Document Detail


The trials and errors in MS therapy.
MedLine Citation:
PMID:  18808741     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The development programme for novel therapies in multiple sclerosis (MS) has an impressive track record which is unique in the field of neurology, and has led to the approval of several drugs during the past decade. However, therapeutic prosperities face numerous trials that either failed to show efficacy or that had to be halted because of other reasons including adverse events. Moreover, certain treatment strategies are controversial, both for reasons of practicability and for their true clinical benefit. There are serious caveats that highly immunoselective approaches such as monoclonal antibodies can only be applied at the expense of an increased risk of acute or long-term adverse effects. This review focuses on the most important clinical trials on yet unlicensed compounds in relapsing-remitting and secondary-progressive MS which failed, were halted or are associated with significant adverse effects since 2002. Furthermore, we discuss the implications these experiences have for our current view of MS pathogenesis as well as future study design. Examples include agents that target leukocyte differentiation molecules, co-stimulatory molecules, adhesion molecules and chemotaxis, as well as novel immunomodulators and anti-infective therapies.
Authors:
Christoph Kleinschnitz; Sven G Meuth; Heinz Wiendl
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  International MS journal / MS Forum     Volume:  15     ISSN:  1352-8963     ISO Abbreviation:  Int MS J     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-23     Completed Date:  2008-11-18     Revised Date:  2008-12-03    
Medline Journal Info:
Nlm Unique ID:  9804403     Medline TA:  Int MS J     Country:  England    
Other Details:
Languages:  eng     Pagination:  79-90     Citation Subset:  IM    
Affiliation:
Department of Neurology, University of Wurzburg, Wurzburg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Antibodies, Monoclonal / adverse effects,  therapeutic use
Clinical Trials as Topic
Drugs, Investigational / adverse effects,  therapeutic use*
Humans
Multiple Sclerosis, Chronic Progressive / drug therapy*
Multiple Sclerosis, Relapsing-Remitting / drug therapy*
Treatment Failure
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Drugs, Investigational

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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