Insights

  

Multiple Sclerosis: A Disease of an Immune System Gone Awry


In light of recent changes in the multiple sclerosis treatment paradigm, Clyde E. Markowitz, MD, and Fred D. Lublin, MD, reflect on remaining unmet needs and potential directions for future therapeutic management to take.

An explanation of the complexities of and important considerations for switching therapy while treating multiple sclerosis is provided by Patricia K. Coyle, MD, and Clyde E. Markowitz, MD.

Both experts review the effectiveness of natalizumab against its safety profile in multiple sclerosis given past experience and clinical trial data.

Fred D. Lublin, MD, establishes the role for 2 of the original agents used to treat multiple sclerosis (MS), interferon and glatiramer acetate, before warning against the use of intravenous immunoglobulin.

All 3 keynote opinion leaders aim to nuance optimal approaches to therapy selection among disease-modifying therapies (DMTs) for multiple sclerosis (MS), particularly oral versus infusion therapy.

After clarifying differences between pediatric and adult multiple sclerosis (MS), Patricia K. Coyle, MD, highlights key take-home messages from the PARADIGMS trial.

As the community faces ongoing challenges in the setting of progressive multiple sclerosis (MS), Clyde E. Markowitz, MD, shares how the EXPAND trial introduced new data that might impact the treatment paradigm.

Fred D. Lublin, MD, reviews an array of important factors to track and consider while testing agents in the clinical trial setting and to select the best options for patients with multiple sclerosis.

In light of the challenges inherent in treating multiple sclerosis, Fred D. Lublin, MD, shares insight on how appropriate use of novel agents is poised to improve outcomes.

An elucidation of the American Academy of Neurology guidelines with regard to disease-modifying therapies for patients with multiple sclerosis is provided by all 3 key opinion leaders.

Clyde E. Markowitz, MD, and Patricia K. Coyle, MD, provide insight on the 2017 revisions to the McDonald criteria that will optimize the management of patients with multiple sclerosis.

Fred D. Lublin, MD, reviews the impact that phenotype has on the extremely variable prognoses of patients with multiple sclerosis.

Fred D. Lublin, MD, and Patricia K. Coyle, MD, outline and elucidate the core phenotypes of multiple sclerosis, including the reclassification of progressive-relapsing multiple sclerosis into further subtypes.

Fred D. Lublin, MD, and Patricia K. Coyle, MD, establish the foundational understandings and conjectures of multiple sclerosis regarding etiology and its potential driving factors.
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