Multiple Sclerosis: A Systemic Review of Drugs and Therapeutics

2017 ◽  
Vol 1 (3) ◽  
pp. 01-03
Author(s):  
Theodore Eric
Keyword(s):  
Multiple Sclerosis ◽  
Demyelinating Disease ◽  
Disease Process ◽  
The United States ◽  
Systemic Review ◽  
Patient Response ◽  
Relapsing Remitting ◽  
The Central Nervous System ◽  
Individual Patient Response ◽  
Phase Ii And Iii

Multiple sclerosis (MS) is a chronic inflammatory autoimmune demyelinating disease of the central nervous system. It affects approximately 400,000 people in the United States and onset is usually during young adulthood. There are four clinical forms of MS, of which relapsing remitting type is the most common. As the etiology of MS is unknown, finding a cure will remain challenging. The main mechanism of injury appears to be inflammation and 8 agents are now FDA approved to help control MS. These agents for relapsing forms of MS target different parts of the immune system, with the end goal of decreasing and avoiding further inflammation. No agents are FDA approved for the primary progressive version of MS. FDA approved agents include four preparations of interferon β (Avonex, Rebif, Betaseron and Extavia), glatiramer acetate (Copaxone), mitoxantrone (Novantrone), natalizumab (Tysabri) and fingolimod (Gilenya). There are several drug undergoing phase II and III trials. The heterogeneity of the MS disease process, individual patient response, and medication toxicities continue to challenge the treating physician.

scholarly journals HIV infection and multiple sclerosis: a case with unexpected “no evidence of disease activity” status

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199957
Author(s):  
Fernando Labella ◽  
Fernando Acebrón ◽  
María del Carmen Blanco-Valero ◽  
Alba Rodrígez-Martín ◽  
Ángela Monterde Ortega ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Hiv Infection ◽  
Disease Activity ◽  
Demyelinating Disease ◽  
Clinical Course ◽  
Disease Modifying Drugs ◽  
Immunodeficiency Virus ◽  
Relapsing Remitting ◽  
The Central Nervous System ◽  
Disease Modifying

Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system whose etiology remains unclear. It has been suggested that MS can be triggered by certain viruses; however, human immunodeficiency virus (HIV) infection is associated with reduced incidence of MS. We present the case of a young patient diagnosed with active relapsing-remitting MS whose clinical course substantially improved following HIV infection and treatment. The patient achieved no evidence of disease activity status without any disease-modifying drugs. Both HIV-induced immunosuppression and antiretroviral therapy may have attenuated the clinical course in this patient.

Relapsing-Remitting Multiple Sclerosis - Current Treatment Options and Perspectives for the Future

2010 ◽  
Vol 5 (1) ◽  
pp. 78
Author(s):  
Alex Rae-Grant ◽  
Daniel Ontaneda ◽  
◽  
Keyword(s):  
Multiple Sclerosis ◽  
Treatment Options ◽  
Current Treatment ◽  
Relapsing Remitting ◽  
Significant Disability ◽  
The Central Nervous System ◽  
Disease Modifying Agents ◽  
Phase Ii And Iii ◽  
Relapsing Remitting Multiple Sclerosis ◽  
Made In

Multiple sclerosis (MS) is the most prevalent demyelinating condition of the central nervous system and produces significant disability over time. For many years it was considered to be an untreatable disease, but great advances have been made in the treatment of MS in the last 20 years. There are currently six US Food and Drug Administration (FDA)-approved disease-modifying agents for the relapsing form of the disease. We review in detail these medications and the pivotal trials leading to their approval. We will briefly review non-FDA-approved medications already used in MS. We will also discuss some of the medications currently being studied in phase II and III trials that are not yet approved for use in MS.

Multiple sclerosis attacks are associated with picornavirus infections

2004 ◽  
Vol 10 (2) ◽  
pp. 145-148 ◽  
Author(s):  
John D Kriesel ◽  
Andrea White ◽  
Frederick G Hayden ◽  
S L Spruance ◽  
Jack Petajan
Keyword(s):  
Multiple Sclerosis ◽  
At Risk ◽  
Demyelinating Disease ◽  
Respiratory Infections ◽  
Risk Period ◽  
Relapsing Remitting ◽  
The Central Nervous System ◽  
Upper Respiratory ◽  
Polymerase Chain

Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system, which often follows a relapsing-remitting (RR) course with discrete attacks. MS attacks have been associated with upper respiratory infections (URIs), but the specific viruses responsible have not been identified. We studied a cohort of 16 RRMS patients experiencing URI and followed them for clinically identifiable attacks. The viral causes of 21 separate URIs were investigated using culture and polymerase chain reactio n (PCR) of nasal swab specimens, and by serology. Sibley’s ‘at-risk’ period for MS attacks, beginning two weeks before and continuing for five weeks after a URI, was used for the analysis. Seven of the nine (78%) URIs due to picornaviruses were associated with an MS attack during the at-risk period. By contrast, only two of 12 (17%) picornavirus-negative URIs were associated with an MS attack (P =0.01). The possible role of picornaviruses in the patho genesis of MS deserves further study.

scholarly journals Assessment of the influence of various risk factors on the severity of psycho-emotional disorders in patients with multiple sclerosis

2021 ◽  
Vol 17 (5) ◽  
pp. 31-35
Author(s):  
T.A. Odintsova ◽  
O.O. Kopchak
Keyword(s):  
Risk Factors ◽  
Multiple Sclerosis ◽  
Emotional Disorders ◽  
Demyelinating Disease ◽  
External Factors ◽  
Depression And Anxiety ◽  
Relapsing Remitting ◽  
The Central Nervous System ◽  
Severity Levels ◽  
Relapsing Remitting Multiple Sclerosis

Multiple sclerosis is an insidious disabling, both physically and mentally, demyelinating disease of the central nervous system. People with multiple sclerosis, apart from the classic manifestations, can also experience depression and anxiety. The study was aimed to assess peculiarities of influence of socio-demographic, external factors, and characteristics of the disease on depression and anxiety among patients with relapsing-remitting multiple sclerosis. The following article highlights the main risk factors and their ways of influence on the aforementioned disorders, distinguished by the multifactorial analysis. Also, it estimates the frequency of different severity levels of either depression or anxiety depending on the pre-sence of each risk factor.

Multiple Sclerosis Relapsing Remitting Progressive Type

2020 ◽  
Vol 14 (2) ◽  
Author(s):  
Nora Fitri ◽  
Basjiruddin Ahmad ◽  
Yuliarni Syafrita
Keyword(s):  
Multiple Sclerosis ◽  
Immune Cell ◽  
Demyelinating Disease ◽  
Brain Mri ◽  
Clinical Findings ◽  
Blurred Vision ◽  
System A ◽  
Progressive Type ◽  
Relapsing Remitting ◽  
The Central Nervous System

Multiple sclerosis (MS) is the most common neurologic demyelinating disease in high-income countries. The causes of MS is multifactorial involve genetics and the environment in which immune cell infiltration occurs across the blood-brain barrier, causing inflammation, demyelination, gliosis, and neuroaxonal degeneration in the substantia grisea in the central nervous system. A 23-year-old female patient was treated with four limbs weakened since 2 weeks ago accompanied by blurred vision, pain, cramps and stiffness in the back muscles and legs. The patient has experienced the same complaint before. Clinical findings reveal lhermitte sign, atrophy papillae, and tetraparese. On thoracic vertebral MRI examination without contrast and brain MRI with contrast obtained multiple sclerosis lesions. Patients receive steroid and antidepressant therapy. MS needs to be studied further because this number of cases began to emerge. 

scholarly journals Pathology and Pathogenesis of Progressive Multiple Sclerosis: Concepts and Controversies

2017 ◽  
Vol 01 (03) ◽  
pp. E171-E181
Author(s):  
Adrian-Minh Schumacher ◽  
Christoph Mahler ◽  
Martin Kerschensteiner
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Deficits ◽  
Progressive Disease ◽  
Disease Duration ◽  
Disease Process ◽  
Progressive Multiple Sclerosis ◽  
Relapsing Remitting ◽  
Inflammatory Processes ◽  
The Central Nervous System

AbstractMultiple sclerosis (MS) is an inflammatory disease of the central nervous system that initially is often dominated by relapsing-remitting neurological symptoms. With increasing disease duration these relapses are more and more superimposed by a progressive disease process that leads to an irreversible accumulation of motor, sensory and cognitive deficits. This progressive phase of MS is still only incompletely understood and by and large refractory to therapy. Here we aim to use recent pathological and pathomechanistic insights to outline a unifying concept of progressive MS. Based on this view of the disease we examine current controversies surrounding progressive MS. We discuss whether neurodegenerative or inflammatory processes drive progression, question whether the classification of primary and secondary progressive MS is all that useful and deliberate, which therapeutic strategies are best suited to limit the insidious neurological decline of progressive MS patients.

Relapsing–Remitting Multiple Sclerosis—Current Treatment Options and Perspectives for the Future

US Neurology ◽  
2010 ◽  
Vol 06 (01) ◽  
pp. 64 ◽  
Author(s):  
Alex Rae-Grant ◽  
Daniel Ontaneda ◽  
◽  
Keyword(s):  
Multiple Sclerosis ◽  
Treatment Options ◽  
Current Treatment ◽  
Relapsing Remitting ◽  
Significant Disability ◽  
The Central Nervous System ◽  
Disease Modifying Agents ◽  
Phase Ii And Iii ◽  
Relapsing Remitting Multiple Sclerosis ◽  
Made In

Multiple sclerosis (MS) is the most prevalent demyelinating condition of the central nervous system and produces significant disability over time. For many years it was considered to be an untreatable disease, but great advances have been made in the treatment of MS in the last 20 years. There are currently six US Food and Drug Administration (FDA)-approved disease-modifying agents for the relapsing form of the disease. We review in detail these medications and the pivotal trials leading to their approval. We will briefly review non-FDA-approved medications already used in MS. We will also discuss some of the medications currently being studied in phase II and III trials that are not yet approved for use in MS.

Association Between Multiple Sclerosis and Depression

2017 ◽  
Vol 41 (S1) ◽  
pp. S632-S632
Author(s):  
A. Fornelos ◽  
V. Espírito Santo ◽  
M. Silva ◽  
M. Roque
Keyword(s):  
Multiple Sclerosis ◽  
Demyelinating Disease ◽  
Depressive Symptomatology ◽  
Signs And Symptoms ◽  
Visual Deficits ◽  
Autoimmune Inflammatory Disease ◽  
Relapsing Remitting ◽  
The Central Nervous System ◽  
Caucasian Women ◽  
Competing Interest

IntroductionMultiple Sclerosis (MS) is considered an autoimmune inflammatory disease and it is the most common demyelinating disease of the central nervous system. Although its aetiology remains unknown, it has been considered to be multifactorial. MS tends to be more commonly diagnosed in young Caucasian women. It has been described four clinical courses: relapsing-remitting MS, primary progressive MS, secondary progressive MS and progressive remitting MS based on the temporal sequence in which the symptoms arise. Clinic is also very different because it depends on the sites where the lesions occur. The most frequent signs and symptoms are motor and visual deficits, paraesthesia, gait ataxia, diplopia, dizziness and bladder dysfunction. Depressive symptomatology is also among the most common symptoms of MS.ObjectivesShow the importance of depressive symptomatology in patients with MS.AimsEvaluation the connection between MS and depression.MethodsSearch for articles concerning MS and depression on Pubmed and Scielo databases from July 2014 through October 2016.ResultsPsychiatric manifestations, and especially depressive symptoms, affect almost 40% of MS patients in remission, and about 90% of those in a flare-up. This may be due to the diagnosis itself, with its large amount of symptoms and its variable progression, but also due to side effects of therapy. It gives a major contribute to suicidality (7.5%) when compared to the general population.ConclusionA combined approach and treatment is in order to diminish the incapacity caused by both these illnesses in every single patient.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals lincR-Ccr2-5′AS and THRIL as potential biomarkers of multiple sclerosis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Olfat Gamil Shaker ◽  
Amr Hassan ◽  
Asmaa Mohammed Mohammed ◽  
Shereen Rashad Mohammed
Keyword(s):  
Multiple Sclerosis ◽  
Demyelinating Disease ◽  
Fold Change ◽  
Motor Weakness ◽  
Tnf Α ◽  
Relapsing Remitting ◽  
Treatment Naïve ◽  
The Central Nervous System ◽  
Nuclear Ribonucleoprotein ◽  
Relapsing Remitting Multiple Sclerosis

Abstract Background Multiple sclerosis (MS) is a demyelinating disease affecting the central nervous system (CNS). Long non-coding RNAs (lncRNAs) were believed to play a role in the pathogenesis of neurological disorders including MS. lincR-Ccr2-5′AS is expressed in the T helper2 (Th2) lineage. TNF-α heterogeneous nuclear ribonucleoprotein L (THRIL) causes the induction of TNF-α and regulates innate immune response and inflammation. We investigated the expression of lincR-Ccr2-5′AS and THRIL in MS to clarify their association with MS risk and the clinical features. Results LincR-Ccr2-5′AS was significantly downregulated in MS patients (fold change = 0.43±0.29, p = 0.03). The expression level was significantly low in patients with motor weakness and optic neuritis, patients with Expanded Disability Status Scale (EDSS) ≥5.5, and treatment-naïve patients. THRIL was significantly upregulated in MS patients (fold change = 6.18±2, p = 0.02). Its expression was significantly higher in patients with relapsing-remitting multiple sclerosis (RRMS), patients with motor weakness, patients with EDSS ≤5, and patients who received interferon. Conclusion Our results showed the downregulation of lincR-Ccr2-5′AS and the upregulation of lncRNA THRIL in MS patients. This differential expression of both lncRNAs may have an important role in MS pathogenesis.

scholarly journals Visual Field Changes in Multiple Sclerosis

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
D E A Mansour ◽  
A M E Abdelhamid ◽  
S S M Fahmy
Keyword(s):  
Multiple Sclerosis ◽  
Visual Field ◽  
Demyelinating Disease ◽  
Visual Field Loss ◽  
University Hospitals ◽  
Mcdonald Criteria ◽  
International Panel ◽  
Relapsing Remitting ◽  
The Central Nervous System ◽  
Multiple Sclerosis Patients

Abstract Background multiple sclerosis (MS) is a demyelinating disease of the central nervous system and the leading cause of disability in young adults. Afferent pregeniculate visual pathways (retina, optic nerves, chiasm, and tracts) are preferential targets of inflammation, demyelination, and axonal degeneration. Aim of the Work in our study was to find and correlate visual field findings in multiple sclerosis patients with clinical data. Patients and Methods this study included 30 eyes of 17 patients previously diagnosed as multiple sclerosis according to the international panel on diagnosis of MS (McDonald criteria 2001) and its revision by Polman etal 2005. All our cases were from both sexes and of different age group ranging from 18 years old to 51 years old. there were subtypes of MS included in our study which were relapsing remitting (RR), and secondary progressive (SP). All cases were from Ain-shams university hospitals, outpatient clinics. Results this study was conducted in Ain-shams university hospitals out-patient clinics, it included 17 patients previously diagnosed as MS. The age in our study was ranging from 18 to 51 years old with mean age of 33.67± 9.37.Our cases were from both sex with prevelance of female patients. Conclusion these findings illustrate the role of perimetry in detecting both clinically overt & and clinically occult optic nerve involvement in patients with MS. It quantifies the depth of visual field loss, identifies atypical cases of optic neuritis, aids in counseling patients about prognosis.

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