We summarize here 10 years of experience of using glatiramer acetate (Copaxone) in 74 patients with active remitting multiple sclerosis (MS). Significant decreases in the frequency of disease exacerbation over all 10 years were noted. Disease severity on the EDSS was stable and increased significantly only by the tenth year of observations. Positive stable clinical dynamics were independent of disease severity at the moment of treatment initiation. Tolerance of glatiramer acetate was good, allowing us to come close to controlling the course of MS – 64.8% of patients had no more than one exacerbation in 10 years, while 71.6% showed no or minimal progression of disease (up to 1 point on the EDSS scale). These observations lead to the conclusion that 10 years of treatment with Copaxone allows disease development to be controlled in many patients.

The aim of the study was to describe the atrophy of the thalamus in young patients with active relapsing multiple sclerosis (MS) treated with cerebrolysin. Eighteen MS patients (mean age 20.10±0.45 years) with disease onset in childhood or adolescence were studied. Neurological examination using the EDSS, neuropsychological testing and MRI were used. At baseline, MRI revealed the hypotrophy of the thalamus that was not correlated with the performance on neuropsychological tests. After treatment with cerebrolysin, there was the decrease in the level of atrophy that suggested the neuroprotective effect of this drug. This effect was more prominent in younger patients with the high frequency of previous relapses.

Experience of 10-year administration of glatimer acetate (copaxone) in 74 patients with active remitting multiple sclerosis is summarized. The significant decrease in the frequency of exacerbations was seen over these ten years. Disease severity on the EDSS was stable and decreased only to the end of the 10-year period. The positive stable clinical dynamics did not depend on the disease severity at baseline. The drug was well-tolerated that allowed to control the course of multiple sclerosis: 64.8% of patients had no more than one exacerbation over 10 years and in 71.6% patients, the disease progression was absent or minimal (less than one score on EDSS). It has been concluded, that the long-term 10-year treatment with copaxone enables to control the development of disease in many patients.

The experience of the treatment of patients with remitting multiple sclerosis (MS) with intramuscular introduction of beta-interferon-1a (avonex) is presented. Seventeen children and adolescents, aged from 11 to 18 years, and 55 adults, aged over 55 years, were treated for at least one-year period. Results revealed a significant reduction of exacerbations in both groups (from 1.35 to 0.06 in average in adolescents and from 0.86 to 0.17 in adults). The changes were accompanied by the stabilization of MS severity index: EDSS scores have decreased in 23.6% of adults and in 17.6% of adolescents. In both groups, good tolerability of the treatment was noted. There was a low probability of side-effects with the exception of increased frequency of a flu-like syndrome (47% cases) in patients younger than 18 years that demands special attention from children neurologists. The high efficacy and good tolerability and safety profile of beta-interferon-1a give grounds for administering this drug to children and adolescents with MS.

Symptomatic therapy of bladder hyporeflexia in patients with multiple sclerosis by intermittent catheterization in cases of insufficient efficacy of alpha-adrenoblockers allows to prevent bacterial infection complications and chronic renal failure and to achieve significant improvement of quality of life of such patients.

An analysis of 5-years experience of treatment of 255 patients with multiple sclerosis drugs (100 patients with betaferon and 155 with copaxone) is presented. Betaferon was assigned to patients with remitted and secondary progressive multiple sclerosis (MS) with exacerbations. Copaxone was administered only in remitted MS with severity up to 6,5 EDSS scores in all cases. Patients were obligatory examined every 3 months. Patients initially switched to betaferon had more active and severe MS course. After 5 years, 147 patients (57,6%) continued treatment with betaferon, 56% - with betaferon and 58,7% with copaxone. During all this period, the stable significant decrease of exacerbation frequency was observed. No exacerbations were found in 26,8% of patients receiving betaferon and in 31,9% of patients receiving copaxone. Nevertheless, frequency of exacerbations did not decrease in 7% patients treated with betaferon and in 6,5% patients treated with copaxone that was a main reason for drug withdrawal. These cases imply the resistance to the used type of drug. Stabilization of disability with EDSS scores increasing by 0,5 score was observed in 48,2% patients treated with betaferon, including secondary progressive MS, and in 75,8% patients receiving copaxone. However, on the 4(th) year of treatment with betaferon and on the 5(th) year of copaxone treatment, EDSS score became significantly higher as compared to the base-line, i.e. the neurodegenerative process was not completely stopped. The main reasons for drug withdrawal were clinical inefficiency and patient's wish. Side-effects caused the drug withdrawal only in 6% in case of betaferon and in 6,5% in case of copaxone that suggests high tolerability of these drugs during long-term use. During 5 follow-up years after withdrawal of the drugs, MS course in patients who did not receive other multiple sclerosis drugs (31% patients after betaferon and 15,5% patients after copaxone) was progressive with the same intensity as it was prior to prescription of betaferon and copaxone, i.e. neither "withdrawal syndrome" nor "consequences" were found. In cases of patients' wish to stop taking these medications, the main reason was not clinical inefficiency but motivation and adherence issues that are discussed in details.

The study included 54 patients with a definite diagnosis of relapsing-remitting multiple sclerosis (MS) in the remission stage and depression who were divided into two groups, 30 patients receiving citalopram (opra) and 24 - fluoxetine. Both drugs were prescribed in dosage 20 mg daily for 8 weeks. After the treatment all patients underwent a neurological and a neuropsychological examination. Two groups were similar for MS characteristics and severity of depression. A positive effect was revealed in both groups that suggests a possible use of the drugs in treatment of depressive syndrome in patients with MS. The marked decrease of HADS scores on the anxiety subscale during the treatment and more rapid effect (on the 2(nd) week) were observed in patients receiving citalopram as compared to those treated with fluoxetine (on the 4(th) week).

In last decades, practical neurologists are able to use DMT in multiple sclerosis (MS) in every day practice. This paper presents data of 3-year study of DMT (copaxone and betaferon) treatment of 280 patients with definite diagnosis of multiple sclerosis (MS), 166 patients regularly receiving DMT (104 - copaxone and 62 - betaferon) for, at least, 3 years. Clinical symptoms of the patients, reasons of treatment withdrawal (48 - copaxone and 31 - betaferon) and the features of MS course after the withdrawal are analyzed. Patients who received betaferon previously had more severe MS course with frequent relapses, half of them had secondary progressive MS course (SPMS) with relapses. This made impossible a direct comparison of the data of two treatment groups. Treatment with copaxone reduced 5 times annual relapse rate, from 1,45 before DMT to 0,27 during these 3 years (p < 0,001), and this reduction remained stable. For 36 months, 40,4% of patients were relapse-free though all of them had, at least, one relapse per year before the treatment. No EDSS progression was observed in 80% of these patients. Treatment with betaferon caused the reduction of relapse rate from 1,84 to 0,69 per year (2,7 times), 8 patients (26%) with previously active RMS being relapse-free for 36 months. In 31 patients with SPMS, the reduction of relapse rate was also significant, from 1,89 to 0,49 (3,8 times, p < 0,001). Twenty-two patients (71%) with previous SPMS did not have EDSS progression for 36 months that indicate the positive effect of the therapy. Side-effects were moderate and were not the main cause of the treatment withdrawal. The latter was caused mainly by clinical un efficacy, most frequently by the increase of EDSS due to transformation of the MS course to SPMS without relapses and poor understanding by the patient of the goals and the possibilities of DMT. These facts stress the significance of improving compliance, motivation and adherence to DMT in everyday neurological practice.