Alemtuzumab, Cladribine, Fingolimod, and Natalizumab as First-Line Treatments in Adult Patients With Highly Active Relapsing Multiple Sclerosis

Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system, in which the immune system causes an inflammatory response that damages or destroys myelin, axons, and oligodendrocytes. Damaged myelin forms scar tissue (sclerosis) that replaces the myelin and, as a result, nerve impulses transmitted to and from the brain and spinal cord are distorted or interrupted, producing a variety of symptoms.

Fingolimod, cladribine, natalizumab, and alemtuzumab have been approved by Health Canada for the treatment of MS. These drugs are generally reserved for patients with poor response or tolerability with first-line drugs. This review will evaluate the clinical efficacy and safety of alemtuzumab, natalizumab, cladribine, and fingolimod as first-line treatments in patients with highly active relapsing MS.

Projects listed as “in progress” are at various stages and points of completion. These products have different processes and timelines; therefore, the timing of posting of the final reports varies and expected completion dates may change. Find out more about Projects in Progress.

The “Projects in Progress” page on the CADTH website is updated on a seven- to eight-day cycle. Please be advised that there may be overlap between when a new report is posted online and when the section is updated. View our current Projects in Progress.