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M2000 decreased the disability progression over the 6-month period. The EDSS score was decreased in the M2000 treated group in the sixth month versus the conventional drug ( 0.009). Furthermore, we did not observe any short-term side effects. As compared with the conventional drug, mannuronic acid (M200 improved the rate of disability progression. This clinical trial demonstrated the efficacy and safety of mannuronic acid in patients with SPMS. (Registered Clinical Trials number, IRCT2016111313739N6). As compared with the conv