By Chris H. Polman
This thoroughly revised version of the best-selling a number of Sclerosis: The advisor to therapy and administration is a finished, obtainable advisor to the current healing ideas and their efficacy. specified positive aspects contain specialist opinion statements for every MS remedy; a different consultant to the broad variety of healing strategies on hand; a radical dialogue of the usefulness, effectiveness, and uncomfortable side effects of person remedies; a brand new bankruptcy on unconventional treatments; and a close consultant to additional reading.This compendium of the main often used remedies for a number of sclerosis is an authoritative reference for all physicians and a genuine advisor for sufferers who desire information regarding cures. For reader accessibility, the ebook is equipped into sections facing the therapy of acute exacerbations, disease-modifying remedies, symptom administration, and replacement cures. each one bankruptcy within the re-creation concludes with references, in particular beneficial for readers who wish additional info concerning the treatments mentioned.
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Extra resources for Multiple Sclerosis: The Guide to Treatment and Management, Sixth Edition
More recently, large, randomized, controlled trials have been performed with substances that should be seen as immune modulators rather than as immune suppressors. These studies have led to the regulatory approval of a series of “diseasemodifying” agents [Avonex®, Betaseron® (Betaferon® in Europe), Copaxone®, and Rebif® worldwide, and mitoxantrone (Novantrone®) and Tysabri® in North America]. Although there 21 22 Multiple Sclerosis: The Guide to Treatment and Management is some evidence for a reduction in the rate of progression of neurologic impairment and disability, none of these agents have been shown to achieve a sustained remission, complete halt of further progression, or substantially alleviate long-standing disability.
Although longterm follow-up of monosymptomatic patients indicates that the likelihood of a second clinical event and the development of disability increases with certain clinical characteristics (progressive course of disease, sphincter or motor symptoms at onset, male sex, or high attack frequency within the first years) as well as with the lesion load on brain MRI, determining the exact future prospectives for a given individual is still not possible because the prognostic value of these factors is only modest.
The issue of long-term safety is likely to limit the duration of treatment. Treatments That Affect the Long-Term Course of the Disease 39 Natalizumab (Tysabri®) Natalizumab (Tysabri®) is a humanized monoclonal antibody against the α4 chain of α4β1 integrin. Monoclonal antibodies are antibodies that can be very specifically targeted to certain molecules; they thereby represent a way of inducing selective immunomodulation. “Humanized” means that a murine antibody clone has been grafted to a human framework in order to reduce its immunogenicity.