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Rigshospitalet - a part of Copenhagen University Hospital
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New management algorithms in multiple sclerosis

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  1. Editorial: Remaining diagnostic issues and start of a treatment era for muscle diseases

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  2. The window of opportunity for treatment of progressive multiple sclerosis

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  3. The changing course of multiple sclerosis: rising incidence, change in geographic distribution, disease course, and prognosis

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  4. The influence of lifestyle and gender on cluster headache

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  5. Exercise in muscle disorders: what is our current state?

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  1. Dimethyl Fumarate Treatment in Patients With Primary Progressive Multiple Sclerosis: A Randomized, Controlled Trial

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  2. Exposure to passive smoking during adolescence is associated with an increased risk of developing multiple sclerosis

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Using Smartphones and Wearable Devices to Monitor Behavioral Changes During COVID-19

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  4. The apparently milder course of multiple sclerosis: changes in the diagnostic criteria, therapy and natural history

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  5. Initial high-efficacy disease-modifying therapy in multiple sclerosis: A nationwide cohort study

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PURPOSE OF REVIEW: Our current treatment algorithms include only IFN-β and glatiramer as available first-line disease-modifying drugs and natalizumab and fingolimod as second-line therapies. Today, 10 drugs have been approved in Europe and nine in the United States making the choice of therapy more complex. The purpose of the review has been to work out new management algorithms for treatment of relapsing-remitting multiple sclerosis including new oral therapies and therapeutic monoclonal antibodies.

RECENT FINDINGS: Recent large placebo-controlled trials in relapsing-remitting multiple sclerosis have shown efficacy of new oral disease-modifying drugs, teriflunomide and dimethyl fumarate, with similar or better efficacy than the injectable disease-modifying drugs, IFN-β and glatiramer acetate. In addition, the new oral drugs seem to have a favorable safety profile. Further, the monoclonal antibody alemtuzumab, which in clinical trials has shown superiority to subcutaneous IFN-β 1a, has been approved in Europe, but not yet in the United States.

SUMMARY: In de novo-treated patients, the injectables, IFN-β and glatiramer acetate, will to a great extent be replaced by the new orals, dimethyl fumarate and teriflunomide. However, patients who are stable on an injectable with no or minor side-effects could continue their current therapy. Alemtuzumab should be used as a second-line therapy.

Original languageEnglish
JournalCurrent Opinion in Neurology
Volume27
Issue number3
Pages (from-to)246-59
Number of pages14
ISSN1350-7540
DOIs
Publication statusPublished - Jun 2014

ID: 44352621