%0 Journal Article
%T Current and Future Therapies for Multiple Sclerosis
%A Alireza Minagar
%J Scientifica
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/249101
%X With the introduction of interferon-¦Â1b in 1993 as the first FDA-approved treatment for multiple sclerosis, the era of treatment of this incurable disease began, and its natural course was permanently changed. Currently, seven different treatments for patients with multiple sclerosis with different mechanisms of action and dissimilar side effect profiles exist. These medications include interferon-¦Â1a intramuscular (Avonex), interferon-¦Â1a subcutaneous (Rebif), interferon-¦Â1b subcutaneous (Betaseron/Extavia), glatiramer acetate (Copaxone), natalizumab (Tysabri), fingolimod (Gilenya), teriflunomide (Aubagio), and mitoxantrone (Novantrone). In addition, a large number of clinical trials are being conducted to assess the safety and efficacy of various experimental agents in patients with multiple sclerosis, including alemtuzumab, dimethyl fumarate, laquinimod, rituximab, daclizumab, and cladribine. In this paper, the author presents a concise and comprehensive review of present and potential treatments for this incurable disease. 1. Introduction Multiple sclerosis (MS) is an immune-mediated demyelinating disease of the human central nervous system (CNS), which causes neurological disability in young adults [1, 2]. Presently, the etiology and cure for MS remain unknown. MS develops in individuals who are genetically susceptible following exposure to an unidentified environmental agent. Extensive epidemiological studies indicate that genetic factors play a significant role in the development of MS [1, 3, 4]. In addition, certain environmental factors such as exposure to or infection with certain viruses such as Epstein-Barr virus, low serum vitamin D levels, and smoking may contribute to the development of MS. MS is commonly a disabling disease and remains the leading cause of acquired neurological disability in young adults individuals between 15 to 45 years [5]. The peak age of onset is 29 years, and similar to other immune-mediated diseases, in most forms of MS, females outnumber the males. MS affects both white and gray matters of the CNS (whole brain disease), and its underlying neuropathology leads to loss of myelin/oligodendrocyte complex as well as neuronal and axonal degeneration (demyelination versus neurodegeneration) [6]. Clinically, MS presents with four relatively distinguishable patters: relapsing remitting (RRMS), secondary progressive (SPMS), primary progressive (PPMS), and relapsing progressive (RPMS). The most common clinical phenotype of MS, RRMS, may initiate with a single uni- or multifocal demyelinating attack, referred to as
%U http://www.hindawi.com/journals/scientifica/2013/249101/