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52 - Treatment for patients with primary progressive multiple sclerosis

from Section IV - Therapy in clinical practice

Published online by Cambridge University Press:  05 December 2011

By
Zhaleh Khaleeli  and
Alan J. Thompson
Edited by
Jeffrey A. Cohen  and
Richard A. Rudick
Jeffrey A. Cohen
Affiliation:
Cleveland Clinic
Richard A. Rudick
Affiliation:
Cleveland Clinic
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Summary

The atypical characteristics of primary progressive multiple sclerosis (PPMS) have presented problems in the recruitment to and design of therapeutic trials. The problem areas in the implementation of therapeutic trials are: diagnostic criteria, sample size calculations, and choice of outcome measures. Although there is no definitively proven disease-modifying treatment available for PPMS, several randomized controlled trials have now been specifically designed for this group. The clinical trials in PPMS are based on glatiramer acetate and rituximab. The planned clinical trials in PPMS are based on fingolimod (FTY720) and cladribine. The smaller trials in PPMS are based on Interferon beta-1a, Interferon beta-1b, mitoxantrone and riluzole. A retrospective open-label study of intravenous cyclophosphamide and methylprednisolone in progressive MS included 128 patients with PPMS. PPMS may be the ideal model to investigate disease progression and neuronal protection, and is becoming an important focus for treatment trials in these areas.

Keywords

progesteroneestriolmultiple sclerosispregnancyestradiolanti-inflammatory effectscentral nervous system
Type
Chapter
Information
Multiple Sclerosis Therapeutics , pp. 604 - 613
Publisher: Cambridge University Press
Print publication year: 2011

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