appropriate choice for patients who are unable to tolerate flu-like symptoms or have coexisting depressive disorder.oNatalizumab: is a humanized monoclonal antibody that is designed to block the movement of potentially damaging immune cells from your bloodstream to your brain and spinal cord. It may be considered a first line treatment for some people with severe MS or as a second line treatment in others. This medication increases the risk of a viral infection of the brain called progressive multifocal leukoencephalopathy in some people (Mayo Clinic, 2017).
oMitoxantrone: this immunosuppressant drug chemically related to the antineoplastic agents doxorubicin and daunorubicin. It can be harmful to the heart and is associated with development of blood cancers. As a result, its usein treating MS is extremely limited. It is usually used only to treat severe, advanced MS.oFingolimod: is a new class of medication called a sphingosine 1-phosphate receptor modulator (an immunomodulator) that acts by retaining certain white blood cells (lymphocytes) in the lymph nodes, thereby preventing those cells from crossing the blood-brain barrier into the central nervous system (CNS). Preventing the entry of these cells into the CNS reduces inflammatory damage to nerve cells as well as reduces relapses.oTeriflunomide: a pyrimidine synthesis inhibitor, an immunomodulatory agent that inhibits the function of specific immune cells that have been implicated in MS.oDimethyl fumarate: an immunomodulator that inhibits immune cells and molecules, and may have anti-oxidant properties that could be protective against damage to the brain and spinal cord. In addition, they have been shown to reduce the likelihood of developing a second attack after a first CIS consistent with MS.oAlemtuzumab: is a humanized monoclonal antibody directed at CD52, and helps reduce relapses of MS by targeting a protein on the surface of immune cells and depleting white blood cells. Because of this medication’s safety profile, the FDA recommends that this medication generally be reserved for people who have had an inadequate response to two or more MS therapies (NMSS, 2017).oDaclizumab: is a laboratory-created monoclonal antibody. It is designed to inhibit certain inflammatory functions of T cells and increase important immune cells that help regulate the immune system. It is also reserved for people who have had an inadequate response to two or more disease-modifying medications.
- Summer '15