New and Emerging Disease-Modifying Therapies for Relapsing-Remitting Multiple Sclerosis: What is New and What is to Come

Abstract

The therapeutic landscape for multiple sclerosis (MS) is rapidly changing. Currently, there are eight FDA approved disease modifying therapies for MS including: IFN-β-1a (Avonex, Rebif), IFN-β-1b (Betaseron, Extavia), glatiramer acetate (Copaxone), mitoxantrone (Novantrone), natalizumab (Tysabri), and fingolimod (Gilenya). This review will highlight the experience to date and key clinical trials of the newest FDA approved agents, natalizumab and fingolimod. It will also review available efficacy and safety data on several promising therapies under active investigation including four monoclonal antibody therapies: alemtuzumab, daclizumab, ocrelizumab and ofatumumab and three oral agents: BG12, laquinimod, and teriflunomide. To conclude, we will discuss where each of these new therapies may best fit into treatment algorithms.

The Antipsoriatic Agent Monomethylfumarate Has Antiproliferative, Prodifferentiative, and Anti-Inflammatory Effects on Keratinocytes

“…These data also suggest that MMF may be effective for treating other hyperproliferative skin disorders. In addition, a drug containing DMF as its major ingredient, Tecfidera or BG-12 (Ruggieri et al, 2014) is currently available on the US market for the treatment of multiple sclerosis (Nicholas et al, 2012;Salmen and Gold, 2014). Thus, our results suggest the possibility of repurposing this already US Food and Drug Administration-approved drug for the benefit of psoriatic patients.…”

Critical Appraisal of Effectiveness of Oral Fingolimod on Relapsing Multiple Sclerosis

“…This review revealed there were some side effects from administering fingolimod, such as bradycardia, first or second heart block, macular edema, increased serum alanine aminotransferase (ALT), lymphopenia, and infection. Most of those side effects were infrequent and resolved with discontinuation of fingolimod (Nicholas et al, 2012).…”

Clinical recommendations on the use of alemtuzumab (lemtrada)

“…Данные результаты послужили основанием для регистрации препарата алемтузумаб для лечения взрослых пациентов с РРС с активным по клиническим и нейровизуализационным параметрам. В настоящее время место алемтузумаба в терапевтическом алгоритме РС определяется поразному [16][17][18]. Согласно рекомендациям ЕМА препарат показан для лечения взрослых пациентов с РРС с признаками активности заболевания, определяемыми на основании клинической картины и данных нейровизуализационных исследований.…”