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Yıl:2011; Cilt: 48; Sayı: Özel 2>> Özet
TAM METİN
Nöropsikiyatri Arşivi; 2011;48(Özel 2):46-55
Dünden Bugüne, Multipl Skleroz’da Hastalık Sürecini Kontrol Eden Tedaviler
M Eraksoy
İstanbul Üniversitesi İstanbul Tıp Fakültesi, Nöroloji Anabilim Dalı, İstanbul, Türkiye
Multipl skleroz (MS)’lu hastalar yaşam boyu süren ve henüz kesin tedavisi olmayan bir hastalığa sahiptir. Tedavilerin altta yatan inflamasyon, demiyelinizasyon ve akson kaybı üzerinde sürekli tedavi edici bir etkisi olması gerekir. İnterferon beta (IFNB) ve glatiramer asetatın (GA) geliştirimesi MS tedavisinde önemli bir köşe taşıdır. İnterferonlar, 1995 yılından beri, glatiramer asetat 1999 yılından beri multipl skleroz tedavisinde kullanılmak üzere Türkiye pazarında bulunmaktadır. Geçen sürede, bu ilaçların etkinlik, güvenilirlik ve tahammül yönünde, uzun süreli, doz karşılaştırmalı, beyin MRG rehberliğinde, nötralizan antikorların durumunu inceleyen çalışmalar farklı klinik seyir tiplerinde ve farklı etnik gruplarda yapılmıştır. Bu çalışmalar sonucunda, bu ilaçların MS’in özellikle relapsing-remitting (RRMS) formunda oldukça etkili ve güvenli ilaçlar olduğu, ilk sıra tedavisi olarak kullanılabilecekleri ortaya konmuştur.Yeni geliştirilen tedaviler bulunmakla birlikte, bu ilaçları klinik kesin MS’i ve atakları olan hastaların çoğunluğu kullanmalıdır. Hasta gereksinimleri temel alınarak yapılan değerlendirmelerle, bu ilaçların MS tedavisindeki konumlarını, korumaya devam edecekleri beklenmektedir.
Past and Present of Disease-Modifying Treatments in Multiple Sclerosis
Patients with multiple sclerosis have a lifelong disease for which no cure is currently available. Treatments for MS should demonstrate sustained efficacy to slow or stop the inflammation, demyelination or axonal damage in the central nervous system. The development of interferon beta (IFNB) preparations and glatiramer acetate (GA) as treatments for MS represents a critical milestone in the care of patients with this potentially disabling disease. Interferons for MS have been available in the Turkish market since 1995, and GA - since 1999. Since those days, many clinical trials have been conducted in order to understand the efficacy, safety, tolerability, as well as the adverse effects of IFNB and GA in different clinical courses of the disease and ethnic groups. These studies revealed that IFNBs and GA are efficient and safe therapies as the first-line treatment, particularly for relapsing-remitting MS. Although there are other recently developed drugs, it is expected that IFNBs and GA will continue to be available in the market for patients with MS. Most patients with clinically definite MS and a history of relapses should be considered for treatment with these agents while the search for better agents is ongoing.

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