Current Concepts in the Treatment of Multiple System Atrophy.
Santiago Perez-LloretOlivier FlabeauPierre-Olivier FernagutAnne Pavy-Le TraonMaría Verónica ReyAlexandra Foubert-SamierFrancois TisonOlivier RascolWassillios G MeissnerPublished in: Movement disorders clinical practice (2015)
MSA is a progressive neurodegenerative disorder characterized by autonomic failure and a variable combination of poor levodopa-responsive parkinsonism and cerebellar ataxia (CA). Current therapeutic management is based on symptomatic treatment. Almost one third of MSA patients may benefit from l-dopa for the symptomatic treatment of parkinsonism, whereas physiotherapy remains the best therapeutic option for CA. Only midodrine and droxidopa were found to be efficient for neurogenic hypotension in double-blind, controlled studies, whereas other symptoms of autonomic failure may be managed with off-label treatments. To date, no curative treatment is available for MSA. Recent results of neuroprotective and -restorative trials have provided some hope for future advances. Considerations for future clinical trials are also discussed in this review.
Keyphrases
- clinical trial
- end stage renal disease
- chronic kidney disease
- randomized controlled trial
- parkinson disease
- spinal cord injury
- newly diagnosed
- physical activity
- prognostic factors
- study protocol
- drug induced
- peritoneal dialysis
- brain injury
- deep brain stimulation
- replacement therapy
- patient reported
- rectal cancer
- subarachnoid hemorrhage
- phase iii