Treatment effects of immunomodulatory therapies at different stages of multiple sclerosis in short-term trials

@article{Bates2011TreatmentEO,
  title={Treatment effects of immunomodulatory therapies at different stages of multiple sclerosis in short-term trials},
  author={David W. Bates},
  journal={Neurology},
  year={2011},
  volume={76},
  pages={S14 - S25}
}
  • D. Bates
  • Published 4 January 2011
  • Medicine
  • Neurology
Intervention with interferon-β (IFNβ) therapy counters early inflammatory damage to myelin and protects axons; such therapy might demonstrate greater efficacy earlier in the disease course compared with later when permanent damage has already occurred. Clinical trials conducted in patients with clinically isolated syndrome (CIS) show clinical benefits of early treatment of multiple sclerosis (MS), as evidenced by delayed conversion to clinically definite multiple sclerosis and reduced… 
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References

SHOWING 1-10 OF 57 REFERENCES
Why treat early multiple sclerosis patients?
  • G. Comi
  • Medicine
    Current opinion in neurology
  • 2000
TLDR
Data indicate that patients with relapsing remitting multiple sclerosis may benefit from early treatment, and the positive results of the Controlled High Risk Subjects Avonex Multiple Sclerosis Prevention Study support this conclusion.
Intramuscular interferon beta‐1a for disease progression in relapsing multiple sclerosis
TLDR
Interferon beta‐ la had a significant beneficial impact in relapsing multiple sclerosis patients by reducing the accumulation of permanent physical disability, exacerbation frequency, and disease activity measured by gadolinium‐enhanced lesions on brain magnetic resonance images.
Treatment with interferon beta-1b delays conversion to clinically definite and McDonald MS in patients with clinically isolated syndromes.
TLDR
Interferon beta-1b 250 mug subcutaneously every other day delayed conversion to clinically definite multiple sclerosis, and should be considered as a therapeutic option in patients presenting with a first clinical event suggestive of multiple sclerosis.
Intramuscular interferon beta-1a therapy initiated during a first demyelinating event in multiple sclerosis. CHAMPS Study Group.
TLDR
Starting treatment with interferon beta-1a at the time of a first demyelinating event is beneficial for patients with brain lesions on MRI that indicate a high risk of clinically definite multiple sclerosis.
Impact of interferon beta-1a on neurologic disability in relapsing multiple sclerosis
TLDR
It is demonstrated that IFNβ-1a treatment is associated with robust, clinically important beneficial effects on disability progression in relapsing MS patients and post hoc analyses related to disability outcomes using data collected during the double-blind, placebo-controlled phase III clinical trial.
Effect of early interferon treatment on conversion to definite multiple sclerosis: a randomised study
TLDR
Interferon beta-1a treatment at an early stage of multiple sclerosis had significant positive effects on clinical and MRI outcomes.
Treatment with interferon beta-1b delays conversion to clinically definite and McDonald MS in patients with clinically isolated syndromes
TLDR
Interferon beta-1b 250 μg subcutaneously every other day delayed conversion to clinically definite multiple sclerosis, and should be considered as a therapeutic option in patients presenting with a first clinical event suggestive of multiple sclerosis.
Placebo-controlled multicentre randomised trial of interferon β-1b in treatment of secondary progressive multiple sclerosis
TLDR
Treatment with interferon β-1b is the first treatment to show a therapeutic effect in patients with SP-MS, and delayed progression for 9–12 months in a study period of 2–3 years.
Long-term effect of early treatment with interferon beta-1b after a first clinical event suggestive of multiple sclerosis: 5-year active treatment extension of the phase 3 BENEFIT trial
TLDR
Effects on the rate of conversion to CDMS and the favourable long-term safety and tolerability profile support early initiation of treatment with interferon beta-1b, although a delay in treatment by up to 2 years did not affect long- term disability outcomes.
Effect of early versus delayed interferon beta-1b treatment on disability after a first clinical event suggestive of multiple sclerosis: a 3-year follow-up analysis of the BENEFIT study
TLDR
The data suggest that early initiation of treatment with interferon beta-1b prevents the development of confirmed disability, supporting its use after the first manifestation of relapsing-remitting MS.
...
1
2
3
4
5
...