Emerging therapies for the management of multiple sclerosis

Abstract

Objective: To provide a comprehensive overview on the emerging treatments used for the treatment management of multiple sclerosis (MS). Data Sources: PubMed, MEDLINE, Cochrane, and Toxnet databases were used to conduct all comprehensive literature searches over the time period of 1989 to 2009. Search terms such as: multiple sclerosis and oral treatment, monoclonal antibodies, hormonal therapy, and stem cell transplant were used as key word search indicators. Study Selection: A total of 48 studies were reviewed and selected based on Level 1, 2, and 3 search strategies. Data Extraction: Level 1 search strategies were initially aimed at evidence-based trials of large sample size (N > 100) with a randomized, double-blind, placebo-controlled design in the area of specialized interest. A level 2 search was conducted for additional trials that had many but not all of the desirable traits of evidence-based trials. In addition, a level 3 search strategy was conducted to compare key findings stated in anecdotal reports of very small (N < 15), poorly designed trials with the results of well-designed, evidence-based trials identified in level 1 and/or level 2 searches. Data Synthesis and Conclusion: Despite the wide array of recent treatment advances in the field of MS, the cure still remains elusive. At present, current available treatments at best are only able to slow disease progression by reducing the incidence severity and duration of MS attacks. Recent treatment advances involving the use of newly designed orally administered drugs, monoclonal antibodies with the introduction of stem cell transplantation have revolutionized clinical outcomes for MS patients. Despite great strides made toward disease attenuation, the risks associated with the new treatments are real and have to be weighed against the projected benefits of drug treatment for a disease which has no cure. © the author(s).