[New therapeutic approaches in progressive multiple sclerosis].

Area of Science:

• Neuroimmunology
• Neurology
• Pharmacology

Background:

• Recent advancements in multiple sclerosis (MS) therapy have primarily benefited the relapsing-remitting phase.
• Therapies for progressive forms of MS have seen less success historically.
• Emerging treatments show promise for progressive MS, addressing its complex pathomechanisms.

Purpose of the Study:

• To review the current understanding of progressive MS pathogenesis.
• To discuss the development and potential of novel therapeutic strategies for progressive MS.
• To highlight therapeutic approaches targeting chronic inflammation, neurodegeneration, and specific cellular pathways.

Main Methods:

• Review of scientific literature on multiple sclerosis pathogenesis and therapy.
• Analysis of approved and investigational drugs for progressive MS.
• Discussion of pathomechanisms including chronic inflammation, cellular activation, iron accumulation, and neurodegeneration.

Main Results:

• Ocrelizumab, a B-cell depleting antibody, is approved for active primary progressive MS.
• Siponimod, a sphingosine-1-receptor modulator, is under development for secondary-progressive MS.
• Understanding of progressive MS pathomechanisms involves chronic inflammation, T/B cell and microglia activation, oxidative stress, iron accumulation, and neurodegeneration.

Conclusions:

• Significant progress in MS therapy has been made, particularly for relapsing-remitting disease.
• Therapies for progressive MS are emerging, targeting key pathomechanisms.
• Further research into pathogenesis and therapeutic approaches is crucial for effective progressive MS management.