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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2015; 3(7): 545-555
Published online Jul 16, 2015. doi: 10.12998/wjcc.v3.i7.545
Published online Jul 16, 2015. doi: 10.12998/wjcc.v3.i7.545
Treatment strategies for multiple sclerosis: When to start, when to change, when to stop?
Alberto Gajofatto, Department of Neurological and Movement Sciences, University of Verona, 37134 Verona, Italy
Alberto Gajofatto, Maria Donata Benedetti, Regional Center for Multiple Sclerosis, Unit of Neurology, Policlinico Borgo Roma, Azienda Ospedaliera Universitaria Integrata Verona, 37134 Verona, Italy
Author contributions: Gajofatto A conceived and drafted the review; Benedetti MD revised the manuscript for important intellectual content.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Alberto Gajofatto, MD, PhD, Department of Neurological and Movement Sciences, University of Verona, Policlinico G. Rossi, Piazzale Scuro 9, 37134 Verona, Italy. alberto.gajofatto@univr.it
Telephone: +39-045-8124285 Fax: +39-045-8027492
Received: December 29, 2014
Peer-review started: December 30, 2014
First decision: February 7, 2015
Revised: May 1, 2015
Accepted: May 5, 2015
Article in press: May 6, 2015
Published online: July 16, 2015
Peer-review started: December 30, 2014
First decision: February 7, 2015
Revised: May 1, 2015
Accepted: May 5, 2015
Article in press: May 6, 2015
Published online: July 16, 2015
Core Tip
Core tip: Disease-modifying therapies for multiple sclerosis (MS) modulate or suppress with different mechanisms the autoimmune process that underlies the disease. Patients with relapsing MS may benefit from treatment but individual response to a given therapy and adverse events occurrence are largely unpredictable and many cases need to change several drugs to stabilize their disease. Nevertheless, a high proportion of patients evolve to a progressive phase, which is not responsive to any existing therapy. As opposed, some cases have a benign course without treatment. A critical review of strategies for starting, switching and stopping disease-modifying therapies for MS is here presented.