Prognosis-modifying therapy in multiple sclerosis.

The neurologist's views on disease therapy have changed over recent years from nihilism to reasonable optimism, thanks to the development of MS-specific therapies (interferon beta and COP-1) and to the remarkable advances in the understanding of the pathogenesis of the disease. Available immunological, clinical and pathological data suggest that the early treatment of RRMS patients with immunomodulatory drugs could be more advantageous compared to treatment started later in the disease course. The early reduction of relapse rate as well as of the extent of pathological lesions, should be the strategy for patients particularly in the first phases of the disease. Early treatment has a robust rationale both in prevention of irreversible pathological changes and in reducing clinical and MRI activity with favorable prognostic implications. For the near future, interferon beta and COP-1 seem to be the pharmacological agents best qualified to be utilized for this purpose.