S.M. trattamento delle sindromi clinicamente isolate (CIS)

Class I clinical trials demonstrated that immunomodulatory treatments (Interferon b and Glatiramer Acetate) reduce the disease activity and the accumulation of disability in relapsing remitting multiple sclerosis MS. Moreover Interferon b-1b had similar positive effects also in secondary progressive multiple sclerosis. The magnitude of these clinical effects was modest, but the reduction of inflammatory activity, as revealed by magnetic resonance imaging, was marked. There are converging evidences from new pathological studies and from new magnetic resonance techniques, characterised by an increased pathological specificity, that already in the early phases of the disease the inflammatory activity determines irreversible axonal damage. Moreover, the amount of inflammatory activity at clinical presentation of the disease has some values for predicting the long-term disability. Taken all together, these data indicate that patients may benefit from an early treatment; the positive results of two double-blind placebo-controlled clinical trials (Early Treatment of Multiple Sclerosis and Controlled High Risk Subjects Avonex Multiple Sclerosis Prevention Study) support this conclusion.