Journal of Rehabilitation Research & Development (JRRD)

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Volume 48 Number 10, 2011
   Pages 1223 — 1230

Abstract — Disease-modifying agents in progressive multiple sclerosis: Management of 100 patients at Louis Stokes Cleveland VAMC, Spinal Cord Injury Division

Saisho Mangla, BS;1 Seema Jain;1 Stephen Selkirk, MD, PhD2???3*

Departments of??? 1Neuroscience and 2Neurology, Case Western Reserve School of Medicine, Cleveland, OH; 3Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Spinal Cord Injury Division, Cleveland, OH
Abstract???Multiple sclerosis (MS) is a chronic disease in which disability progresses over time. Progressive forms of MS have a poor prognosis, are associated with greater levels of disability and, unfortunately, are unresponsive to current treatments. Here, we have reviewed the management of 100 patients with MS. The majority of these patients had progressive disease, Expanded Disability Status Scale scores >6, and extensive medical complications. A significant number of patients in this cohort were also treated with MS disease-modifying agents that lack efficacy in patients with progressive disease. Although these drugs are relatively safe, their use here is significantly costly to the healthcare system, with limited benefit to patients. We suggest that these drugs be discontinued in these patients and resources be directed toward symptomatic treatment, rehabilitation needs, and management of medical complications until drugs with proven efficacy become available.
Key words: central nervous system, Copaxone, disease-modifying agents, EDSS, interferon beta, primary progressive multiple sclerosis, rehabilitation, relapsing-remitting multiple sclerosis, secondary progressive multiple sclerosis, spinal cord injury.

View HTML  ¦  View PDF  ¦  Contents Vol. 48, No. 10
This article and any supplementary material should be cited as follows:
Mangla S, Jain S, Selkirk S. Disease-modifying agents in progressive multiple sclerosis: Management of 100 patients at Louis Stokes Cleveland VAMC, Spinal Cord Division. J Rehabil Res Dev. 2011;48(10):1223???30.
DOI:10.1682/JRRD.2010.10.0200
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Last Reviewed or Updated  Tuesday, March 20, 2012 11:23 AM

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