PMID- 18694542
OWN - NLM
STAT- MEDLINE
DCOM- 20090122
LR  - 20220321
IS  - 1473-4877 (Electronic)
IS  - 0300-7995 (Linking)
VI  - 24
IP  - 9
DP  - 2008 Sep
TI  - Managing adverse effects of disease-modifying agents used for treatment of 
      multiple sclerosis.
PG  - 2679-90
LID - 10.1185/03007990802329959 [doi]
AB  - BACKGROUND: First-line agents approved in the United States for treatment of 
      relapsing multiple sclerosis (MS) include intramuscular interferon beta 
      (IFNbeta)-1a, subcutaneous (SC) IFNbeta-1a, SC IFNbeta-1b, and SC glatiramer 
      acetate. Intravenous mitoxantrone is the only agent approved for secondary 
      progressive MS, progressive relapsing MS, and worsening relapsing MS. Intravenous 
      natalizumab is approved for relapsing forms of MS generally in patients who have 
      an inadequate response to, or are unable to tolerate, first-line therapies. 
      Corticosteroids are commonly used to treat relapses. This paper reviews the 
      incidence and management of common adverse events (AEs) associated with these 
      treatments. METHODS: MEDLINE and EMBASE were searched for clinical trials and 
      other publications between 1985 and 2007 reporting AEs associated with MS 
      therapies, using these search terms: multiple sclerosis, interferon, Avonex, 
      Betaseron, Rebif, glatiramer, copolymer 1, Copaxone, mitoxantrone, natalizumab, 
      adverse events. RESULTS: A class-specific flu-like syndrome associated with 
      IFNbeta can be managed through initial dose escalation and administration of 
      analgesics and antipyretics, prophylactically or symptomatically. Injection-site 
      reactions can occur in patients receiving injectable therapies, particularly SC 
      IFNbeta or glatiramer acetate. The greatest risk to patients receiving 
      mitoxantrone is cardiotoxicity; thus, the cumulative dose is limited. Allergic 
      reactions occur rarely with natalizumab, and there is a potential risk of 
      progressive multifocal leukoencephalopathy. AEs associated with short-term pulse 
      corticosteroid therapy are usually transient and largely resolve after treatment 
      is completed. CONCLUSIONS: To improve adherence to therapy, it is important to 
      educate patients regarding AEs and to manage AEs proactively.
FAU - Moses, Harold Jr
AU  - Moses H Jr
AD  - Vanderbilt Stallworth Rehabilitation Hospital, Vanderbilt University Medical 
      Center, Nashville, TN 37212, USA. harold.moses@vanderbilt.edu
FAU - Brandes, David W
AU  - Brandes DW
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20080808
PL  - England
TA  - Curr Med Res Opin
JT  - Current medical research and opinion
JID - 0351014
RN  - 77238-31-4 (Interferon-beta)
SB  - IM
MH  - Humans
MH  - Interferon-beta/adverse effects/*therapeutic use
MH  - Multiple Sclerosis/*drug therapy
MH  - Patient Compliance
MH  - United States
EDAT- 2008/08/13 09:00
MHDA- 2009/01/23 09:00
CRDT- 2008/08/13 09:00
PHST- 2008/08/13 09:00 [pubmed]
PHST- 2009/01/23 09:00 [medline]
PHST- 2008/08/13 09:00 [entrez]
AID - 4163d [pii]
AID - 10.1185/03007990802329959 [doi]
PST - ppublish
SO  - Curr Med Res Opin. 2008 Sep;24(9):2679-90. doi: 10.1185/03007990802329959. Epub 
      2008 Aug 8.