Back to Browse Journals » Drug Design, Development and Therapy » Volume 5

Development of oral immunomodulatory agents in the management of multiple sclerosis

Authors Nicholas R, Giannetti P, Alsanousi A, Friede T, Muraro PA

Published Date May 2011 Volume 2011:5 Pages 255—274

DOI http://dx.doi.org/10.2147/DDDT.S10498

Published 10 May 2011

Richard Nicholas1,2, Paolo Giannetti2, Ali Alsanousi2, Tim Friede3, Paolo A Muraro1,2
1Imperial College Healthcare NHS Trust, London, UK; 2Centre for Neurosciences, Division of Experimental Medicine, Department of Medicine, Imperial College London, UK; 3Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany

Abstract: The emergence of oral disease-modifying therapies in multiple sclerosis (MS) will have a significant impact on the evolving scenario of immunomodulatory treatments in MS where current therapies are all injectable. Reducing relapses in trials translates for individuals with MS into a therapeutic aim of stopping future events. Thus the possible absence of any perceived benefits to the individual together with the long disease course, variable outcome, and a younger age group affected in MS makes side effects the major issue. The use of disease-modifying therapies as a whole needs to be placed in the context of a widening therapeutic indication where the use of these therapies is being justified at an increasingly early stage and in pre-MS syndromes such as clinically isolated and radiologically isolated syndromes where no fixed disability is likely to have accumulated. The five oral therapies discussed (cladribine, fingolimod, laquinimod, BG-12, and teriflunomide) have just completed Phase III studies and some have just been licensed. New oral drugs for MS need to be placed within this evolving marketplace where ease of delivery together with efficacy and side effects needs to be balanced against the known issues but also the known long-term safety of standard injectables.

Keywords: multiple sclerosis, immunomodulatory treatment, cladribine, fingolimod, laquinimod, BG-12, teriflunomide

Download Article [PDF] View Full Text [HTML] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Readers of this article also read:

Adherence and persistence with branded antidepressants and generic SSRIs among managed care patients with major depressive disorder

Xianchen Liu, Yi Chen, Douglas E Faries, et al

ClinicoEconomics and Outcomes Research 2011, 3:63-72

Published Date: 15 March 2011

Treatment of nephrotic syndrome with adrenocorticotropic hormone (ACTH) gel

Andrew S Bomback, James A Tumlin, Joel Baranski, et al

Drug Design, Development and Therapy 2011, 5:147-153

Published Date: 14 March 2011

Continuation treatment of major depressive disorder: is there a case for duloxetine?

Trevor R Norman, James S Olver

Drug Design, Development and Therapy 2010, 4:19-31

Published Date: 12 February 2010

Structure-based design of anticancer prodrug PABA/NO

Xinhua Ji, Ajai Pal, Ravi Kalathur, Xun Hu, Yijun Gu, et al

Drug Design, Development and Therapy 2008, 2:123-130

Published Date: 11 August 2008