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Keywords:

  • multiple sclerosis;
  • interferon beta;
  • glatiramer acetate;
  • fingolimod;
  • fumarate;
  • cladribine;
  • teriflunomide;
  • natalizumab;
  • alemtuzumab;
  • daclizumab;
  • rituximab;
  • fampridine;
  • antigen-based therapies;
  • statins

Abstract

New insights into the complex immunopathogenesis of multiple sclerosis have led to a proliferation of promising new therapeutic strategies. While the current armamentarium of immunomodulatory medications has demonstrated beneficial effects on the disease, more effective and tolerable therapies are needed. Several novel therapeutic strategies under investigation include oral therapies, monoclonal antibodies, symptomatic treatments, insights into neuroprotection and repair as well as combination regimens. New therapies may prove more efficacious and tolerable than the available arsenal of treatments; however, decisions regarding first-line therapies will expectedly become more complicated, with greater influence if risk-to-benefit ratios in light of premature safety data. Biomarker profiles may help elucidate disease subtypes as well as therapeutic response in an effort to individualize treatment choice. This review will highlight recent promising therapeutic strategies under investigation in the field of MS. Mt Sinai J Med 75: 157–167, 2008© 2008 Mount Sinai School of Medicine