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Trials of antivirals in the treatment of multiple sclerosis

Review article
Authors Jan Lycke
Published in Acta Neurologica Scandinavica
Volume 136
Pages 45-48
ISSN 0001-6314
Publication year 2017
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
Pages 45-48
Language en
Links doi.org/10.1111/ane.12839
Keywords acyclovir, antiviral treatment, herpes virus, human endogenous retrovirus, multiple sclerosis, trial, progressive multifocal leukoencephalopathy, central-nervous-system, cerebrospinal-fluid analysis, disease-modifying therapies, virus-antibody levels, risk stratification, pml risk, bk virus, natalizumab, viremia, Neurosciences & Neurology
Subject categories Neurosciences

Abstract

There is increasing evidence that human herpes viruses and human endogenous retroviruses ( HERV) are involved in the aetiology and pathogenesis of multiple sclerosis ( MS). In order to acquire the ultimate evidence to confirm such a relationship, it is probably required to use specific antiviral drugs in clinical trials of MS. The results of published antiviral clinical trials in patients with MS are summarized in this review. None of them showed statistically significant effects on primary outcomes of disease activity or on disability development. However, given their small sample sizes, the strong trends and effects observed in subgroup analysis of antiherpes virus treatment in patients with MS warrant further studies. The possible involvement of HERV in MS is intriguing, and drugs have been developed that could reduce the impact of HERV in MS. However, larger studies are needed as the phase I and II trials were not designed to show clinical efficacy in MS.

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