What's on this Page
Role of oral medications in Multiple Sclerosis
What is the role of oral medications agents for the treatment of Multiple Sclerosis?
Only recently have oral agents been approved to reduce relapses in MS. These include:
• Fingolimod (Gilenya)—A sphingosine-1-phosphate receptor modulator that inhibits migration of T cells from lymphoid tissue into the circulation. It has potentially serious cardiac, macular, and other toxicities.
• Teriflunomide (Aubagio)—Interferes with the syntheses of pyrimidines and thus blocks rapidly dividing cells. Because it is an antimetabolite it has potential toxicity from immune suppression and is contraindicated in patients considering childbearing.
• Dimethyl fumarate (Tecfidera)—An antiinflammatory molecule with an unknown mechanism of action. It can cause flushing and diarrhea, with rare reports of opportunistic infections.
Sources
- Noseworthy J, Hartung HP: Multiple sclerosis and related conditions. In Noseworthy J (ed): Neurological therapeutics , ed 2. London: Martin Dunitz, pp 1224-1254, 2006.
- Ransohoff RM: Natalizumab for multiple sclerosis. N Engl J Med 356(25):2622-2629, 2007.
- Coles AJ, Twyman CL, Arnold DL, Cohen JA, Confavreux C, Fox EJ, et al.: Alemtuzumab for patients with relapsing multiple sclerosis after disease-modifying therapy: a randomised controlled phase 3 trial. Lancet 380(9856):1829-1839, 2012.
- Pelletier D, Hafler DA: Fingolimod for multiple sclerosis. N Engl J Med 366(4):339-347, 2012.
- Miller A, Kappos L, Comi G, et al. Teriflunomide efficacy and safety in patients with relapsing multiple sclerosis. Neurology S1:80, 2013.
- Gold R, Linker RA, Stangel M: Fumaric acid and its esters: an emerging treatment for multiple sclerosis. Clin Immunol 142(1):44-48, 2012.
