RATIONAL CLINICAL IMMUNOTHERAPY FOR MULTIPLE-SCLEROSIS

In this article, we assess the roles and the efficacy of immunopharmac ologic agents in the treatment of multiple sclerosis (MS) and other de myelinating disease syndromes. The initial clinical manifestations of demyelinating disease, immunotherapeutic goals, efficacy of individual agents, and specific immunopharmacologic recommendations are discusse d. MS and other idiopathic demyelinating disease syndromes can be effe ctively managed with immunotherapy. Exacerbations are treatable, and t he frequency and severity of exacerbations can be reduced. Although so me agents have a minor effect on progression of disability, current ap proaches have not proved to have a major influence on treatment of pro gressive MS. Immunotherapy for inflammatory demyelinating disease nece ssitates a high degree of clinical certainty about the diagnosis. Beca use all available therapeutic agents have limitations and significant toxic effects, careful consideration is necessary before use, Treatmen t should be individualized on the basis of the clinical course of the disease and the degree of patient disability.