Multiple sclerosis: Combination therapy in MS--still a valid strategy.

摘要

In many neurological disorders, combination therapy is a feasible strategy to achieve additive or synergistic effects to monotherapy, without substantially jeopardizing patient safety. Multiple sclerosis (MS) is a disease in which established therapies are only partially effective, or may carry a substantial risk in the treatment of a subset of patients. No effective interventions are currently available for patients with progressive non-relapsing forms of MS. Data generated from in vitro studies, in vivo studies of experimental autoimmune encephalomyelitis (EAE) -an animal model of MS-and small clinical studies have shown that statins possess diverse immunomodulatory effects. Statins are, therefore, interesting candidates for combination therapy with other approved therapeutic agents for this disease. However, the recent SIMCOMBIN (simvastatin as add-on therapy to IFN-betaIa for relapsing-remitting MS [RRMS]) study, published in The Lancet Neurology, failed to demonstrate any beneficial clinical or paraclinical effect of simvastatin as an add-on therapy to intramuscular IFN-beta1a for the treatment of MS.