ABSTRACT
Thus, there is a clear need for more effective and better tolerated therapies. Several approaches can be considered for future experimental therapeutics in MS:
(1) Focused studies to optimize the use of currently available agents. For example, the use of current drugs at the first neurological episode compatible with MS may result in improved long-term benefits. Two prospective therapeutic trials using IFN-β-1a in this setting showed that this strategy was able to delay the occurrence of the second neurological symptom8,9. In both studies there was a suggestion that beginning therapy at a very early stage of the disease improved efficacy. In addition, some studies suggest that some patients may benefit from a higher dose of IFN-β or more frequent dosing, albeit at the expense of increased adverse effects10. Individualized dose adjustment could conceivably
improve the balance of efficacy and tolerability. Finally, pharmacogenomic or pathogenic heterogeneity probably leads to patients who respond to a given therapy and others who do not. Matching patients to a therapy to which they respond clearly would improve the overall treatment response for patients as a group.
