Several therapeutic agents are currently used as first-line agents in the
management of multiple sclerosis (MS) including interferon-beta 1a, interferon-beta 1b,
and glatiramer acetate. Currently approved second-line agents include natalizumab,
cyclophoshamide, mitoxantrone and the oral agent fingolimod. In addition, there are
several emerging therapeutic agents including laquinimod, alemtuzumab, teriflunomide,
ocrelizumab, and fumaric acid that are presently being evaluated in clinical trials. While
these new treatments have the potential to have a powerful effect on MS disease
activity, many also carry significant risks of adverse events or tolerability concerns.
With the expanding repertoire of available MS therapies clinicians will have to carefully
consider efficacy, safety, and tolerability when engaging with patients to make
treatment decisions. In this article, we describe the mechanism of action, efficacy data,
and side effect profile of MS therapies with a focus on the newly emerging agents.
Keywords: Multiple sclerosis, therapy, treatment, immunotherapy, interferon,
glatiramer acetate, natalizumab, rituximab, fingolimod, alemtuzumab,
ocrelizumab, laquinimod, cyclophosphamide, daclizumab, teriflunamide.
