New outlook for the treatment of secondary progressive multiple sclerosis

Klinika Neurologii z Pododdziałem Leczenia Udaru Mózgu, Kliniczny Szpital Wojewódzki nr 2 w Rzeszowie, Polska. Kierownik Kliniki: prof. dr hab. n. med. Halina Bartosik-Psujek
Adres do korespondencji: Kliniczny Szpital Wojewódzki nr 2 im. Św. Królowej Jadwigi, ul. Lwowska 60, 35-301 Rzeszów, tel.: +48 17 866 45 06, e-mail: m-lenkan@wp.pl

Aktualn Neurol 2015, 15 (3), p. 130–134
DOI: 10.15557/AN.2015.0018
ABSTRACT

Multiple sclerosis is a chronic autoimmune disease of the central nervous system which has an unknown origin and variable course. In about 85% of cases it starts as the relapsing-remitting form that, in different periods of time depending on the patient, turns into the secondary progressive form with constant progression of disability, sometimes with preserved relapse and magnetic resonance imaging activity at the beginning. The treatment options for the secondary progressive form of multiple sclerosis are still limited. Based on the results of Mitoxantrone in Multiple Sclerosis Study, mitoxantrone has been registered for the treatment of secondary progressive multiple sclerosis. In addition, the drugs that have received registration in Europe are interferon beta-1b and interferon beta-1a given subcutaneously. These drugs have a proven effect in slowing the progression of disability (interferon beta-1b, mitoxantrone) as well as reducing the annualised relapse rate (interferon beta-1b, interferon beta-1a, mitoxantrone) and the number of new outbreaks in magnetic resonance imaging (interferon beta-1a, interferon beta-1b). The study of North American Study Group on Interferon β-1b in Secondary Progressive MS showed no effect of the therapy with interferon beta-1b on the inhibition of disability progression and as a result, the drug has not obtained registration for the treatment of secondary progressive multiple sclerosis in the United States. The patients who benefit most from the therapy which modifies the course of the progressive form of multiple sclerosis are younger, with a shorter history of the disease, preserved relapse activity and rapidly increasing disability.

Keywords: multiple sclerosis, immunosuppression, mitoxantrone, interferon beta-1a, interferon beta-1b