Primary goals of long-term MS therapy are to prevent relapses and disease progression. Assuming that MS is an autoimmune disease, most therapeutics aim to modulate or suppress the immune system. Until now many drugs have proven efficacy in RRMS, but none in PPMS. Interferon-β (IFN-β) and glatiramer acetate are known in RRMS therapy for years. Based on preclinical research and clinical trials, new treatment strategies have emerged and were transferred from bench to bedside. The 4β-integrin-antagonist natalizumab was approved in 2005. Fingolimod, BG12 and teriflunomide were the first oral drugs introduced in MS therapy. Recently alemtuzuab another monoclonal antibody was approved. Promising future perspectives are alemtuzumab, daclizumab, and laquinimod.
Here, we review drug mechanisms in the therapy of MS. The mechanisms of action and the effect of the drugs on the immune system are summarized. We report recent results of clinical trials, highlight special features of different treatment strategies, and discuss future perspectives and ongoing clinical trials