CRMBM UMR 7339 CNRS, Aix Marseille Université, 13005 Marseille, France; AP-HM, Hôpital de la Timone, Pôle d'Imagerie Médicale, CEMEREM, 13005 Marseille, France; AP-HM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, 13005 Marseille, France.
AP-HM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, 13005 Marseille, France.
Rev Neurol (Paris). 2018 Jun;174(6):429-440. doi: 10.1016/j.neurol.2018.01.369. Epub 2018 May 17.
In 1993, the US Food and Drug Administration (FDA) approved the first drug specifically for treating multiple sclerosis (MS). More than two decades later, a dozen such treatments are now available. Of these, four are considered second-line treatments for use in escalation strategies and two new drugs are currently undergoing accreditation procedures. Soon, they will provide clinicians with a range of six effective disease-modifying treatments (DMTs) to thwart the inflammatory processes in MS patients with active disease. However, while such a large number of DMTs for MS can help to control early inflammation, any decisions to be made by clinicians have also been made substantially more complex. This complexity is increased by the lack of head-to-head studies comparing these second-line therapies and the benefit-risk profiles for each of these drugs, which are likely to vary among patients. Ultimately, good awareness of the benefits and, more important, the risks of each MS DMT is crucial for the effective management of inflammation in MS.
1993 年，美国食品和药物管理局 (FDA) 批准了第一种专门用于治疗多发性硬化症 (MS) 的药物。二十多年后，现在已有十几种此类治疗方法。其中，有四种被认为是二线治疗方法，可用于升级策略，两种新药物目前正在进行认证程序。很快，它们将为临床医生提供一系列六种有效的疾病修正治疗 (DMT)，以阻止 MS 患者的炎症过程。然而，尽管有如此多的 MS DMT 可以帮助控制早期炎症，但临床医生做出的任何决策也变得更加复杂。由于缺乏比较这些二线治疗方法的头对头研究，以及每种药物的获益-风险概况，这些药物可能因患者而异，这种复杂性进一步增加。最终，对每种 MS DMT 的益处，更重要的是，对每种 MS DMT 的风险有良好的认识，对于 MS 炎症的有效管理至关重要。
