Sykdomsmodulerende behandling av multippel sklerose - en review av godkjente medikamenter

Denne studien er basert på litteratursøk av publiserte randomiserte kontrollerte fase III forsøk av sykdomsmodulerende medikamenter godkjent for RRMS, indeksert i PubMed til 21 mai 2015. Studien er utført av forskere tilknyttet kompetansetjenesten, og er publisert i det internasjonale tidsskriftet Eur J Neurol.

 

BACKGROUND AND PURPOSE:

There is still no curative treatment for multiple sclerosis (MS), but during the last 20 years eight different disease-modifying compounds have been approved for relapsing-remitting MS (RRMS).

METHODS:

A literature search was conducted on published randomized controlled phase III trials indexed in PubMed on the approved medications until 21 May 2015.

RESULTS:

In this review the mode of action, documented treatment effects and side effects of the approved MS therapies are briefly discussed.

CONCLUSIONS:

Based on current knowledge of risk-benefit of the approved MS medications, including factors influencing adherence, it is suggested that oral treatment with dimethyl fumarate or teriflunomide should be preferred as a starting therapy amongst the first-line preparations for de novo RRMS. In the case of breakthrough disease on first-line therapy, or rapidly evolving severe RRMS, second-line therapy with natalizumab, fingolimod or alemtuzumab should be chosen based on careful risk-benefit stratification.

REFERENCE:

Torkildsen Ø, Myhr KM, Bø L. Disease-modifying treatments for multiple sclerosis - a review of approved medications. Eur J Neurol. 2016 Jan;23 Suppl 1:18-27