Multiple sclerosis: Update on current immunotherapies

After many years without effective treatments for multiple sclerosis, we appear to be on the threshold of an exponential increase in new therapies. This is occurring because of better-designed protocols, greater understanding of the pathogenesis of demyelination, and the use of MRI as a major end-point of efficacy. Treatments are now available for hastening remissions, decreasing exacerbation rate and probably slowing the rate of progression. Newer therapies can be expected, perhaps used in combination, which will also alter the long-term prognosis. As in the past, clinicians will need to assess risk:benefit ratios in recommending these therapies to their patients.