Since commercialisation of the first immunomodulatory drug (IMD) for multiple sclerosis (subcutaneous interferon beta-1b) in 1995, three new IMD have been on the market: two interferons (intramuscular interferon beta-1a and subcutaneous interferon beta-1a) and glatiramer acetate. These four immunomodulatory drugs have a similar efficiency: they reduce by about 30% the relapse rate of treated patients compared to untreated patients. Their effect on disability is moderate mainly due to the reduced relapse rate. Lately, in 2002, mitoxantrone was approved for aggressive relapsing-remitting MS and in 2007 the first monoclonal antibody (natalizumab) was approved for active relapsing-remitting MS.
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