[Escalating immunomodulatory therapy of multiple sclerosis. 1st supplement: December 2000].

New clinical studies in multiple sclerosis provided data on the treatment of clinical isolated syndromes and secondary progressive forms which may have important implications for the optimal care of MS patients. The MSTKG critically evaluated the available data again and provides evidence-based recommendations for the application of immunoprophylactic therapies. Initiation of treatment after the first relapse may be indicated if there is clear evidence from MRI for subclinical dissemination of disease. Recent trials indicate that efficacy of therapy with IFN--is more likely with superimposed bouts or other indicators of inflammatory disease activity than without them in secondary progressive MS. If immunoprophylactic treatment is initiated with a provisional diagnosis of MS, confirmation of MS is essential. In long-term treated patients secondary treatment failure should be identified by follow-up examinations and other treatment options discussed.