An overview on disease modifying and symptomatic drug treatments for multiple sclerosis.

IF 3.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Expert Review of Clinical Pharmacology Pub Date : 2024-10-08 DOI:10.1080/17512433.2024.2410393

Gloria Dalla Costa, Letizia Leocani, Mariaemma Rodegher, Luca Chiveri, Alessandro Gradassi, Giancarlo Comi

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引用次数: 0

Abstract

Introduction: Multiple sclerosis (MS) is an inflammatory and degenerative autoimmune condition, resulting frequently in a disabling condition. Significant improvements of long-term prognosis have been recently achieved with an early and more aggressive use of disease modifying therapies (DMTs). Addressing the complexity of managing its progressive forms remains a significant challenge.

Areas covered: This review provides an update on DMTs for relapsing-remitting MS (RRMS) and progressive MS and their efficacy, safety, and mechanism of action, emphasizing the critical role of biomarkers in optimizing treatment decisions. Moreover, some key information on drugs used to manage symptoms such as pain, fatigue, spasticity and urinary problems will be provided. The literature search was conducted using PubMed, Embase, and Cochrane Library databases covering the period from January 2000 to January 2024.

Expert opinion: Major advances have been achieved in the treatment of RRMS. Treatment should start immediately as soon as the neurologist is confident with the diagnosis and its choice should be based on the prognostic profile and on the patient's propensity to accept drug-related risks. The therapeutic landscape for progressive MS is quite disappointing and necessitates further innovation. Personalized medicine, leveraging biomarker insights, holds promise for refining treatment efficacy and patient outcomes.

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多发性硬化症的改病和对症药物治疗概述。

导言：多发性硬化症（MS）是一种炎症性和变性的自身免疫性疾病，经常导致残疾。最近，通过早期和更积极地使用改变疾病疗法（DMTs），多发性硬化症的长期预后得到了显著改善。但如何应对渐进形式的复杂病情仍然是一项重大挑战：本综述提供了有关治疗复发性多发性硬化症（RRMS）和进展性多发性硬化症的 DMTs 及其疗效、安全性和作用机制的最新信息，强调了生物标志物在优化治疗决策中的关键作用。此外，还将提供一些用于控制疼痛、疲劳、痉挛和泌尿系统问题等症状的药物的关键信息。我们使用 PubMed、Embase 和 Cochrane Library 数据库对 2000 年 1 月至 2024 年 1 月期间的文献进行了检索：RRMS 的治疗已取得重大进展。一旦神经科医生确信诊断结果，就应立即开始治疗，治疗方案的选择应基于预后情况和患者接受药物相关风险的倾向。进展期多发性硬化症的治疗前景令人失望，需要进一步创新。利用生物标志物洞察力的个性化医疗有望改善治疗效果和患者预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Clinical Pharmacology PHARMACOLOGY & PHARMACY-

CiteScore

7.30

自引率

2.30%

发文量

127

期刊介绍： Advances in drug development technologies are yielding innovative new therapies, from potentially lifesaving medicines to lifestyle products. In recent years, however, the cost of developing new drugs has soared, and concerns over drug resistance and pharmacoeconomics have come to the fore. Adverse reactions experienced at the clinical trial level serve as a constant reminder of the importance of rigorous safety and toxicity testing. Furthermore the advent of pharmacogenomics and ‘individualized’ approaches to therapy will demand a fresh approach to drug evaluation and healthcare delivery. Clinical Pharmacology provides an essential role in integrating the expertise of all of the specialists and players who are active in meeting such challenges in modern biomedical practice.