Robert J. Fox, MD Mellen Center for Multiple Sclerosis, 9500 Euclid Avenue, U-10, Cleveland, OH 44122, USA.
Curr Treat Options Neurol. 2007 May;9(3):176-86. doi: 10.1007/BF02938407.
Advances in our understanding of the pathogenesis of multiple sclerosis (MS) lesions are leading to the development of more targeted therapies. Axonal transection is likely an important cause of accumulating disability in disease progression and suggests the importance of early and aggressive therapy. Early treatment with disease-modifying therapy should be considered in patients with first episode of demyelination and presence of MRI lesions consistent with MS. Intravenous steroids are the mainstay of treatment of acute MS exacerbations. Although their benefits must be weighed against the potential for complications, natalizumab and mitoxantrone significantly decrease relapses and MRI lesions in patients with relapsing MS. Many new therapies, including oral and infrequently administered infusion therapies, are currently in phase III trials and will likely become available over the next 3 to 4 years.
我们对多发性硬化症（MS）病变发病机制的认识的进步正在导致更有针对性的治疗方法的发展。轴突横断可能是疾病进展中累积残疾的一个重要原因，这表明早期和积极治疗的重要性。对于首次脱髓鞘发作和存在符合 MS 的 MRI 病变的患者，应考虑早期使用疾病修正治疗。静脉内类固醇是急性 MS 恶化的主要治疗方法。尽管必须权衡其益处与并发症的潜在风险，但那他珠单抗和米托蒽醌可显著减少复发型 MS 患者的复发和 MRI 病变。许多新的治疗方法，包括口服和不频繁给予的输注疗法，目前正在进行 III 期临床试验，可能在未来 3 到 4 年内上市。
