Classical immunomodulatory therapy in multiple sclerosis: how it acts, how it works

Arquivos de Neuro-Psiquiatria

Amélia Mendes¹  Maria José Sá¹ 

[1] ,Hospital de São João Department of Neurology Porto,Portugal

关键词: multiple sclerosis;    interferon beta;    glatiramer acetate;    immunomodulatory therapy;    esclerose múltipla;    interferão beta;    acetato de glatirâmero;    terapêutica imunomoduladora;   

DOI  :  10.1590/S0004-282X2011000400024

来源: SciELO

【 摘 要 】

Interferon beta (IFNβ) and glatiramer acetate (GA) were the first immunomodulators approved to the treatment of relapsing-remitting multiple sclerosis (MS) and clinically isolated syndromes. Despite the enlargement of the therapeutic armamentarium, IFNβ and GA remain the most widely drugs and the therapeutic mainstay of MS. OBJECTIVE: To review the mechanisms of action of IFNβ and GA and main clinical results in MS. RESULTS: IFNβ modulates T and B-cell activity and has effects on the blood-brain barrier. The well proved mechanism of GA is an immune deviation by inducing expression of anti-inflammatory cytokines. Some authors favor the neuroprotective role of both molecules. Clinical trials showed a 30% reduction on the annualized relapse rate and of T2 lesions on magnetic resonance. CONCLUSION: Although the precise mechanisms how IFNβ and GA achieve their therapeutics effects remain unclear, these drugs have recognized beneficial effects and possess good safety and tolerability profiles. The large clinical experience in treating MS patients with these drugs along almost two decades deserves to be emphasized, at a time where the appearance of drugs with more selective mechanisms of action, but potentially less safer, pave the way to a better selection of the most appropriate individualized treatment.

【 授权许可】

CC BY   
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