Contemporary immunomodulatory therapy for multiple sclerosis.

Multiple sclerosis (MS) is no longer considered an unmanageable disease. Five drugs have obtained regulatory approval to safely and effectively modify the course of MS. Three preparations of interferon beta-Avonex (interferon beta-1a), Betaseron (interferon beta-1b), and Rebif (interferon beta 1a)-have shown efficacy in relapsing-remitting MS and show promise in slowing the course of secondary progressive MS. Glatiramir acetate (Copaxone) has demonstrated efficacy in relapsing-remitting MS, and is being tested for the management of primary progressive disease. Mitoxantrone (Novantrone) has been approved for secondary progressive and progressive relapsing MS. There is a tendency toward early diagnosis and treatment based on the hypothesis that treatment effectiveness declines with advancing disease.