GUIDELINES FOR THE THERAPEUTIC MANAGEMENT OF MULTIPLE-SCLEROSIS

Strategies proposed for the treatment of multiple sclerosis are numerous and sometimes contradictory. This review summarizes the most recent studies on the treatment of multiple sclerosis. Possibilities of influencing progression of the disease and the degree of disability suffered by patients are discussed. The treatment of acute relapses with high-dose intravenous glucocorticoids is now widely accepted because it has been shown that the duration of the relapse is reduced. Interval therapy between relapses and treatment of the chronic progressive variant of multiple sclerosis are still under debate. Immunosuppression, in particular with azathioprin, appears to have a positive effect on the long-term outcome. Whether other regimens, e.g. treatment with recombinant lymphokines, have a therapeutic effect, is difficult to assess at present since these substances have either never been tested in controlled double blind studies or the results of these studies are not yet available.