Freedom from disease activity in multiple sclerosis

Background: Multiple sclerosis (MS) shares many pathologic features with other immune-mediated inflammatory diseases, such as rheumatoid arthritis, Crohn disease, and psoriasis. The development of effective biologic agents for rheumatoid arthritis has resulted in a treatment paradigm shift such that disease remission is now an explicit goal. Expert Clinical Opinion: The traditional immunomodulatory disease-modifying therapies for MS (interferon beta and glatiramer acetate) delay disease progression and reduce activity on brain MRI to varying degrees; however, they have not been demonstrated to induce disease remission. Therefore, the concept of disease remission or freedom from disease activity in MS has received little attention from the neurology community. We discuss some potential definitions of disease remission in MS and whether freedom from disease activity can become an increasingly useful measure of therapeutic response. Future Directions: Future research should be directed at determining the long-term significance of freedom from disease activity during a short-term clinical trial in relapsing-remitting MS.

[1]  H. Paulus,et al.  Remission in Rheumatoid Arthritis , 2010, Current rheumatology reports.

[2]  C. Polman,et al.  Effect of natalizumab on clinical and radiological disease activity in multiple sclerosis: a retrospective analysis of the Natalizumab Safety and Efficacy in Relapsing-Remitting Multiple Sclerosis (AFFIRM) study , 2009, The Lancet Neurology.

[3]  B. Hazleman,et al.  Immune-mediated inflammatory diseases (IMIDs) and biologic therapy: a medical revolution , 2007, Postgraduate Medical Journal.

[4]  D. M. van der Heijde,et al.  Comparison of etanercept and methotrexate, alone and combined, in the treatment of rheumatoid arthritis: two-year clinical and radiographic results from the TEMPO study, a double-blind, randomized trial. , 2006, Arthritis and rheumatism.

[5]  Ludwig Kappos,et al.  A randomized, placebo-controlled trial of natalizumab for relapsing multiple sclerosis. , 2006, The New England journal of medicine.

[6]  S. Okie.  Brave New Face , 2006 .

[7]  C. Bingham,et al.  Remission in rheumatoid arthritis: wishful thinking or clinical reality? , 2005, Seminars in arthritis and rheumatism.

[8]  D. M. van der Heijde,et al.  Combination of infliximab and methotrexate therapy for early rheumatoid arthritis: a randomized, controlled trial. , 2004, Arthritis and rheumatism.

[9]  P. Hannonen,et al.  Retardation of joint damage in patients with early rheumatoid arthritis by initial aggressive treatment with disease-modifying antirheumatic drugs: five-year experience from the FIN-RACo study. , 2004, Arthritis and rheumatism.

[10]  S. Galetta,et al.  Immunomodulatory agents for the treatment of relapsing multiple sclerosis: a systematic review. , 2002, Archives of internal medicine.

[11]  E. Gremese,et al.  Analysis of improvements, full responses, remission and toxicity in rheumatoid patients treated with step-up combination therapy (methotrexate, cyclosporin A, sulphasalazine) or monotherapy for three years. , 2002, Rheumatology.

[12]  C. Geisler,et al.  The chimeric anti-CD20 antibody rituximab induces apoptosis in B-cell chronic lymphocytic leukemia cells through a p38 mitogen activated protein-kinase-dependent mechanism. , 2002, Blood.

[13]  Massimo Filippi,et al.  European/Canadian multicenter, double‐blind, randomized, placebo‐controlled study of the effects of glatiramer acetate on magnetic resonance imaging–measured disease activity and burden in patients with relapsing multiple sclerosis , 2001, Annals of neurology.

[14]  D. Paty,et al.  Magnetic resonance imaging results of the PRISMS trial: A randomized, double‐blind, placebo‐controlled study of interferon‐β1a in relapsing‐remitting multiple sclerosis , 1999 .

[15]  G. Ebers,et al.  Randomised double-blind placebo-controlled study of interferon β-1a in relapsing/remitting multiple sclerosis , 1998, The Lancet.

[16]  R. Rudick,et al.  Axonal transection in the lesions of multiple sclerosis. , 1998, The New England journal of medicine.

[17]  Jeanelle Sheeder,et al.  Magnetic resonance studies of intramuscular interferon β–1a for relapsing multiple sclerosis , 1998 .

[18]  M. Prevoo,et al.  Remission in a prospective study of patients with rheumatoid arthritis. American Rheumatism Association preliminary remission criteria in relation to the disease activity score. , 1996, British journal of rheumatology.

[19]  C. Granger,et al.  Intramuscular interferon beta‐1a for disease progression in relapsing multiple sclerosis , 1996, Annals of neurology.

[20]  J. W. Rose,et al.  Copolymer 1 reduces relapse rate and improves disability in relapsing‐remitting multiple sclerosis , 1995, Neurology.

[21]  J. Woody,et al.  Repeated therapy with monoclonal antibody to tumour necrosis factor α (cA2) in patients with rheumatoid arthritis , 1994, The Lancet.

[22]  D. Li,et al.  Interferon beta‐1b is effective in relapsing‐remitting multiple sclerosis , 1993, Neurology.

[23]  D. Paty,et al.  Interferon beta‐1b is effective in relapsing‐remitting multiple sclerosis , 1993, Neurology.

[24]  P. Duquette,et al.  Interferon beta-1b is effective in relapsing-remitting multiple sclerosis. I. Clinical results of a multicenter, randomized, double-blind, placebo-controlled trial. The IFNB Multiple Sclerosis Study Group. , 1993 .

[25]  D. Mitchell,et al.  Preliminary criteria for clinical remission in rheumatoid arthritis. , 1981, Arthritis and rheumatism.

[26]  Manjit,et al.  Neurology , 1912, NeuroImage.

[27]  P. M. Davis,et al.  Abatacept modulates human dendritic cell-stimulated T-cell proliferation and effector function independent of IDO induction. , 2008, Clinical immunology.

[28]  F. Breedveld,et al.  The PREMIER study: A multicenter, randomized, double-blind clinical trial of combination therapy with adalimumab plus methotrexate versus methotrexate alone or adalimumab alone in patients with early, aggressive rheumatoid arthritis who had not had previous methotrexate treatment. , 2006, Arthritis and rheumatism.

[29]  D. Li,et al.  Magnetic resonance imaging results of the PRISMS trial: a randomized, double-blind, placebo-controlled study of interferon-beta1a in relapsing-remitting multiple sclerosis. Prevention of Relapses and Disability by Interferon-beta1a Subcutaneously in Multiple Sclerosis. , 1999, Annals of neurology.

[30]  ichard,et al.  AXONAL TRANSECTION IN THE LESIONS OF MULTIPLE SCLEROSIS , 1998 .

[31]  Randomised double-blind placebo-controlled study of interferon beta-1a in relapsing/remitting multiple sclerosis. PRISMS (Prevention of Relapses and Disability by Interferon beta-1a Subcutaneously in Multiple Sclerosis) Study Group. , 1998, Lancet.

[32]  M. Prevoo,et al.  Development and validation of the European League Against Rheumatism response criteria for rheumatoid arthritis. Comparison with the preliminary American College of Rheumatology and the World Health Organization/International League Against Rheumatism Criteria. , 1996, Arthritis and rheumatism.

[33]  M. Prevoo,et al.  Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. , 1995, Arthritis and rheumatism.

[34]  Jeffrey A. Cohen,et al.  Copolymer 1 reduces relapse rate and improves disability in relapsing-remitting multiple sclerosis: results of a phase III multicenter, double-blind placebo-controlled trial. The Copolymer 1 Multiple Sclerosis Study Group. , 1995, Neurology.

[35]  J. Mussini,et al.  [Immunology of multiple sclerosis]. , 1982, La semaine des hopitaux : organe fonde par l'Association d'enseignement medical des hopitaux de Paris.