hrvatski

Recommendations for the diagnosis and treatment of patients with multiple sclerosis

This paper presents recommendations for the diagnosis and treatment of patients with multiple sclerosis ((MS). Diagnostic aspects of a demyelinating disease type MS and argumented clinical and paraclinical criteria have been given. Also, the value of individual therapeutic agents in the treatment of acute phase, as well as the possibility of prevention of new relapses and progress of the disease has been assessed. On the basis of class I trials interferon beta (IFNβ ) has been demonstrated to reduce the attack rate (measured clinically and by magnetic resonance imaging - MRI) in patients with MS or with clinically isolated syndrome who are at high risk for developing MS. Treatment of MS with IFNβ produces a beneficial effect on disease severity (measured clinically or by MRI) and probably slows sustained disability progression. Treatment with glatiramer acetate also produces a beneficial effect on disease severity (results based on clinical and MRI findings) and possibly also slows sustained disability progression in patients with relapsing-remitting multiple sclerosis (RRMS). On the basis of trials that involved small number of patients it was concluded that intravenous immunoglobulins (IVIg) reduce the attack rate and sustained disability progression in patients with RRMS. Class II and class III clinical trials have shown that mitoxantrone possibly alters the course of progressive form of MS and probably reduces the attack rate in patients with RRMS. Similar results have been accomplished in clinical trials that involved smaller groups of patients with other cytostatics (cyclophosphamide, cladribine, azathioprine, methotrexate). Until recently no treatment has shown positive effect to primary progressive form of disease. Howewer, results of one study point out beneficial effect of interferon beta 1b (IFNβ -1b) on MRI parameters in this group of patients. Special review has been dedicated to the possibility of symptomatic treatment of these patients.

multiple sclerosis; diagnosis; clinical studies; treatment

Rad na hrvatskom jeziku objavljen je na stranicama 67-93.

engleski

Recommendations for the diagnosis and treatment of patients with multiple sclerosis

This paper presents recommendations for the diagnosis and treatment of patients with multiple sclerosis ((MS). Diagnostic aspects of a demyelinating disease type MS and argumented clinical and paraclinical criteria have been given. Also, the value of individual therapeutic agents in the treatment of acute phase, as well as the possibility of prevention of new relapses and progress of the disease has been assessed. On the basis of class I trials interferon beta (IFNβ ) has been demonstrated to reduce the attack rate (measured clinically and by magnetic resonance imaging - MRI) in patients with MS or with clinically isolated syndrome who are at high risk for developing MS. Treatment of MS with IFNβ produces a beneficial effect on disease severity (measured clinically or by MRI) and probably slows sustained disability progression. Treatment with glatiramer acetate also produces a beneficial effect on disease severity (results based on clinical and MRI findings) and possibly also slows sustained disability progression in patients with relapsing-remitting multiple sclerosis (RRMS). On the basis of trials that involved small number of patients it was concluded that intravenous immunoglobulins (IVIg) reduce the attack rate and sustained disability progression in patients with RRMS. Class II and class III clinical trials have shown that mitoxantrone possibly alters the course of progressive form of MS and probably reduces the attack rate in patients with RRMS. Similar results have been accomplished in clinical trials that involved smaller groups of patients with other cytostatics (cyclophosphamide, cladribine, azathioprine, methotrexate). Until recently no treatment has shown positive effect to primary progressive form of disease. Howewer, results of one study point out beneficial effect of interferon beta 1b (IFNβ -1b) on MRI parameters in this group of patients. Special review has been dedicated to the possibility of symptomatic treatment of these patients.

multiple sclerosis; diagnosis; clinical studies; treatment

Rad na hrvatskom jeziku objavljen je na stranicama 67-93.