Klin Farmakol Farm. 2008;22(1):23-29

CONTEMPORARY TREATMENT OF RELAPSING-REMITTING MULTIPLE SCLEROSIS AND FUTURE PERSPECTIVES

Eva Krasulová, Eva Havrdová

Centrum pro demyelinizační onemocnění Neurologická klinika 1. LF UK a VFN Praha

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS) with the prevalence in the Czech Republic 1:1 000. It is the most frequent neurological condition leading to disability of young people, and therefore very important field of neuroimmunology. In about 85 % of the patients MS begins with an acute development of neurological symptoms, with excluded other etiology and demyelination confirmed by magnetic rezonance imaging and cerebrospinal fluid findings. This is so called clinically isolated syndrome (CIS) and according to current knowledge the most optimal time for starting and adequate immunomodulatory treatment as well. MS diagnosis according to McDonald criteria is fulfilled in 85 % of the patients within two years after CIS, inflammatory activity can be proved and we are talking about relapsing-remitting MS. Natural course of MS leads in 6-10 years to CNS reserves depletion, the inflammation burns out and irreversible neurodegeneration outweights. In this secondary progressive MS there are no clinically evident attacks of acute neurological symptoms and neurological deficit slowly accumulates. In 10 % of the patients the MS course is progressive from the beginning of the disease, there are no evident attacks - we are talking about primary progressive MS. Maximum of our present treatment options including a number of new perspective drugs belongs to the group of immunosuppressive and immunomodulatory drugs. However neuroprotective treatment is absolutely missing - therefore our treating efforts have to be concentrated on early initiation of an adequate treatment, optimally in the CIS phase, with the aim of postponing irreversible CNS neurodegeneration and patients disability.

Keywords: Key words: multiple sclerosis, clinically isolated syndrome, disease progression, treatment.

Published: April 1, 2008  Show citation