Advancements in Pharmacotherapy and Mobile Health Applications for Self-Management in Multiple Sclerosis: A Comprehensive Review.

Abstract

Introduction: Multiple sclerosis (MS) is a chronic autoimmune demyelinating disorder of the central nervous system, affecting nearly three million individuals worldwide. Long-term pharmacotherapy and treatment adherence remain major determinants of relapse prevention and disability progression.

Methods: Following PRISMA guidelines, a narrative review compared FDA and EMA approved disease-modifying therapies (DMTs) for MS. Clinical, real-world, and patentbased data were synthesized to evaluate efficacy, adherence, and safety profiles. Digital health applications supporting self-management were also assessed.

Results: Injectable therapies such as interferons and glatiramer acetate showed approximately 30% ARR reduction with excellent safety. Oral agents (fingolimod, dimethyl fumarate, teriflunomide, cladribine) achieved 45-55% ARR reduction and markedly better adherence, though periodic laboratory monitoring was required. Monoclonal antibodies (natalizumab, ocrelizumab) reached up to 68% relapse reduction, representing the highest efficacy while demanding close surveillance for PML and infection risks.

Discussion: While newer high-efficacy agents yield stronger disease control, the balance between potency, adherence, and practicality remains crucial. Oral DMTs provide the most realistic compromise for long-term management. Digital self-monitoring through validated m-health applications could substantially improve adherence and disease awareness. Integration of biotechnology with tele-neurology and AI-supported analytics represents the next step toward personalized MS care.

Conclusion: Monoclonal antibodies define the upper limit of efficacy in current MS therapy, but sustainability depends on safety oversight and patient engagement. Oral formulations remain clinically pragmatic first-line options. The synergy between pharmacotherapy and mobile health technology offers a pathway to transform adherence, monitoring, and outcome optimization in future MS management.