GUIDELINES FOR THE THERAPEUTIC MANAGEMENT OF MULTIPLE-SCLEROSIS

Strategies proposed for the treatment of multiple sclerosis are numero us and sometimes contradictory. This review summarizes the most recent studies on the treatment of multiple sclerosis. Possibilities of infl uencing progression of the disease and the degree of disability suffer ed by patients are discussed. The treatment of acute relapses with hig h-dose intravenous glucocorticoids is now widely accepted because it h as been shown that the duration of the relapse is reduced. Interval th erapy between relapses and treatment of the chronic progressive varian t of multiple sclerosis are still under debate. Immunosuppression, in particular with azathioprin, appears to have a positive effect on the long-term outcome. Whether other regimens, e.g. treatment with recombi nant lymphokines, have a therapeutic effect, is difficult to assess at present since these substances have either never been tested in contr olled double blind studies or the results of these studies are not yet available.