An update on combination therapies for multiple sclerosis: where are we now?
Research output: Contribution to journal › Review › Research › peer-review
INTRODUCTION: In theory, combination of two agents, which are suboptimal when given individually, may result in a significant increase in therapeutic effect. Combination therapies have proven particularly effective against infections such as HIV, cancer, and also chronic autoimmune diseases such as rheumatoid arthritis.
AREAS COVERED: The authors review the literature, searching for randomized placebo-controlled or comparative, double-blind or investigator-blinded clinical trials, not including open label clinical trials, of treatment of multiple sclerosis (MS) with combination therapy or add-on therapy, including trials of induction therapy, trials for prevention of disease activity or worsening, amelioration of adverse effects, and treatment of relapses, and trials to increase remyelination.
EXPERT OPINION: Combination of two platform therapies (Interferon-beta or glatiramer acetate) was without additional effect. Clinical trials with add-on, often applying repurposed drugs (e.g. simvastatin, atorvastatin, minocycline, estriol, cyclophosphamide, azathioprine, albuterol, vitamin D), have been negative, apart from monthly methylprednisolone that, however, had low tolerability. Combination therapy for neuroprotection/remyelination showed some interesting results, though we are still awaiting results of phase III trials. The results of combination of anti-inflammatory therapies have in general been disappointing. In the future, combination of new effective neuroprotective/remyelinating drugs and highly effective anti-inflammatory treatments may benefit people with MS.
Original language | English |
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Journal | Expert Review of Neurotherapeutics |
Volume | 23 |
Issue number | 12 |
Pages (from-to) | 1173-1187 |
Number of pages | 15 |
ISSN | 1473-7175 |
DOIs | |
Publication status | Published - 2023 |
- Humans, Multiple Sclerosis/drug therapy, Immunosuppressive Agents/therapeutic use, Multiple Sclerosis, Relapsing-Remitting/drug therapy, Glatiramer Acetate/therapeutic use, Anti-Inflammatory Agents/therapeutic use, Randomized Controlled Trials as Topic
Research areas
ID: 387696134