Treatment of Multiple Sclerosis.

Area of Science:

• Neurology
• Immunology
• Clinical Therapeutics

Background:

• Multiple sclerosis (MS) relapses stem from acute inflammatory demyelination.
• Symptoms may worsen due to systemic issues, not necessarily new MS activity.
• Current treatment strategies for newly diagnosed or active MS are evolving.

Purpose of the Study:

• To review the evidence for treating acute MS relapses.
• To guide the selection of disease-modifying therapies (DMTs) for various MS types.
• To emphasize patient monitoring and shared decision-making in MS management.

Main Methods:

• Evidence synthesis of current treatment guidelines and clinical trial data.
• Analysis of therapeutic approaches for relapsing MS, radiologically isolated syndrome, and progressive MS.
• Discussion of diagnostic considerations for MS relapse symptoms.

Main Results:

• High-dose corticosteroids can accelerate recovery from acute MS relapses.
• Shared decision-making is crucial for selecting appropriate DMTs in active MS.
• Ongoing monitoring for safety and efficacy is essential for all MS therapies.
• Benefit from current DMTs may be limited in progressive MS without active disease.

Conclusions:

• Effective management of MS requires differentiating true relapses from other causes of symptom worsening.
• Personalized treatment selection and vigilant monitoring are key to optimizing outcomes in MS.
• Emerging data support the benefit of early MS therapy, particularly in the relapsing form.