Neurol. praxi. 2008;9(4):223-225

Léčba progresivní roztroušené sklerózy

MUDr. Ivana Kovářová
Centrum pro demyelinizační onemocnění Neurologická klinika 1. LF UK a VFN Praha

Pro progresivní stadium RS je typické zhoršování neurologického deficitu a malá nebo žádná odpověď na léčbu. Zánět je kompartmentalizován za hematoencefalickou bariéru v CNS a je obtížně ovlivnitelný dostupnou terapií. Převažují neurodegenerativní změny. Rychlost a tíže progrese je individuální, a i přes závažnou prognózu tohoto stadia je třeba využít dostupné léčebné postupy, k nimž patří imunomodulační a imunosupresivní léčba, cytostatické režimy a pulzní podávání metylprednisolonu. Nedílnou součástí léčby v tomto stadiu RS je také symptomatická terapie.

Keywords: Klíčová slova: roztroušená skleróza, progresivní stadium, zánět, neurodegenerace.

Published: November 1, 2008  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Kovářová I. Léčba progresivní roztroušené sklerózy. Neurol. praxi. 2008;9(4):223-225.
Download citation

References

  1. Cavazzuti M, Merelli E, et al. Lesion load quantification in serial MR of early relapsing multiple sclerosis patients in azathioprine treatment. A retrospective study. Eur Neurol. 1997; 38(4): 284-290. Go to original source... Go to PubMed...
  2. Edan G, Miller D, Clanet M, et al. Therapeutic effect of mitoxantrone combined with methylprednisolone in multiple sclerosis: a randomised multicentre study of active disease using MRI and clinical criteria. J Neurol Neurosurg Psychiatry 1997; 62(2): 112-118. Go to original source... Go to PubMed...
  3. European Study Group on interferon beta-1b in secondary progressive MS. Placebo-controlled multicentre randomised trial of interferon beta-1b in treatment of secondary progressive multiple sclerosis. Lancet 1998, 7; 352(9139): 1491-1497.
  4. Frohman EM, Havrdova E, Levinson B, et al. Azathioprine myelosuppression in multiple sclerosis: characterizing thiopurine methyltransferase polymorphisms. Mult Scler. 2006; 12(1): 108-111. Go to original source... Go to PubMed...
  5. Goodkin DE, Kinkel P, Weinstock-Guttman B, et al. A phase II study of IV methylprednisolone in secondary-progressive multiple sclerosis. Neurology 1998; 51: 239-245. Go to original source... Go to PubMed...
  6. Hartung HP, Gonsette R, König N, et al. Mitoxantrone in progressive multiple sclerosis: a placebo-controlled, double-blind, randomised, multicentre trial. Lancet 2002 Dec 21-28; 360(9350): 2018-2025. Go to original source... Go to PubMed...
  7. Kesselring J, Miller DH, MacManus DG, et al. Quantitative Hernan MA, Jick SS, Logroscino G, et al. Cigarette smoking and the progression of multiple sclerosis. Brain 2005; 128: 1461-1465. Go to original source... Go to PubMed...
  8. Lassmann H. New concepts on progressive multiple sclerosis. Curr Neurol Neurosci Rep, 2007; 7(3): p. 239-244. Go to original source... Go to PubMed...
  9. Magliozzi R, et al. Meningeal B-cell follicles in secondary progressive multiple sclerosis associate with early onset of disease and severe cortical pathology Brain 2007; 130(Pt 4): p. 1089-1104. Go to original source... Go to PubMed...
  10. Munger KL, Zhang SM, O'Reilly E, et al. Vitamin D intake and incidence of multiple sclerosis. Neurology. 2004, 62: 60-65. Go to original source... Go to PubMed...
  11. Poehlau D, Federlein J, Postert T, Sailer M, Bethke F, Kappos L, et al. Intravenous immunoglobulin (IVIG) treatment for patients with primary or secondary progressive multiple sclerosis - outline of a double-blind randomized, placebo-controlled trial. Multiple Sclerosis 1997; 3: 149-152. Go to original source... Go to PubMed...
  12. Sorensen PS, et al. The role of intravenous immunoglobulin in the treatment of multiple sclerosis. 7th European Charcot Foundation Lecture. J Neurol Sci 2003; 206: 123-130. Go to original source... Go to PubMed...
  13. Stangel M, Gold R. Intravenous immunoglobulins in MS. The International MS Journal 2005; 12: 4-10.
  14. Trapp BD, et al. Axonal transection in the lesions of multiple sclerosis. N Engl J Med 1998; 338(5): p. 278-285. Go to original source... Go to PubMed...
  15. Weiner HL, Mackin GA, Orav EJ, et al. Intermittent cyclophosphamide pulse therapy in progressive multiple sclerosis: final report of the Northeast Cooperative Multiple Sclerosis Treatment Group. Neurology. 1993; 43(5): 910-8. Go to original source... Go to PubMed...
  16. Yudkin PL, Ellison GW, Ghezzi A, Goodkin DE, Hughes RA, McPherson K, Mertin J, Milanese C. Overview of azathioprine treatment in multiple sclerosis. Lancet 1991, 26; 338(8774): 1051-1055. Go to original source... Go to PubMed...
  17. Zhang SM, Hernan MA, Olek MJ, et al. Intakes of carotenoids, vitamin C, and vitamin E and MS risk among two large cohorts of women. Neurology 2001, 57: 75-80. Go to original source... Go to PubMed...
  18. Zivadinov R, Rudick RA, De Masi R, Nasuelli D, Ukmar M, Pozzi-Mucelli RS, Grop A, Cazzato G, Zorzon. Effects of IV methylprednisolone on brain atrophy in relapsing-remitting MS. Neurology 2001; 57: 1239-1247. Go to original source... Go to PubMed...




Neurology for Practice

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.