An update on combination therapies for multiple sclerosis: where are we now?
Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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An update on combination therapies for multiple sclerosis : where are we now? / Sorensen, Per Soelberg; Magyari, Melinda; Sellebjerg, Finn.
I: Expert Review of Neurotherapeutics, Bind 23, Nr. 12, 2023, s. 1173-1187.Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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TY - JOUR
T1 - An update on combination therapies for multiple sclerosis
T2 - where are we now?
AU - Sorensen, Per Soelberg
AU - Magyari, Melinda
AU - Sellebjerg, Finn
PY - 2023
Y1 - 2023
N2 - 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.
AB - 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.
KW - Humans
KW - Multiple Sclerosis/drug therapy
KW - Immunosuppressive Agents/therapeutic use
KW - Multiple Sclerosis, Relapsing-Remitting/drug therapy
KW - Glatiramer Acetate/therapeutic use
KW - Anti-Inflammatory Agents/therapeutic use
KW - Randomized Controlled Trials as Topic
U2 - 10.1080/14737175.2023.2289572
DO - 10.1080/14737175.2023.2289572
M3 - Review
C2 - 38058171
VL - 23
SP - 1173
EP - 1187
JO - Expert Review of Neurotherapeutics
JF - Expert Review of Neurotherapeutics
SN - 1473-7175
IS - 12
ER -
ID: 387696134