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.
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