Multiple Sclerosis - A Practical Guide to Rehabilitation - 8

AIMS

A PRACTICAL GUIDE TO IDIOPATHIC PULMONARY FIBROSIS

Table 2: Disease Modifying Therapies for MS15 (cont.)
Approval

Dose & Route of
Administration

Fingolimod (Gilenya®)

2010

0.5 mg, PO, QD

Siponimod (Mayzent®)*

2019

2 mg/day
(after 5-day titration),
PO

Selective sphingosine-1phosphate receptor (subtypes 1
and 5) modulator; prevents
egress of lymphocytes from
lymphoid tissues into the
periphery

Teriflunomide (Aubagio®)

2012

7 mg or 14 mg,
PO, QD

Inhibition of dihydro-orotate
dehydrogenase, a key enzyme in
de novo pyrimidine synthesis
required by rapidly dividing
lymphocytes; diminishes the
numbers of activated T- and
B-cells available to migrate to
the CNS

Dimethyl fumarate
(Tecfidera®)

2013

240 mg, PO, BID

Anti-inflammatory properties
via effects on the Nrf2 pathway;
Th1 to Th2 shift, anti-oxidant
properties, potential
neuroprotective effects

Cladribine
(Mavenclad®)†

2019

PO, twice annual,
weight based dosage:
3.5 mg/kg divided into
2 treatment cycles
(1.75 mg/kg per
treatment course)

Thought to have cytotoxic
effects on B- and T-lymphocytes
through interference with DNA
repair

Treatment

Mechanism of Action

Oral
Sphingosine1-phosphate
receptor modulator; prevents
egress of lymphocytes from
lymphoid tissues into the
periphery

*Also FDA-approved for treatment of clinically isolated syndrome and active secondary progressive disease.
†
Also FDA-approved for treatment of active secondary progressive disease.

overall quality of life. Pharmacologic agents used
for the medical management of MS symptoms are
summarized in Table 3 (page 9). (Note: uses of
some of the agents shown are off-label/not
FDA-approved).

8

Rehabilitation in MS
Rehabilitation is an integral part of
comprehensive MS care. The goals of MS
rehabilitation are to maintain and/or improve
functioning and reduce the impact of the disease
on personal activities, social participation,
independence, and quality of life.20 The approach

Introduction



Multiple Sclerosis - A Practical Guide to Rehabilitation

Table of Contents for the Digital Edition of Multiple Sclerosis - A Practical Guide to Rehabilitation

Contents
Multiple Sclerosis - A Practical Guide to Rehabilitation - Contents
Multiple Sclerosis - A Practical Guide to Rehabilitation - Cover2
Multiple Sclerosis - A Practical Guide to Rehabilitation - 1
Multiple Sclerosis - A Practical Guide to Rehabilitation - 2
Multiple Sclerosis - A Practical Guide to Rehabilitation - 3
Multiple Sclerosis - A Practical Guide to Rehabilitation - 4
Multiple Sclerosis - A Practical Guide to Rehabilitation - 5
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Multiple Sclerosis - A Practical Guide to Rehabilitation - 8
Multiple Sclerosis - A Practical Guide to Rehabilitation - 9
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Multiple Sclerosis - A Practical Guide to Rehabilitation - Cover3
Multiple Sclerosis - A Practical Guide to Rehabilitation - Cover4
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