The aim is to describe and discuss the ongoing debate on how to balance an increase in clinical efficacy against a heightened risk of developing serious side-effects, as has surfaced recently with some novel therapies for relapsing forms of multiple sclerosis.
New therapies are emerging that differ with regard to their mechanism of action, their mode of administration, their side-effect profile and the clinical benefits that they offer to patients in comparison with established therapeutic modalities in multiple sclerosis. Treating physicians will need to make choices on the best treatments for their patients on the basis of limited experience. This process requires optimal assessment of risks and benefits.
Careful assessment of the risk–benefit profile of the various options may allow treatment choices and perhaps ensure that patients obtain the most benefit from treatment without being exposed to unnecessary risk.
aDepartment of Neurology, Heinrich-Heine-University, Duesseldorf, Germany
bDepartment of Neurology – Inflammatory Diseases of the Nervous System and Neurooncology, University of Muenster, Muenster, Germany
cVeterans Affairs North Texas Healthcare System, Dallas Veterans Affairs Medical Center, USA
dDepartment of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
Correspondence to Bernd C. Kieseier, MD, Department of Neurology, Heinrich-Heine-University, Moorenstrasse 5, 40225 Duesseldorf, Germany Tel: +49 211 8118973; fax: +49 211 8116282; e-mail: firstname.lastname@example.org