Die immunmodulatorische frühbehandlung der multiplen sklerose

The therapeutic value of immunomodulatory substances in relapsing-remitting multiple sclerosis is well established. While escalating immunotherapeutic strategies for progressive deterioration in multiple sclerosis were already well defined, there was still some uncertainty with regard to immunomodulatory therapy in the early phases of the disease. Converging evidence from histopathological and magnetic resonance imaging (MRI) studies demonstrates that axonal damage already occurs in early disease stages, thus emphasizing the potential importance of early treatment. Here we discuss relevant aspects of the natural history as well as histopathological and MRI evidence that argue for an early therapy of multiple sclerosis. We discuss controlled clinical trials of the use of beta-interferons at clinical onset of the disease. Furthermore, the new consensus statements regarding early immunomodulatory therapy with beta-interferons will be reviewed.