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{{Template:Multiple sclerosis}}
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==Overview==


==Future or investigational therapies==
==Future or Investigational Therapies==
===Diagnostic studies under investigation===
Therapies under investigation:
New diagnostic and evolution evaluation methods are also being investigated. The measurement of [[antibody|antibodies]] against myelin [[protein]]s such as [[myelin oligodendrocyte glycoprotein]] and [[myelin basic protein]] could be useful for diagnosis. [[Optical coherence tomography]] of the eye's [[retina]] could be used as a measure of response to medication, axonal degeneration and brain atrophy.<ref>{{cite journal |author=Albrecht P, Fröhlich R, Hartung HP, Kieseier BC, Methner A |title=Optical coherence tomography measures axonal loss in multiple sclerosis independently of optic neuritis |journal=J Neurol |volume=Online |issue=  |pages = 1595|year=2007 |pmid=17987252 |doi=10.1007/s00415-007-0538-3}}</ref><ref>{{cite journal |author=Gordon-Lipkin E, Chodkowski B, Reich DS ''et al'' |year=2007 |month=October |title=Retinal nerve fiber layer is associated with brain atrophy in multiple sclerosis |journal=Neurology |volume=69 |issue=16 |pages=1603–09 |pmid=17938370 | doi = 10.1212/01.wnl.0000295995.46586.ae <!-- Retrieved from CrossRef by DOI bot -->}}</ref> Currently there are no clinically established laboratory investigations available that can predict prognosis.  However, several promising approaches have been proposed, such as the measurement of a [[lipid]]-specific [[immunoglobulin M]] as predictor of long-term outcomes.<ref name="pmid18755821">{{cite journal
* Combination of MS drugs: Combination of [[mitoxantrone]] and [[glatiramer acetate]].<ref>[http://www.mxga-mstrial.co.uk United Kingdom early Mitoxantrone Copaxone trial.] Onyx Healthcare (2006-01-01). Retrieved on 2007-09-02.</ref>  
| author=Thangarajh M, Gomez-Rial J, Hedström AK, ''et al''
* Drugs that are used in other diseases: [[alemtuzumab]]<ref>[http://www.genzyme.com/corp/media/GENZ%20PR-050207.asp Genzyme and Bayer HealthCare Announce Detailed Interim Two-Year Alemtuzumab in Multiple Sclerosis Data Presented at AAN.] Genzyme (2007-02-01). Retrieved on 2007-09-02.</ref>, [[daclizumab]] <ref>[http://www.pdl.com/index.cfm?navId=49 Daclizumab.] PDL Biopharma  (2006-01-01). Retrieved on 2007-09-02.</ref>, [[inosine]]<ref>[http://www.clinicaltrials.gov/ct/show/NCT00067327 Treatment of Multiple Sclerosis Using Over the Counter Inosine.] ClinicalTrials.gov (2006-03-16). Retrieved on 2007-09-02.</ref>, BG00012<ref>[http://www.clinicaltrials.gov/ct2/show/NCT00420212?term=biogen&recr=Open&rank=12 Efficacy and Safety of BG00012 in Relapsing-Remitting Multiple Sclerosis.] ClinicalTrials.gov (2007-09-01). Retrieved on 2007-11-12.</ref>, [[fingolimod]]<ref>[http://www.clinicaltrials.gov/ct/show/NCT00289978 Efficacy and Safety of Fingolimod in Patients With Relapsing-Remitting Multiple Sclerosis.] ClinicalTrials.gov (2006-02-09). Retrieved on 2007-09-02.</ref> and teriflunomide.  
| title=Lipid-specific immunoglobulin M in CSF predicts adverse long-term outcome in multiple sclerosis
* Drugs designed specifically for MS: [[laquinimod]]<ref name="pmid15781813">{{cite journal |author=Polman C, Barkhof F, Sandberg-Wollheim M, Linde A, Nordle O, Nederman T |title=Treatment with laquinimod reduces development of active MRI lesions in relapsing MS |journal=Neurology |volume=64 |issue=6 |pages=987–91 |year=2005 |pmid=15781813|doi=10.1212/01.WNL.0000154520.48391.69}}</ref> and ''[[Neurovax]]''.<ref>{{cite journal |author=Darlington CL |title=Technology evaluation: NeuroVax, Immune Response Corp |journal=Curr. Opin. Mol. Ther. |volume=7 |issue=6 |pages=598–603 |year=2005|pmid=16370383 |doi=}}</ref>
| journal=Mult. Scler.
* Others: [[Low dose naltrexone]] is used for some [[autoimmune diseases]] such as multiple sclerosis.<ref>{{cite journal |author=Agrawal YP |title=Low dose naltrexone therapy in multiple sclerosis |journal=Med. Hypotheses |volume=64 |issue=4 |pages=721–4 |year=2005 |pmid=15694688 |doi=10.1016/j.mehy.2004.09.024|url=}}</ref><ref>[http://clinicaltrials.gov/ct2/results?term=Low+dose+naltrexone+Multiple+Sclerosis search of clinicaltrials.gov data-base for Low dose naltrexone Multiple Sclerosis]</ref>  
| volume=
| issue=
| pages=
| year=2008
| month=August
| pmid=18755821
| doi=10.1177/1352458508095729
| url=
}}</ref>
 
=== Therapies under investigation ===
{{main|therapies under investigation for multiple sclerosis}}
A number of treatments that may curtail attacks or improve function are under investigation. Some of these treatments involve the combination of drugs that are already in use for multiple sclerosis, such as the joint administration of [[mitoxantrone]] and [[glatiramer acetate]] (''Copaxone'').<ref> [http://www.mxga-mstrial.co.uk United Kingdom early Mitoxantrone Copaxone trial.] Onyx Healthcare (2006-01-01). Retrieved on 2007-09-02.</ref> However, most treatments already in clinical trials involve drugs that are used in other diseases. These are [[alemtuzumab]] (trade name ''Campath''),<ref>[http://www.genzyme.com/corp/media/GENZ%20PR-050207.asp Genzyme and Bayer HealthCare Announce Detailed Interim Two-Year Alemtuzumab in Multiple Sclerosis Data Presented at AAN.] Genzyme (2007-02-01). Retrieved on 2007-09-02.</ref> [[daclizumab]] (trade name''Zenapax''),<ref> [http://www.pdl.com/index.cfm?navId=49 Daclizumab.] PDL Biopharma  (2006-01-01). Retrieved on 2007-09-02.</ref>[[inosine]],<ref> [http://www.clinicaltrials.gov/ct/show/NCT00067327 Treatment of Multiple Sclerosis Using Over the Counter Inosine.] ClinicalTrials.gov (2006-03-16). Retrieved on 2007-09-02.</ref>BG00012,<ref>[http://www.clinicaltrials.gov/ct2/show/NCT00420212?term=biogen&recr=Open&rank=12 Efficacy and Safety of BG00012 in Relapsing-Remitting Multiple Sclerosis.] ClinicalTrials.gov (2007-09-01). Retrieved on 2007-11-12.</ref> [[fingolimod]],<ref>[http://www.clinicaltrials.gov/ct/show/NCT00289978 Efficacy and Safety of Fingolimod in Patients With Relapsing-Remitting Multiple Sclerosis.] ClinicalTrials.gov (2006-02-09). Retrieved on 2007-09-02.</ref> and teriflunomide, the active metabolite of the [[DMARD]] [[leflunomide]]. Alemtuzumab performed better than interferon beta-1a in relapsing-remitting MS reducing disability, imaging abnormalities and frequence of relapses, at the cost of increased [[autoimmunity]] problems. These included three cases of [[immune thrombocytopenic purpura|thrombocytopenic purpura]] which led to the suspension of the therapy.<ref name="pmid1234567">{{cite journal |author=The CAMMS223 Trial Investigators |title=Alemtuzumab vs. Interferon Beta-1a in Early Multiple Sclerosis |journal=N Engl J Med |volume=359 |issue=17 |pages=1786–1801 |year=2008 |pmid=18946064 |doi= |url=}}</ref>
 
Other drugs in clinical trials have been designed specifically for MS, such as [[laquinimod]],<ref name="pmid15781813">{{cite journal |author=Polman C, Barkhof F, Sandberg-Wollheim M, Linde A, Nordle O, Nederman T |title=Treatment with laquinimod reduces development of active MRI lesions in relapsing MS |journal=Neurology |volume=64 |issue=6 |pages=987–91 |year=2005 |pmid=15781813|doi=10.1212/01.WNL.0000154520.48391.69}}</ref> and ''[[Neurovax]]''.<ref>{{cite journal |author=Darlington CL |title=Technology evaluation: NeuroVax, Immune Response Corp |journal=Curr. Opin. Mol. Ther. |volume=7 |issue=6 |pages=598–603 |year=2005|pmid=16370383 |doi=}}</ref>
 
[[Low dose naltrexone]] has been prescribed off-label for certain autoimmune disorders, including MS, and there is anecdotal evidence of benefit,<ref>{{cite journal |author=Agrawal YP |title=Low dose naltrexone therapy in multiple sclerosis |journal=Med. Hypotheses |volume=64 |issue=4 |pages=721–4 |year=2005 |pmid=15694688 |doi=10.1016/j.mehy.2004.09.024|url=}}</ref><ref>[http://clinicaltrials.gov/ct2/results?term=Low+dose+naltrexone+Multiple+Sclerosis search of clinicaltrials.gov data-base for Low dose naltrexone Multiple Sclerosis]</ref> but only two small clinical trials have been conducted (as on December 2008), one in San Francisco, USA,<ref>[http://clinicaltrials.gov/ct2/show/NCT00501696?term=Low+dose+naltrexone+Multiple+Sclerosis&rank=1 2007 clinical trial using LDN]</ref> the other for the primary progressive variety in Milan, Italy.<ref name="pmid18728058">{{cite journal |author=Gironi M, Martinelli-Boneschi F, Sacerdote P, Solaro C, Zaffaroni M, Cavarretta R, Moiola L, Bucello S, Radaelli M, Pilato V, Rodegher M, Cursi M, Franchi S, Martinelli V, Nemni R, Comi G, Martino G |title=A pilot trial of low-dose naltrexone in primary progressive multiple sclerosis. |journal=Multiple Sclerosis|volume=14 |issue=8 |pages=1076–83 |year=2008 |pmid=18728058 |doi=}}</ref>


==References==
==References==
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[[Category:Autoimmune diseases]]
[[Category:Neurological disorders]]
[[Category:Multiple sclerosis]]
[[Category:Neurology]]
[[Category:Orthopedics]]
[[Category:Disease]]

Latest revision as of 22:47, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Future or Investigational Therapies

Therapies under investigation:

References

  1. ↑ United Kingdom early Mitoxantrone Copaxone trial. Onyx Healthcare (2006-01-01). Retrieved on 2007-09-02.
  2. ↑ Genzyme and Bayer HealthCare Announce Detailed Interim Two-Year Alemtuzumab in Multiple Sclerosis Data Presented at AAN. Genzyme (2007-02-01). Retrieved on 2007-09-02.
  3. ↑ Daclizumab. PDL Biopharma (2006-01-01). Retrieved on 2007-09-02.
  4. ↑ Treatment of Multiple Sclerosis Using Over the Counter Inosine. ClinicalTrials.gov (2006-03-16). Retrieved on 2007-09-02.
  5. ↑ Efficacy and Safety of BG00012 in Relapsing-Remitting Multiple Sclerosis. ClinicalTrials.gov (2007-09-01). Retrieved on 2007-11-12.
  6. ↑ Efficacy and Safety of Fingolimod in Patients With Relapsing-Remitting Multiple Sclerosis. ClinicalTrials.gov (2006-02-09). Retrieved on 2007-09-02.
  7. ↑ Polman C, Barkhof F, Sandberg-Wollheim M, Linde A, Nordle O, Nederman T (2005). "Treatment with laquinimod reduces development of active MRI lesions in relapsing MS". Neurology. 64 (6): 987–91. doi:10.1212/01.WNL.0000154520.48391.69. PMID 15781813.
  8. ↑ Darlington CL (2005). "Technology evaluation: NeuroVax, Immune Response Corp". Curr. Opin. Mol. Ther. 7 (6): 598–603. PMID 16370383.
  9. ↑ Agrawal YP (2005). "Low dose naltrexone therapy in multiple sclerosis". Med. Hypotheses. 64 (4): 721–4. doi:10.1016/j.mehy.2004.09.024. PMID 15694688.
  10. ↑ search of clinicaltrials.gov data-base for Low dose naltrexone Multiple Sclerosis

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