Intro to Modifying the Course of Multiple Sclerosis: The Growing Treatment Armamentarium

In launching the Modifying the Course of Multiple Sclerosis: The Growing Treatment Armamentarium video series, moderator Peter Salgo, MD, Professor of Medicine and Anesthesiology at Columbia University and Associate Director of Surgical Intensive Care at the New York-Presbyterian Hospital in New York City, reviews available therapies for multiple sclerosis (MS) with the expert panel, which consists of Patricia K. Coyle, MD, Professor and Vice Chair of the Department of Neurology at Stony Brook University Medical Center in Stony Brook, NY; Andrew D. Goodman, MD, FAAN, Professor of Neurology, Director of the Multiple Sclerosis Center, and Chief of the Neuroimmunology Unit in the Department of Neurology at the University of Rochester Medical Center in Rochester, NY; Stephen Krieger, MD, Assistant Professor of Neurology at the Corinne Goldsmith Dickinson Center for MS and Director of the Neurology Residency Program at the Icahn School of Medicine at Mount Sinai in New York City; and Clyde E. Markowitz, MD, Director of the MC Center and Associate Professor of Neurology at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia.

Kicking off the discussion, Salgo claims “this is almost a brave new world of MS medications,” to which Markowitz adds the first MS agents only became available in the early 1990s.

“Over the years, we’ve had a few different injectable therapies — some that were interferon-based, some were some glatiramer acetate — and then, eventually, it became obvious that we needed non-injectable drugs, and so there have been efforts to look at getting orals to market, and we now have 3 (oral) agents,” Markowitz relates. Between the debuts of injectable and oral MS therapies, 2 intravenously infused agents known as mitoxantrone and natalizumab were introduced — the latter of which is currently “regaining a lot of interest because we now have abilities to screen patients for concerns of progressive multifocal encephalopathy (PML),” Markowitz notes.

Regardless of their delivery method, MS medications have reduced the attack rate, slowed the progression of disability, and lowered the requirements for receiving corticosteroid treatments, Markowitz says. Essentially, the MS agents “have changed the need for relapse treatments,” Salgo concludes.