immunotherapy in multiple sclerosis, the clinician is faced with the challenge of keeping pace with the literature, acquiring familiarity with the various treatment options and opinions, and then offering the patients the most current and appropriate management. Given the inherent nature of a multifocal and unpredictable disease such as multiple sclerosis, along with the availability of multiple treatment options, it behooves the clinician to develop an evidence-based rationale for how to best manage patients. This article reflects the common questions that arise from referring neurologists regarding my personal approach to the management of patients with multiple sclerosis.

KEYWORDS

Multiple sclerosis - immunotherapy - demyelinating disease

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References

REFERENCES

1 McFarlin D E, McFarland H F. Multiple sclerosis. N Engl J Med . 1982; 307 1183-1252
2 Rudick R A, Cohen J A, Guttman-Weinstock B. Management of multiple sclerosis. New Engl J Med . 1997; 337 1604-1611
3 Goodin D S, Frohman E M, Garmany G P. Disease modifying therapies in multiple sclerosis. Neurology . 2002; 58 169-178
4 Lublin F D, Reingold S C. Defining the clinical course of multiple sclerosis: results of an international survey. Ann Neurol . 1996; 46 907-911
5 Weinshenker B G, Bass B, Rice G PA. The natural history of multiple sclerosis: a geographic based study. I. Clinical course and disability. Brain . 1989; 112 133-146
6 Weinshenker B G, Bass B, Rice G PA. The natural history of multiple sclerosis: a geographically based study. II. Predictive value of the early clinical course. Brain . 1989; 112 1419-1428
7 Khoury S J, Guttman C RG, Orav E J. Longitudinal MRI in multiple sclerosis: correlation between disability and lesion burden. Neurology . 1994; 44 2120-2124
8 Beck R, for the Optic Neuritis Study Group. The 5-year risk of MS after optic neuritis. Experience of the Optic Neuritis Treatment Trial. Neurology . 1997; 49 1404-1413
9 Miller D H, Ormerod I EC, Rudge P, Kendall R E, Moseley I F, McDonald W I. The early risk of multiple sclerosis following isolated acute syndromes of the brainstem and spinal cord. Ann Neurology . 1989; 26 635-639
10 Paolino E, Fainardi E, Ruppi P. A prospective study on the predictive value of CSF oligoclonal bands and MRI in acute isolated neurological syndromes for subsequent progression to multiple sclerosis. J Neurol Neurosurg Psych . 1996; 60 572-575
11 Filippi M, Horsfield M A, Morrissey S P. Quantitative brain MRI lesion load predicts the course of clinically isolated syndromes suggestive of multiple sclerosis. Neurology . 1994; 44 635-641
12 McDonald W I, Compston A, Edan G. Recommended diagnostic criteria for multiple sclerosis: guidelines from the international panel on the diagnosis of multiple sclerosis. Ann Neurol . 2001; 50 121-127
13 The IFNB Multiple Sclerosis Study Group. Interferon beta-1b is effective in relapsing remitting multiple sclerosis. I. Clinical results of a multi-center, randomized, double-blinded, placebo-controlled trial. Neurology . 1993; 43 665-661
14 Lublin F D, Whitaker J N, Eidelman B H, Miller A E, Arnason B GW, Burks J S. Management of patients receiving interferon beta-1b for multiple sclerosis: report of a consensus conference. Neurology . 1996; 46 12-18
15 Jacobs L D, Cookfair D L, Rudick R A. Intramuscular interferon beta-1a for disease progression in relapsing multiple sclerosis. Ann Neurol . 1996; 39 285-294
16 The PRISMS study group. PRISMS-4: long-term efficacy of interferon-beta-1a in relapsing MS. Neurology . 2001; 56 1628-1636
17 Rice G. The significance of neutralizing antibodies in patients with multiple sclerosis treated with interferon beta. Neurology . 2001; 58 1297-1298
18 Johnson K P, Brooks B R, Cohen J A. Copolymer 1 reduces relapse rate and improves disability in relapsing-remitting multiple sclerosis: results of phase III multicenter, double-blind, placebo-controlled trial. Neurology . 1995; 45 1268-1276
19 Millefiorini E, Gasperini C, Pozzilli C. Randomized placebo-controlled trial of mitoxantrone in relapsing-remitting multiple sclerosis: 24-month clinical and MRI outcome. J Neurol . 1997; 244 153-159
20 Jacobs L D, Beck R W, Simon J H. Intramuscular interferon Beta-1a therapy initiated during a first demyelinating event in multiple sclerosis. NEJM . 2000; 343 898-904
21 European Study Group on Interferon-beta-1b in secondary progressive MS. Placebo-controlled multicentre randomized trial of interferon B-1b in treatment of secondary progressive multiple sclerosis. Lancet . 1998; 352 1491-1497