Pharmacotherapy in Secondary Progressive Multiple Sclerosis: An Overview

Area of Science:

• Neuroimmunology
• Clinical Neurology
• Translational Medicine

Background:

• Multiple sclerosis (MS) is a central nervous system inflammatory disease causing demyelination and neurodegeneration.
• MS presents with relapsing-remitting (RRMS) or progressive courses (primary progressive MS, PPMS, and secondary progressive MS, SPMS).
• Existing disease-modifying therapies are effective for RRMS but not SPMS, representing a significant unmet need.

Purpose of the Study:

• To review recent advancements in therapeutic strategies for secondary progressive multiple sclerosis (SPMS).
• To discuss novel drugs with immunomodulatory, neuroprotective, or regenerative properties for SPMS.
• To examine clinical trial outcomes from the past decade, focusing on the last five years.

Main Methods:

• Comprehensive literature review of phase II and III randomized controlled trials.
• Focus on studies investigating treatments for progressive and relapsing multiple sclerosis phenotypes.
• Analysis of recent findings on immunomodulatory, neuroprotective, and regenerative drug candidates.

Main Results:

• Limited efficacy of current therapies in halting disability progression in SPMS.
• Emerging modest success with siponimod for SPMS and ocrelizumab for PPMS.
• Ongoing research into novel therapeutic agents targeting inflammation and neurodegeneration.

Conclusions:

• Developing treatments to delay or prevent SPMS progression remains a critical research goal.
• A combination of immunomodulatory, neuroprotective, and regenerative approaches may be necessary.
• Continued investigation of clinical trial data is essential for advancing SPMS treatment.