Pathogenesis and management of multiple sclerosis revisited

Area of Science:

• Neurology
• Immunology
• Pharmacology

Background:

• Multiple sclerosis (MS) is a chronic autoimmune inflammatory disease affecting CNS neurons, including the optic nerve.
• Its relapsing-remitting course has historically presented diagnostic and therapeutic challenges.
• The significant prevalence of MS necessitates continuous development of effective management strategies.

Approach:

• A comprehensive literature review was performed using PubMed and Google Scholar.
• The review focused on compiling recent advances in MS pathogenesis, classification, and treatment.
• Key developments in understanding disease mechanisms and identifying drug targets were analyzed.

Key Points:

• Numerous disease-modifying therapies (DMTs) have revolutionized MS management, including interferon preparations, monoclonal antibodies (natalizumab, ocrelizumab), glatiramer acetate, S1PR1 modulators (Siponimod), and teriflunomide.
• Oral formulations of traditional parenteral drugs have improved patient adherence and acceptability.
• Repurposing existing drugs and exploring remyelination strategies show promise for future MS treatment.

Conclusions:

• Recent therapeutic and diagnostic advancements have transformed the approach to multiple sclerosis.
• The introduction of DMTs and novel agents marks a significant turning point in MS care.
• Ongoing research and development are crucial for enhancing the quality of life for individuals with MS.