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


Project Status:
Open for Stakeholder Feedback
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Project Line:
Health Technology Review
Project Sub Line:
Health Technology Assessment
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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.