Freedman Mark S
The Ottawa Hospital, 501 Smyth Rd, Ottawa, ON K1H 8L6, Canada.
Continuum (Minneap Minn). 2013 Aug;19(4 Multiple Sclerosis):968-91. doi: 10.1212/01.CON.0000433288.30715.e3.
The treatment of multiple sclerosis (MS) is evolving beyond the current parenteral immunomodulators and early oral alternatives, offering physicians considerable choice of therapies. Although all agents are tested in similarly designed clinical studies, comparison of their outcomes is not possible except in carefully controlled head-to-head comparator studies. In this review, the current, recent, and most imminent therapies are discussed and an overall summary is presented along with a discussion of how they are perceived relative to the older or other recent agents.
The list of potentially effective agents for the treatment of MS may be exhaustive, but several have now completed their phase 3 trials and have received or imminently expect government approval. This review discusses these new agents in terms of their perceived mechanisms of action and their respective results, and attempts to position them among the currently approved and utilized agents for MS.
Although it is not yet possible to predict which treatment is best suited to a given patient, it is nevertheless important to have a perspective of the possible agents and their efficacy and safety, and a plan regarding how to use them in order to maximize benefit and minimize harm in controlling relapsing MS.
多发性硬化症（MS）的治疗正在从当前的肠胃外免疫调节剂和早期口服替代药物发展，为医生提供了相当多的治疗选择。尽管所有药物都在设计相似的临床研究中进行了测试，但除非在精心控制的直接比较研究中，否则无法比较它们的疗效。在本综述中，讨论了当前、近期和即将推出的治疗方法，并给出了总体总结，同时讨论了它们相对于旧药或其他近期药物的情况。
治疗MS的潜在有效药物清单可能已详尽无遗，但有几种药物现已完成3期试验，并已获得或即将获得政府批准。本综述根据这些新药的作用机制和各自的结果进行了讨论，并试图将它们定位在目前已批准和使用的MS药物之中。
虽然目前还无法预测哪种治疗方法最适合特定患者，但了解可能的药物及其疗效和安全性，并制定如何使用它们的计划，对于在控制复发型MS时最大化益处和最小化危害仍然很重要。
