CURRENT AND INVESTIGATIONAL THERAPIES USED TO ALTER THE COURSE OF DISEASE IN MULTIPLE-SCLEROSIS

Extensive research is under way to develop pharmacotherapeutic agents that will prevent the exacerbations and the progression of neurologic disability associated with multiple sclerosis (MS). The most intensive research strategy has involved agents intended to Limit demyelination by reducing inflammation and modifying the immune response. In this c ategory are interferon beta-lb, the first compound approved for use ou tside of clinical trials; interferon beta-1a; and copolymer 1. Experim ental agents include other interferons, methotrexate, linomide, monocl onal antibodies, T-cell receptor peptides, and 2-chlorodeoxyadenosine. Although they have been used effectively to treat exacerbations of MS , corticosteroids and corticotropin are now under evaluation as diseas e-modifying agents. A second strategy, enhancing remyelination by limi ting demyelination and oligodendrocyte injury, is represented by prote in growth factors. A third therapeutic approach, improving conduction in demyelinated fibers, is represented by the potassium channel blocke rs 4-aminopyridine and 3,4-diaminopyridine.