E-Health 2.0 Developments in Treatment and Research in Multiple Sclerosis

The treatment of multiple sclerosis (MS) is entering a new era, characterized by the availability of a broad range of disease modifying drugs (DMDs) for patients in the relapsing-remitting (RR) phase of the disease. Through interference with immunemediated inflammatory processes the DMDs reduce the number and severity of relapses and the increase in relapse-related disability. Each DMD is characterized by a unique combination of mode of action, route of administration, degree of efficacy and potential side effects. In the past two decades the injectable drugs interferon beta-1a (INFb-1a), INFb-1b and glatiramer acetate (GA) have been proven to be safe first-line treatments. In more recent years, the intravenously administered monoclonal antibody natalizumab and the oral drugs fingolimod and cladribine have been demonstrated to be efficacious in RRMS. These DMDs are more potent, but also potentially more hazardous, which by and large restricts their use to patients who have very active disease or are refractory to firstline treatment. Lately, phase II/III studies showed beneficial effects of the oral drugs teriflunomide, laquinimod and BG-12, and the monoclonal antibodies rituximab and alemtuzumab in RRMS. The advent of the new treatments coincides with the Web 2.0 evolution of the internet technology. Web 2.0 offers patients, doctors, and nurses unforeseen possibilities to fundamentally change, and hopefully improve, the ways in which care is delivered and clinical, patient-centered research is performed. The term Web 2.0 is associated with web applications that facilitate participatory information sharing, inter-operability, user-centered design and collaboration on the World Wide Web [1]. A Web 2.0 site allows users to interact and collaborate with each other, e.g. as creators of user-generated content in a virtual community, in contrast to websites where users are limited to the passive viewing of content that was created for them [2]. Basically, e-health 2.0 can be defined as the merging of the Web 2.0 phenomenon within health care [3]. However, e-health 2.0 goes beyond the social networking technology to include a reformative or even revolutionary change in the fields of health care and clinical research [3]. According to O’Grady the main point of e-health 2.0 is the use of social software and its ability to promote collaboration between patients, their caregivers, and medical professionals [3]. Thus, using the web to exchange information with others substantially relates to learning and education about an illness, what treatment options are