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Determining Immune System Suppression versus CNS Protection for Pharmacological Interventions in Autoimmune Demyelination
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Disease modifying therapies for relapsing multiple sclerosis.

Dean M Wingerchuk1, Brian G Weinshenker2

  • 1Department of Neurology, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA wingerchuk.dean@mayo.edu.

BMJ (Clinical Research Ed.)
|August 24, 2016
PubMed
Summary
This summary is machine-generated.

Disease modifying therapies (DMTs) help manage relapsing multiple sclerosis (MS) by reducing relapses and MRI burden. However, current DMTs do not halt disability progression in established secondary progressive MS.

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Area of Science:

  • Neurology
  • Immunology
  • Clinical Therapeutics

Background:

  • Multiple sclerosis (MS) is a disabling neurological disease with autoimmune characteristics.
  • MS progresses from a relapsing-remitting phase to a secondary progressive phase.
  • The interplay between inflammation and neurodegeneration in MS is not fully understood.

Purpose of the Study:

  • To review approved disease-modifying therapies (DMTs) for multiple sclerosis.
  • To examine strategies for individualizing MS treatment in the absence of biomarkers.
  • To discuss emerging therapies and treatment approaches for MS.

Main Methods:

  • Systematic review of evidence for approved DMTs in relapsing MS.
  • Analysis of long-term observational data on DMT efficacy.
  • Discussion of patient stratification and outcome-based treatment selection.

Main Results:

  • Approved DMTs reduce relapse rates and MRI-detected disease burden in relapsing MS.
  • Current DMTs show limited efficacy in slowing disability progression in established progressive MS.
  • Long-term benefits of DMTs beyond three years require further investigation.

Conclusions:

  • Individualized treatment approaches are necessary for managing MS, considering patient risk and preferences.
  • Objective outcomes are crucial for assessing treatment success in MS.
  • Further research into novel therapies is needed for progressive MS management.