Pharmacotherapy of multiple sclerosis: current status

Rudick, Richard A.; Goodkin, Donald E.; Ransohoff, Richard M.

doi:10.3949/ccjm.59.3.267

Cited by 17 publications

(5 citation statements)

References 45 publications

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“…In retrospect, the contemporary literature clearly illustrates how little was known about MS at the time. A definitive contemporary review noted vaguely: “epidemiological data suggest an aetiological role for both genetic and environmental factors in MS, but these have yet to be fully characterized.” 5 A summary of treatment options stated simply that “therapies directed at altering the natural history of the underlying disease process … are controversial or experimental.” 6 We now survey a changed landscape: names have been assigned to major environmental risk factors and genetic susceptibility determinants. Gene–environment interactions have become apparent.…”

Section: Introductionmentioning

confidence: 99%

Multiple sclerosis—a quiet revolution

Ransohoff¹,

Hafler²,

Lucchinetti³

2015

Nat Rev Neurol

306

217

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Multiple sclerosis (MS) has been thought to be a complex and indecipherable disease, and poorly understood with regards to aetiology. Here, we suggest an emphatically positive view of progress over several decades in the understanding and treatment of MS, particularly focusing on advances made within the past 20 years. As with virtually all complex disorders, MS is caused by the interaction of genetic and environmental factors. In recent years, formidable biochemical, bioinformatic, epidemiological and neuroimaging tools have been brought to bear on research into the causes of MS. While susceptibility to the disease is now relatively well accounted for, disease course is not and remains a salient challenge. In the therapeutic realm, numerous agents have become available, reflecting the fact that the disease can be attacked successfully at many levels and using varied strategies. Tailoring therapies to individuals, risk mitigation and selection of first-line as compared with second-line medications remain to be completed. In our view, the MS landscape has been comprehensively and irreversibly transformed by this progress. Here we focus on MS therapeutics—the most meaningful outcome of research efforts.

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Section: Introductionmentioning

confidence: 99%

Multiple sclerosis—a quiet revolution

Ransohoff¹,

Hafler²,

Lucchinetti³

2015

Nat Rev Neurol

306

217

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“…However, the effects of steroids are usu-course into the chronic progressive type (Roally transient and diminish with repeated use so lak, 1996). that patients may eventually reach a stage of steroid unresponsiveness (Rudick et al, 1992). ^,, .…”

Section: Treatment With Emfs As a Novel Therapeutic Modality In Multimentioning

confidence: 99%

II. Therapeutic Effects of Alternating Current Pulsed Electromagnetic Fields in Multiple Sclerosis

Sandyk

1997

The Journal of Alternative and Complementary Medicine

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Multiple sclerosis is the third most common cause of severe disability in patients between the ages of 15 and 50 years. The cause of the disease and its pathogenesis remain unknown. The last 20 years have seen only meager advances in the development of effective treatments for the disease. No specific treatment modality can cure the disease or alter its long-term course and eventual outcome. Moreover, there are no agents or treatments that will restore premorbid neuronal function. A host of biological phenomena associated with the disease involving interactions among genetic, environmental, immunologic, and hormonal factors, cannot be explained on the basis of demyelination alone and therefore require refocusing attention on alternative explanations, one of which implicates the pineal gland as pivotal. The pineal gland functions as a magnetoreceptor organ. This biological property of the gland provided the impetus for the development of a novel and highly effective therapeutic modality, which involves transcranial applications of alternating current (AC) pulsed electromagnetic fields in the picotesla flux density. This review summarizes recent clinical work on the effects of transcranially applied pulsed electromagnetic fields for the symptomatic treatment of the disease.

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“…Für die Behandlung der Blasenentleerungsstörungen steht eine Reihe von Möglichkeiten medikamentöser Art mit tolerablen Nebenwirkungen, aber auch interventionelle Maßnahmen zur Verfügung (20, 39,59,83,97,98,101). Diese sollen erörtert werden, insbesondere nachdem festgestellt wurde (79), daß "nur wenige Ärzte an dem Problem der Versorgung und Behandlung der Inkontinenz bei alters-und krankheitsbedingten Hirnleistungsstörungen interessiert" bzw.…”

Section: Periphere Innervationunclassified

“…Bei Patienten mit neurogen bedingter ineffektiver Miktion treten bei höheren Restharnmengen häufiger Harnwegsinfekte auf (33,39,40,97 Prolonged bladder distension in the management of the unstable bladder.1. Uro!.…”

Section: Harnwegsiofekte -----------unclassified

Blasenentleerungsstörungen bei Encephalomyelitis disseminata - medikamentöse und interventionelle Therapieoptionen

Zwergel

Jost²,

Lindenmeir³

et al. 1995

Fortschr Neurol Psychiatr

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Patients with disseminated encephalomyelitis have various urological presentations, ranging from pollakisuria to urge incontinence. After detailed evaluation (neuro-urological examination, urodynamic investigation) drug therapy and various interventional methods must be adapted to the individual manifestations. Patients with detrusor hyperreflexia are treated with oral anticholinergic agents (oxybutynin, trospium chloride, propiverine). Patients with urinary retention are recommended to be managed with clean intermittent (self)-catheterisation. The various interventional therapeutic options (bladder denervation, electrostimulation, local treatment with botulinum toxin) and the surgical therapy (sacral deafferentation and anterior root stimulation, bladder neck closure and cystostomy, sphincterotomy or augmentation cystoplasty) must be reserved for special cases.

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Pharmacotherapy of multiple sclerosis: current status

Cited by 17 publications

References 45 publications

Multiple sclerosis—a quiet revolution

Multiple sclerosis—a quiet revolution

II. Therapeutic Effects of Alternating Current Pulsed Electromagnetic Fields in Multiple Sclerosis

Blasenentleerungsstörungen bei Encephalomyelitis disseminata - medikamentöse und interventionelle Therapieoptionen

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