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Part 4 of 2016 Symposium: Current and future therapies – Are we getting closer to addressing the unmet needs?
Sven Schippling, Switzerland
The symposium “Do we still have unmet needs in MS therapy?” was sponsored by Merck KGaA, Darmstadt, Germany. It was recorded at ECTRIMS 2016 in London.
Over the past 10 years many new therapies have been approved. Dr Schippling reviews the newer therapies: inhibitors of immune-cell trafficking (eg, natalizumab, fingolimod), influencers of immune cell function (eg. daclizumab), inhibitors of cell replication (eg, mitoxantrone), and promoters of selective immune cell depletion (eg, alemtuzumab, cladribine tablets, ocrelizumab). To safely sequence drug therapies that have different mechanisms of action, it is important to look beyond quantitative drops in T cells and B cells in blood, and to evaluate the quality and function of cells in different immune cell compartments.
Safety is an increasing concern due to the risk of opportunistic infections such as PML and increases in malignancies with specific therapies. Although the burden of therapy and monitoring for side effects has increased, there are opportunities to incorporate software or other resources to properly monitor patients. He addresses the need for therapies that cross the blood brain barrier to potentially help manage neurodegeneration and inflammation in the CNS compartment.