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Research Article| Volume 306, ISSUE 1-2, P170-172, July 15, 2011

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A new treatment era in multiple sclerosis: Clinical applications of new concepts

  • Gilles Edan
    Correspondence
    Corresponding author. Service de neurologie, CHU Pontchaillou, 35033 Rennes Cedex, France. Tel.: +33 2 99 28 41 22; fax: +33 2 99 28 41 32.
    Affiliations
    CHU, Service de Neurologie, 35033 Rennes, France

    INSERM, CIC 0203, Hôpital Pontchaillou, 35033 Rennes, France

    UEB, Université de Rennes 1, Faculté de médecine, 35033 Rennes, France
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  • Emmanuelle Leray
    Affiliations
    INSERM, CIC 0203, Hôpital Pontchaillou, 35033 Rennes, France

    UEB, Université de Rennes 1, Faculté de médecine, 35033 Rennes, France
    Search for articles by this author
Published:October 21, 2010DOI:https://doi.org/10.1016/j.jns.2010.09.018

      Abstract

      Several clinical courses have been defined in multiple sclerosis (MS), but uncertainty remains as to whether they reflect different neuropathological mechanisms. Two recent concepts have emerged which could influence the treatment strategy adopted in MS:
      • inflammation drives axonal damage;
      • disability progression in MS follows a two-stage process.

      Keywords

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      References

        • Lublin F.D.
        • Reingold S.C.
        Defining the clinical course of multiple sclerosis: results of an international survey.
        Neurology. 1996; 46: 907-911
        • Charcot J.M.
        Leçons sur les maladies du système nerveux faites à la Salpétrière.
        A Delahaye, Paris1880
        • Trapp B.D.
        • Peterson J.
        • Ransohoff R.M.
        • Rudick R.
        • Mörk S.
        • Bö L.
        Axonal transection in the lesions of multiple sclerosis.
        N Engl J Med. 1998; 338: 278-285
        • Frischer J.
        • Bramow S.
        • Dal-Bianco A.
        • Lucchinetti C.
        • Rauschka H.
        • Schmidbauer M.
        • et al.
        The relationship between inflammation and neurodegeneration in multiple sclerosis brains.
        Brain. 2009; 132: 1175-1189
        • Fisniku L.K.
        • Brex P.A.
        • Altmann T.R.
        • Riskiel K.A.
        • Benton C.E.
        • Lanyon R.
        • et al.
        Disability and T2 MRI lesions: a 20-year follow-up of patients with relapse onset of multiple sclerosis.
        Brain. 2008; 131: 808-817
        • Kappos L.
        • Freedman M.S.
        • Polman C.H.
        • Edan G.
        • Hartung H.P.
        • Miller D.H.
        • et al.
        BENEFIT Study Group. Effect of early versus delayed interferon beta-1b treatment on disability after a first clinical event suggestive of multiple sclerosis: a 3-year follow-up analysis of the BENEFIT study.
        Lancet. 2007; 370: 389-397
        • Kappos L.
        • Freedman M.S.
        • Polman C.H.
        • Edan G.
        • Hartung H.P.
        • Miller D.H.
        • et al.
        BENEFIT Study Group. Long-term effect of early treatment with interferon beta-1b after a first clinical event suggestive of multiple sclerosis: 5-year active treatment extension of the phase 3 BENEFIT trial.
        Lancet Neurol. 2009; 8: 987-997
        • Panitch H.
        • Miller A.
        • Paty D.
        • Weinshenker B.
        North American Study Group on Interferon beta-1b in secondary progressive MS. Interferon beta-1b in secondary progressive MS: results from a 3-year controlled study.
        Neurology. 2004; 63: 1788-1795
        • Coles A.J.
        • Compston D.A.
        • Selmaj K.W.
        • Lake S.L.
        • Moran S.
        • et al.
        • CAMMS223 Trial Investigators
        Alemtuzumab vs interferon beta-1a in early multiple sclerosis.
        N Engl J Med. 2008; 359: 1786-1801
        • Coles A.J.
        • Cox A.
        • Le Page E.
        • Jones J.
        • Trip S.A.
        • Deans J.
        • et al.
        The window of therapeutic opportunity in multiple sclerosis: evidence from monoclonal antibody therapy.
        J Neurol. 2006; 253: 98-108
        • Lublin F.D.
        • Baier M.
        • Cutter G.
        Effect of relapses on development of residual deficit in multiple sclerosis.
        Neurology. 2003; 61: 1528-1532
        • Weiner H.
        The challenge of multiple sclerosis: how do we cure a chronic heterogeneous disease?.
        Ann Neurol. 2009; 65: 239-248
        • Leray E.
        • Yaouanq J.
        • Le Page E.
        • Coustans M.
        • Laplaud D.
        • Oger J.
        • et al.
        Evidence for a two-stage disability progression in multiple sclerosis.
        Brain. 2010; 133: 1900-1913
      1. Edan G, Comi G, Le Page E, Leray E, Rocca MA, Filippi M, et al. Mitoxantrone prior to interferon beta-1b in aggressive relapsing multiple sclerosis: a 3-year randomized trial. J Neurol Neurosurg Psychiatry (submitted for publication).