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The Shifting Landscape of Disease-Modifying Therapies for Relapsing Multiple Sclerosis

Burton, Jodie, M., MD, MSc, FRCPC; Freedman, Mark, S., MSc, MD, FAAN, FANA, FRCPC

Section Editor(s): Costello, Fiona MD, FRCP(C)

Journal of Neuro-Ophthalmology: June 2018 - Volume 38 - Issue 2 - p 210–216
doi: 10.1097/WNO.0000000000000659
Disease of the Year: Multiple Sclerosis

Background: Multiple sclerosis (MS) is the most common nontraumatic neurological disorder of young adults, and roughly 85% of patients present with the relapsing form of the disease. Over the past 2 decades, the treatment arsenal for relapsing MS has expanded and evolved from mildly effective and relatively benign injectable agents to potent cell-depleting monoclonal agents. The latter have the potential to achieve disease remission coupled with risk of moderate to severe adverse events with which all MS care providers will need to acquaint themselves.

Methods: This review is based on a detailed assessment of MS pivotal trials, extension studies, and expert reviews of the agents discussed.

Results/Conclusions: The following review should aid those practitioners directly and indirectly involved in the care of MS patients in understanding the benefits and risks associated with the medications they prescribe.

Department of Clinical Neurosciences (JMB), Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; and Division of Neurology (MSF), The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada.

Address correspondence to Jodie M. Burton, MD, MSc, FRCPC, Health Sciences Centre, Room 1007c, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada; E-mail:

J. M. Burton has participated in advisory boards for Novartis and EMD Serono, and has received unrestricted educational support and honoraria for educational presentations from Novartis, Sanofi Genzyme, BiogenIdec, and EMD Serono. M. S. Freedman is a member of advisory boards for Actelion, BayerHealthcare, BiogenIdec, Clene Nanomedicine, Hoffman La-Roche, Merck Serono, MedDay, Novartis, Sanofi-Aventis, has received honoraria and consultation fees from Actelion, BayerHealthcare, BiogenIdec, Chugai, Clene Nanomedicine, EMD Canada, Genzyme, Merck Serono, Novartis, Hoffman La-Roche, Sanofi-Aventis, Teva Canada Innovation, and has participated in Sanofi Genzyme's sponsored speaker's bureau. He has also received research/education grants from Genzyme.

© 2018 by North American Neuro-Ophthalmology Society