Tag Archives: Methotrexate

Other Off-Label Agents Used in the Treatment of RRMS

Corticosteroids Corticosteroids are considered as standard treatment for acute relapses. Corticosteroids decrease inflammation and stabilize the blood brain barrier, resulting in more rapid recovery from relapses. The standard dose is 1 g of methylprednisolone (MP) daily for 3-5 days through I/V infusion, although other regimens also have been used. Some studies have suggested that oral… Read More »

Combination Therapy in Multiple Sclerosis

The treatment of multiple sclerosis (MS) has been revolutionalized over the past decade. Just 12 years ago, multiple sclerosis was not considered a treatable neurologic illness and our therapeutic armamentarium consisted largely of symptomatic therapies and corticosteroids to treat acute exacerbations. Currently, there are five drugs [the three beta interferons (IFNs) (Avonex®, Betaseron®, and Rebif®),… Read More »

Therapy in Multiple Sclerosis: IFN, Methylprednisolone, and Methotrexate

Corticosteroids have anti-inflammatory and immunosuppressive properties and have been used to treat acute multiple sclerosis exacerbations for more than 30 years. While periodic pulses of intravenous (IV) methylprednisolone are not effective in preventing disability in patients with progressive MS, a phase II trial concluded that they do have an effect on disability, brain atrophy, and… Read More »

Acute Treatment: Cyclophosphamide

Cyclophosphamide is an alkylating agent with immunosuppressive properties and is commonly used in treatment of immune-mediated disease. The role of cyclophosphamide in multiple sclerosis has been studied extensively, and the current literature supports its use in active inflammatory demyelination. Uncontrolled data suggests that cyclophosphamide may be an effective alternative for treatment of rapidly worsening multiple… Read More »

Delirium: Etiology

Delirium has a wide variety of etiologies, which may occur alone or in combination (). These include primary cerebral disorders, systemic disturbances that affect cerebral function, drug and toxin exposure (including intoxication and withdrawal), and a range of factors that can contribute to delirium but have an uncertain role as etiological factors by themselves (psychological… Read More »

Treatment Of Breakthrough Disease

There is consensus that therapy in relapsing-remitting multiple sclerosis (MS) in the pediatric age group should be initiated with first-line treatments approved for adult multiple sclerosis (MS), namely one of the three forms of interferon-beta or glatiramer acetate (GA). However, as in adults with multiple sclerosis (MS), the disease remains clinically or radiologically active in… Read More »

Breakthrough Therapies: Drugs Approved in Other Indications

Cyclophosphamide Cyclophosphamide is an alkylating agent that is used to treat various types of cancer as well as autoimmune diseases. The main effect of cyclophosphamide is attributed to its metabolite phosphoramide mustard, which forms DNA interstrand crosslinks in cells with low levels of aldehyde dehydrogenase, leading to cell death. For multiple sclerosis therapy, cyclophosphamide is… Read More »

Breakthrough Therapies: Monoclonal antibodies

Rituximab Rituximab is a chimerk monoclonal antibody specific for the B-lymphocyte surface protein CD20. Rituximab induces a very rapid and dramatic depletion of B cells via mechanisms including apoptosis and immune-mediated cytotoxkity. Plasma cells lack CD20 and are therefore not affected by rituximab. B cells are replenished from pre-B cells coming from the bone marrow… Read More »