Service de Neurologie, Département des Neurosciences Cliniques, BT-06, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne, Switzerland,
CNS Drugs. 2014 Jun;28(6):535-58. doi: 10.1007/s40263-014-0160-8.
Multiple sclerosis (MS) is a life-long, potentially debilitating disease of the central nervous system (CNS). MS is considered to be an immune-mediated disease, and the presence of autoreactive peripheral lymphocytes in CNS compartments is believed to be critical in the process of demyelination and tissue damage in MS. Although MS is not currently a curable disease, several disease-modifying therapies (DMTs) are now available, or are in development. These DMTs are all thought to primarily suppress autoimmune activity within the CNS. Each therapy has its own mechanism of action (MoA) and, as a consequence, each has a different efficacy and safety profile. Neurologists can now select therapies on a more individual, patient-tailored basis, with the aim of maximizing potential for long-term efficacy without interruptions in treatment. The MoA and clinical profile of MS therapies are important considerations when making that choice or when switching therapies due to suboptimal disease response. This article therefore reviews the known and putative immunological MoAs alongside a summary of the clinical profile of therapies approved for relapsing forms of MS, and those in late-stage development, based on published data from pivotal randomized, controlled trials.
多发性硬化症（MS）是一种终生的、可能使人衰弱的中枢神经系统（CNS）疾病。MS 被认为是一种免疫介导的疾病，中枢神经系统中存在自身反应性外周淋巴细胞被认为是脱髓鞘和组织损伤过程中的关键因素。尽管多发性硬化症目前无法治愈，但现在已有几种疾病修正治疗（DMT）可用或正在开发中。这些 DMT 都被认为主要抑制中枢神经系统内的自身免疫活性。每种治疗方法都有其自身的作用机制（MoA），因此，每种方法的疗效和安全性都不同。神经科医生现在可以根据患者的个体情况更有针对性地选择治疗方法，目的是在不中断治疗的情况下最大限度地提高长期疗效的潜力。在做出选择或因疾病反应不理想而更换治疗方法时，MS 治疗方法的 MoA 和临床特征是重要的考虑因素。因此，本文根据关键性随机对照试验的已发表数据，综述了已批准用于缓解型多发性硬化症和处于后期开发阶段的治疗方法的已知和推测的免疫 MoA 以及临床特征。
