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Compared benefit of approved and experimental immunosuppressive therapeutic approaches in multiple sclerosis.

机译:比较已批准的和实验性免疫抑制治疗方法在多发性硬化中的益处。

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An important amount has been learnt about the mechanisms of action, efficacy and long-term toxicities of mitoxantrone. Importantly, recent observations strongly suggest that early administration of potent immunosuppressants (mitoxantrone and alemtuzumab) is definitely more effective than approved immunomodulators to delay or even reverse disability progression. Given the cardiotoxicity of mitoxantrone, restricting exposure to the drug to 2 or 3 years, the benefits and risks of immunosuppressants previously used as off-label treatments (cyclophosphamide and cladribine) have been revisited, and the potential efficacy in multiple sclerosis of recent immunosuppressants used in other autoimmune diseases, organ transplantation and cancer therapy has received increasing attention. Those immunosuppressants comprise monoclonal antibodies targeting B cells, lymphocytes and monocytes, IL-2 receptor and alpha4 integrin, as well as new molecules (pixantrone and isoxazole derivatives) and a new generation of immunosuppressants (fingolimod), which modulate lymphocyte re-circulation. This review addresses the most recent data concerning the efficacy and safety of mitoxantrone and of new experimental therapies that are presently in progress.
机译:关于米托蒽醌的作用机理,功效和长期毒性,已经学到了很多。重要的是,最近的观察强烈表明,尽早给予有效的免疫抑制剂(米托蒽醌和阿仑单抗)比批准的免疫调节剂更有效地延缓甚至逆转残疾发展。考虑到米托蒽醌的心脏毒性,将药物暴露限制在2年或3年,以前的非免疫治疗药物(环磷酰胺和克拉屈滨)的益处和风险已被重新审视,最近使用的免疫抑制剂在多发性硬化中的潜在功效在其他自身免疫性疾病中,器官移植和癌症治疗受到越来越多的关注。这些免疫抑制剂包括针对B细胞,淋巴细胞和单核细胞,IL-2受体和alpha4整联蛋白的单克隆抗体,以及新分子(匹克酮和异恶唑衍生物)和新一代免疫抑制剂(芬戈莫德),它们可调节淋巴细胞的再循环。这篇综述涉及有关米托蒽醌的功效和安全性以及目前正在进行的新实验疗法的最新数据。

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