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RESEARCH PRODUCT

Preservation of neuronal function as measured by clinical and MRI endpoints in relapsing-remitting multiple sclerosis: how effective are current treatment strategies?

Christiane GraetzNelly SillerSergiu GroppaFrauke Zipp

subject

Oncologymedicine.medical_specialtyAnti-Inflammatory AgentsNeuroimagingDiseaseNeuropsychological TestsPlaceboNeuroprotectionDisability Evaluation03 medical and health scienceschemistry.chemical_compoundMultiple Sclerosis Relapsing-Remitting0302 clinical medicineInternal medicineTeriflunomidemedicineHumansPharmacology (medical)030212 general & internal medicineNeuronsExpanded Disability Status Scalebusiness.industryGeneral NeuroscienceMultiple sclerosismedicine.diseaseMagnetic Resonance ImagingFingolimodNeuroprotective AgentsTreatment OutcomeMultiple sclerosis functional compositechemistryDisease ProgressionNeurology (clinical)businessImmunosuppressive Agents030217 neurology & neurosurgerymedicine.drug

description

Approved medications for relapsing-remitting multiple sclerosis have shown to be effective in terms of their anti-inflammatory potential. However, it is also crucial to evaluate what long-term effects a patient can expect from current MS drugs in terms of preventing neurodegeneration. Here we aim to provide an overview of the current treatment strategies in MS with a specific focus on potential neuroprotective effects. Areas covered: Randomized, double-blind and placebo or referral-drug controlled phase 2a/b and phase 3 trials were examined; non-blinded phase 4 studies (extension studies) were included to provide long-term data, if not otherwise available. Endpoints considered were expanded disability status scale, various neuropsychological tests, percent brain volume change and T1-hypointense lesions as well as multiple sclerosis functional composite, confirmed disease progression, and no evidence of disease activity. Expert commentary: Overall, neuroprotective functions of classical MS therapeutics are not sufficiently investigated, but available data show limited effects. Thus, further research and development in neuroprotection are warranted. When counselling patients, potential long-term beneficial effects should be presented more conservatively.

https://doi.org/10.1080/14737175.2018.1438190