Multiple Sclerosis: Etiology and Treatment Strategies
Abstract:Objective: To review the etiology and treatment strategies for multiple sclerosis (MS).
Data Sources: Published information on MS and targeted treatment strategies extending back to 1955. The search terms multiple sclerosis and pathology, prevalence, genetics, and each of the common symptoms of MS were used.
Study Selection: Seventy-two studies were reviewed based on level 1, 2, and 3 search strategies.
Data Extraction: Level 1 search strategy targeted evidence-based trials of large sample size (N > 100) with a randomized, double-blind, placebo-controlled design. A level 2 search targeted additional trials with some of the traits of evidence-based trials. A level 3 search compared key findings in reports of very small (N < 15) poorly designed trials with the results of well-designed trials.
Data Synthesis: MS affects each patient differently, making a definitive diagnosis and management of symptoms very difficult. Effective symptom management requires an interprofessional team approach.
Conclusion: Despite all the research dedicated to this disease, there is still no cure. The treatments currently available function at best only to slow the disease progression and mitigate symptoms. Using the skills and knowledge available from a team of health care professionals will help patients navigate the trials and tribulations that follow throughout a life with MS.
Abbreviations: BBB = Blood-brain barrier, CNS = Central nervous system, EBV = Epstein-Barr virus, MRI = Magnetic resonance imaging, MS = Multiple sclerosis, PNS = Peripheral nervous system, PPMS = Primary progressive MS, RRMS = Relapsing-remitting MS, TCAs = Tricyclic antidepressants, UTI = Urinary tract infection.
Consult Pharm 2008;23:886-96.
Document Type: Research Article
Publication date: November 1, 2008
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