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Rigshospitalet - a part of Copenhagen University Hospital
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The window of opportunity for treatment of progressive 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 changing course of multiple sclerosis: rising incidence, change in geographic distribution, disease course, and prognosis

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  3. The influence of lifestyle and gender on cluster headache

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

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  5. Update on new muscle glycogenosis

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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

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  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: Based on the knowledge of disease mechanisms in the progressive course of multiple sclerosis and the experience from randomized clinical trials, we assessed the timing of disease-modifying therapy in patients with progressive multiple sclerosis to define the optimal window of opportunity for treatment of progressive multiple sclerosis.

RECENT FINDINGS: In progressive multiple sclerosis both small molecules that cross the blood--brain barrier (siponimod) and monoclonal antibodies (ocrelizumab) have shown therapeutic efficacy and have been approved for treatment of progressive multiple sclerosis. However, the majority of phase II and phase III trials in progressive forms of multiple sclerosis have been negative, probably owing to either late start of treatment or use of drugs that are ineffective for treatment of progressive multiple sclerosis.

SUMMARY: Results from phase II and III trials suggest that the window of opportunity for treatment of progressive multiple sclerosis with anti-inflammatory drugs is predominantly in the early phase of the progressive disease course when patients have lower age, shorter duration of progressive multiple sclerosis, and more pronounced clinical and MRI inflammatory activity. Ongoing trials of neuroprotective drugs may widen the window of opportunity by expanding targeted pathophysiologies.

Original languageEnglish
JournalCurrent Opinion in Neurology
Volume33
Issue number3
Pages (from-to)262-270
Number of pages9
ISSN1350-7540
DOIs
Publication statusPublished - Jun 2020

    Research areas

  • Antibodies, Monoclonal, Humanized/therapeutic use, Antibodies, Monoclonal/therapeutic use, Azetidines/therapeutic use, Benzyl Compounds/therapeutic use, Disease Progression, Humans, Longitudinal Studies, Magnetic Resonance Imaging, Multiple Sclerosis, Chronic Progressive/diagnostic imaging, Neuroprotective Agents/therapeutic use, Time Factors, Time-to-Treatment, neuroprotective treatment, progressive multiple sclerosis, window of opportunity for start of treatment, disease-modifying therapy, anti-inflammatory treatment

ID: 61640759