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Treatment of multiple sclerosis: role of natalizumab

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Abstract

The results on relapse rate and disease progression of available drugs for multiple sclerosis are shown, as well as their most relevant side effects. Results from pivotal and long-term follw-up studies support the efficacy and safety of intererons and glatiramer acetate. The treatment with mitoxantrone is limited by the occurrence of infertility, cardiotoxicy and leukaemia. Efficacy and tolerability of natalizumab are undisputable, compared to other drugs. Risks related to its treatment are PML, opportunistic infections, hepatotoxicity, melanoma, and their occurrence needs to be more exactly assessed by post-marketing surveillance. The principles of induction versus escalating therapy are also discussed. The final therapeutic decision is based on the evaluation of the disease state and prognosis, based on clinical and instrumental measures, and on the safety/efficacy profile of each treatment.

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The authors declare that they have no conflict of interest related to the publication of this article.

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  1. Department of Neurology, Institute of Experimental Neurology, Scientific Institute San Raffaele Vita-Salute University, via Olgettina 60, 20132, Milan, Italy

    Giancarlo Comi

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  1. Giancarlo Comi
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Comi, G. Treatment of multiple sclerosis: role of natalizumab. Neurol Sci 30 (Suppl 2), 155–158 (2009). https://doi.org/10.1007/s10072-009-0147-2

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