Immunosuppression: Promises and failures

The author participated very early in the use of immunosuppressors in the treatment of multiple sclerosis. He reviews evidence which support their use. IV Methylprednisolone, azathioprine and mitoxantrone are supported in their use by evidence of a level appropriate to the date of their generation while Cyclosporine A and Cyclophosphamide are not. The author also reviews the benefits and side effects of each of these medications, insisting on a practical approach to their use. The author concludes that since immunomodulators have been approved, the use of the irnmunosuppressors has been reduced, however there is a strong possibility that their use will be rekindled in association with immunomodulatory medications. (C) 2007 Elsevier B.V. All rights reserved.