Multiple Sclerosis 15 June 2004, vol. 10, no. Supplement 1, pp. 46-55(10)
Departments of Neurology and Research, University Hospitals, Kantonsspital, Petersgraben 4, CH-4031 Basel, Switzerland
Secondary progressive multiple sclerosis (SPMS) is a form of MS characterized by continuously worsening disability with or without superimposed relapses that occurs after a variable period of relapsing remitting disease and results in limited ambulation for almost all patients.
The use of interferon beta (IFN ß) for immunomodulation in patients with SPMS has been evaluated in four recent clinical trials:
However, results from all studies demonstrated significant positive effects of treatment on relapse, T2 lesion load, and gadolinium enhancement.
Immunomodulation with IFN ß has the potential to significantly slow disease progression and improve quality of life for patients with SPMS.
While results with monthly IV Ig were disappointing, positive effects on disease progression have been reported with the application of immunosuppressants, especially Mitoxantrone.
The risk-benefit ratio of these cytostatic agents remains controversial.
New strategies addressing the important neurodegenerative aspects of the disease are urgently needed.