Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Neurological Sciences
Erschienen in: Neurological Sciences 2/2009

01.10.2009 | MS Treatment

Treatment of multiple sclerosis: role of natalizumab

verfasst von: Giancarlo Comi

Erschienen in: Neurological Sciences | Sonderheft 2/2009

Einloggen, um Zugang zu erhalten

Abstract

The results on relapse rate and disease progression of available drugs for multiple sclerosis are shown, as well as their most relevant side effects. Results from pivotal and long-term follw-up studies support the efficacy and safety of intererons and glatiramer acetate. The treatment with mitoxantrone is limited by the occurrence of infertility, cardiotoxicy and leukaemia. Efficacy and tolerability of natalizumab are undisputable, compared to other drugs. Risks related to its treatment are PML, opportunistic infections, hepatotoxicity, melanoma, and their occurrence needs to be more exactly assessed by post-marketing surveillance. The principles of induction versus escalating therapy are also discussed. The final therapeutic decision is based on the evaluation of the disease state and prognosis, based on clinical and instrumental measures, and on the safety/efficacy profile of each treatment.
Literatur
1.
The IFNB MS Study Group (1993) Interferon beta 1B is effective in relapsing remitting multiple sclerosis. I. Clinical results of a multicenter, randomized, double-blind, placebo-controlled trial. Neurology 43:655–661
2.
Jacobs LD, Cookfair DL, Rudick RA et al (1996) Intramuscular Interferon beta 1a for disease progression in relapsing multiple sclerosis. Ann Neurol 39:285–294CrossRefPubMed
3.
PRISMS (Prevention of Relapses and Disability by Interferon B-1a Subcutaneously in Multiple Sclerosis) Study Group (1998) Randomised double blind placebo-controlled study of interferon β-1a in relapsing-remitting multiple sclerosis. Lancet 352:1498–1504CrossRef
4.
Johnson KP, Brooks BR, Cohen JA et al (1995) Copolymer 1 reduces relapse rate and improves disability in relapsing-remitting multiple sclerosis: results of the phase III multicenter, double blind, placebo-controlled trial. Neurology 45:1269–1276
5.
Polman CH, O’Connor PW, Havrdova E et al (2006) A randomized, placebo-controlled trial of natalizumab for relapsing multiple sclerosis. N Engl J Med 354:899–910CrossRefPubMed
6.
Rudick RA, Stuart WH, Calabresi PA et al (2006) Natalizumab plus interferon beta-1a for relapsing multiple sclerosis. N Engl J Med 354:911–923CrossRefPubMed
7.
Hartung HP, Gonsette R, Kwiecinski H et al (2002) Mitoxantrone in progressive multiple sclerosis: a placebo-controlled, double-blind, randomized, multicenter trial. Lancet 360:2018–2025CrossRefPubMed
8.
The IFNB Multiple Sclerosis Study Group and The University of British Columbia MS/MRI Analysis Group (1995) Interferon beta-1b in the treatment of multiple sclerosis: final outcome of the randomized controlled trial. Neurology 45:1277–1285
9.
Filippini G, Munari L, Incorvaia B et al (2003) Interferons in relapsing remitting multiple sclerosis: a systematic review. Lancet 361:545–552CrossRefPubMed
10.
Kappos L, Polman CH, Freedman MS et al (2006) Treatment with interferon-1b delays conversion to clinically definite and McDonald MS in patients with clinically isolated syndromes. Neurology 67:1242–1249CrossRefPubMed
11.
The PRISMS Study Group and the University of British Columbia MS/RMI Analysis Group PRISMS-4 (2001) Long-term efficacy of interferon-beta-1a in relapsing MS. Neurology 56:1620
12.
Montalban X. BENEFIT trial results. Presentation at: CONy Second World Congress on Controversies in Neurology, Athens, 25 October, 2008
13.
Millefiorini E, Gasperini C et al (1997) Randomized placebo-controlled trial of mitoxantrone in relapsing-remitting multiple sclerosis: 24 month clinical and MRI outcome. J Neurol 244:153–159CrossRefPubMed
14.
Edan G, Miller D et al (1995) Evaluation of the efficacy of mitoxantrone by use of MRI: a multicenter randomised study in multiple sclerosis. Neurology 242(Suppl 2):S38
15.
Jammohammed R, Milligan DW (1989) Mitoxantrone induced congestive heart failure in patients previously treated with anthracyclines. Br J Haematol 71:292–293CrossRef
16.
Ghalie RG, Mauch E, Edan G, Hartung HP, Gonsette RE, Eisenmann S et al (2002) A study of therapy-related acute leukaemia after mitoxantrone therapy for multiple sclerosis. Mult Scler 8:441–445CrossRefPubMed
17.
Avasarala JR, Cross AH, Clifford DB, Singer BA, Siegel BA, Abbey EE (2003) Rapid onset mitoxantrone-induced cardiotoxicity in secondary progressive multiple sclerosis. Mult Scler 9:59–62CrossRefPubMed
18.
Paul F, Dorr J, Wurfel J, Vogel HP, Zipp F (2007) Early mitoxantrone-induced cardiotoxicity in secondary progressive multiple sclerosis. J Neurol Neurosurg Psychiatry 78:198–200CrossRefPubMed
19.
Ellis R, Boggild M (2009) Therapy-related acute leukaemia with mitoxantrone: what is the risk and can we minimise it? Mult Scler 15:505–508CrossRefPubMed
20.
Martinelli V, Amato M, Bellantonio P, Bergamaschi R, Bertolotto A, Capra R, Cocco E, Gallo P, Ghezzi A, Pozzilli C, Rodegher M, Straffi L, Trojano M, Comi G (2008) Incidence of acute leukaemia in multiple sclerosis patients treated with mitoxantrone. Neurol Sci 29(Suppl):S75
21.
22.
23.
Yednock TA, Cannon C, Fritz LC, Sanchez-Madrid F et al (1992) Prevention of experimental autoimmune encephalomyelitis by antibodies against alpha 4 beta 1 integrin. Nature 356:63–66CrossRefPubMed
24.
Theien BE, Miller DH, Khan OA, Sheremata WA, Blumhardt LD, Rice GP, Libonati MA, Willmer-Hulme AJ, Dalton CM, Miszkiel KA, O’Connor PW (2003) A controlled trial of natalizumab for relapsing multiple sclerosis. N Engl J Med 2(348):15–23
25.
Stuve O, Gold R, Chan A, Mix E, Zettl U, Kieseier BC (2008) Alpha4-Integrin antagonism with natalizumab: effects and adverse effects. J Neurol 255(Suppl 6):58–65CrossRefPubMed
26.
27.
Mullen JT, Vartanian TK, Atkins MB (2008) Melanoma complicating treatment with natalizumab for multiple sclerosis. N Engl J Med 358:647–648CrossRefPubMed
28.
O’Connor P, Filippi M, Arnason B, Comi G, Cook S, Goodin D, Hartung HP, Jeffery D, Kappos L, Boateng F, Filipov V, Groth M, Knappertz V, Kraus C, Pohl C, Sandbrink R, Bogumil T (2009) Interferon beta-1b 250 μg versus interferon beta-1b 500 μg versus glatiramer acetate in relapsing-remitting multiple sclerosis: results of a prospective, randomised multicentre study. Lancet (submitted)
29.
Mikol DD et al (2008) Comparison of subcutaneous interferon beta-1a with glatiramer acetate in patients with relapsing multiple sclerosis (the REbif vs Glatiramer Acetate in Relapsing MS Disease [REGARD] study): a multicentre, randomised, parallel, open-label trial. Lancet Neurol 7:903–914CrossRefPubMed
30.
The results of the EVIDENCE, INCOMIN, and phase III studies of interferon beta products in the treatment of multiple sclerosis. Clin Ther 25:105–118
31.
Multiple Sclerosis Therapy Consensus Group (2008) Basic and escalating immunomodulatory treatments in multiple sclerosis: current recommendations. J Neurol 255:1449–1463
32.
Paul F, Dorr J, Wurfel J, Vogel HP, Zipp F (2007) Early mitoxantrone-induced cardiotoxicity in secondary progressive multiple sclerosis. J Neurol Neurosurg Psychiatry 78:198–200
33.
Ellis R, Boggild M (2009) Therapy-related acute leukaemia with mitoxantrone: what is the risk and can we minimise it? Mult Scler 15:505–508
34.
Simon JH, Jacobs LD, Campion M et al (1998) Magnetic resonance studies of intramuscular interferon β-1a for relapsing multiple sclerosis. Ann Neurol 43:79–87CrossRefPubMed
35.
Galetta SL, Markowitz C, Lee AG (2002) Immunomodulatory agents for the treatment of relapsing multiple sclerosis: a systematic review. Arch Intern Med 162:2161–2169CrossRefPubMed
36.
37.
Li DKB, Paty DW, The UBC MS/MRI Analysis Research Group, and PRISMS Study Group (1999) Magnetic resonance imaging results of the PRISMS trial: a randomized, double-blind, placebo-controlled study of interferon-β1a in relapsing–remitting multiple sclerosis. Ann Neurol 46:197–206
38.
Paty DW, Li DK (1993) Interferon beta-1b is effective in relapsing–remitting multiple sclerosis. II. MRI analysis results of a multicenter, randomized, double-blind, placebo-controlled trial. UBC MS/MRI Study Group and the IFNB Multiple Sclerosis Study Group. Neurology 43:662–667
39.
Johnson KP, Brooks BR, Cohen J et al (1998) Extended use of glatiramer acetate (Copaxone) is well tolerated and maintains its clinical effect on multiple sclerosis relapse rate and degree of disability. Copolymer 1 Multiple Sclerosis Study Group. Neurology 50:701–708
40.
Comi G, Filippi M, Wolinsky JS, and The European/Canadian Glatiramer Acetate Study Group (2001) European/Canadian multicenter, double-blind, randomized, placebo-controlled study of the effects of glatiramer acetate on magnetic resonance imaging-measured disease activity and burden in patients with relapsing multiple sclerosis. Ann Neurol 49:290–297
Metadaten
Titel
Treatment of multiple sclerosis: role of natalizumab
verfasst von
Giancarlo Comi
Publikationsdatum
01.10.2009
Verlag
Springer Milan
Erschienen in
Neurological Sciences / Ausgabe Sonderheft 2/2009
Print ISSN: 1590-1874
Elektronische ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-009-0147-2

Weitere Artikel der Sonderheft 2/2009

Neurological Sciences 2/2009 Zur Ausgabe

MS Treatment

Safety profile of Tysabri: international risk management plan

MS Treatment

Mitoxantrone: benefits and risks in multiple sclerosis patients

MS Treatment

New oral drugs for multiple sclerosis

MS Treatment

Autologous haematopoietic stem-cell transplantation in multiple sclerosis: benefits and risks

MS Treatment

The pharmacovigilance program on natalizumab in Italy: 2 years of experience

MS Treatment

Cyclophosphamide as second-line therapy in multiple sclerosis: benefits and risks

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Kostenlos registrieren

Neu im Fachgebiet Neurologie

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Frühe Alzheimertherapie lohnt sich

25.04.2024 AAN-Jahrestagung 2024 Nachrichten

Ist die Tau-Last noch gering, scheint der Vorteil von Lecanemab besonders groß zu sein. Und beginnen Erkrankte verzögert mit der Behandlung, erreichen sie nicht mehr die kognitive Leistung wie bei einem früheren Start. Darauf deuten neue Analysen der Phase-3-Studie Clarity AD.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise