Holmøy Trygve, Celius Elisabeth Gulowsen
Nevrologisk avdeling, Oslo universitetssykehus, Ullevål ogImmunologisk institutt, Universitetet i Oslo, Norway.
Tidsskr Nor Laegeforen. 2011 May 6;131(8):832-6. doi: 10.4045/tidsskr.10.0077.
Current first line treatment for multiple sclerosis is only moderately effective and is associated with frequent and disturbing side effects. We here describe opportunities and challenges related to drugs under development.
Non-systematic search in PubMed and congress abstracts.
Monoclonal antibodies (e.g. natalizumab, alemtuzumab, rituximnab and dacklizumab) and oral agents (e.g. fingolimod and cladribine) target molecules or cells which are important in the immunopathogenesis of multiple sclerosis. These agents seem to have a considerable effect on relapsing-remitting multiple sclerosis, but may also be associated with serious side effects. Natalizumab is licensed as second line treatment for relapsing-remitting multiple sclerosis, and also as first line treatment in especially serious cases. Cladribine and fingolimod may be available in Norway in 2011.
Treatment of exacerbations in multiple sclerosis is changing. Indication for the drugs under development is not yet clear.
目前多发性硬化症的一线治疗效果仅为中等，且伴有频繁且令人困扰的副作用。我们在此描述与正在研发的药物相关的机遇和挑战。
在PubMed和会议摘要中进行非系统性检索。
单克隆抗体（如那他珠单抗、阿仑单抗、利妥昔单抗和达克珠单抗）以及口服制剂（如芬戈莫德和克拉屈滨）靶向在多发性硬化症免疫发病机制中起重要作用的分子或细胞。这些药物似乎对复发缓解型多发性硬化症有显著疗效，但也可能伴有严重副作用。那他珠单抗被批准作为复发缓解型多发性硬化症的二线治疗药物，在特别严重的病例中也可作为一线治疗药物。克拉屈滨和芬戈莫德可能于2011年在挪威上市。
多发性硬化症发作的治疗正在发生变化。正在研发的药物的适应证尚不明确。
