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Update on treatments in multiple sclerosis.

Laure Michel1, Catherine Larochelle1, Alexandre Prat1

  • 1Université de Montréal, faculté de médecine, centre de recherche du CHUM, département de meuroscience, unité de recherche en neuro-immunologie, H2X0A9 Montréal, Canada.

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Multiple sclerosis (MS) treatment involves complex strategies with available disease-modifying drugs (DMTs). This review examines DMTs, therapeutic approaches, and response evaluation for optimal MS management.

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Area of Science:

  • Neurology
  • Immunology
  • Pharmacology

Background:

  • Multiple sclerosis (MS) management has evolved with numerous disease-modifying therapies (DMTs).
  • Current therapeutic strategies for MS are increasingly complex, influencing patient management.
  • First-line immunomodulatory drugs offer a good safety profile but often yield suboptimal clinical responses.

Purpose of the Study:

  • To review currently approved and emerging drugs for multiple sclerosis (MS) treatment.
  • To analyze the benefit/risk profiles and positioning of various MS DMTs.
  • To explore therapeutic strategies and criteria for evaluating response to MS DMTs.

Main Methods:

  • Systematic literature search on PubMed using keywords: treatment, multiple sclerosis, therapeutic, DMT, and treatment response.
  • Inclusion of randomized trials and reviews focusing on MS, DMTs, and management strategies.
  • Synthesis of information on drug profiles, therapeutic approaches, and response assessment.

Main Results:

  • Overview of approved and emerging DMTs for MS, detailing their benefit/risk profiles.
  • Discussion of the current place of different DMTs within the therapeutic arsenal for MS.
  • Presentation of various strategies and criteria for assessing patient response to MS DMTs.

Conclusions:

  • The optimal timing for switching to second-line agents and the efficacy of escalation therapy in MS remain critical considerations.
  • Effective management of MS requires careful selection of DMTs and robust evaluation of treatment response.
  • This review provides a comprehensive overview to guide clinical decision-making in MS therapy.