A Personalized Approach in Progressive Multiple Sclerosis: The Current Status of Disease Modifying Therapies (DMTs) and Future Perspectives

Abstract

Using the term of progressive multiple sclerosis (PMS), we considered a combined population of persons with secondary progressive MS (SPMS) and primary progressive MS (PPMS). These forms of MS cannot be challenged with efficacy by the licensed therapy. In the last years, several measures of risk estimation were developed for predicting clinical course in MS, but none is specific for the PMS forms. Personalized medicine is a therapeutic approach, based on identifying what might be the best therapy for an individual patient, taking into account the risk profile. We need to achieve more accurate estimates of useful predictors in PMS, including unconventional and qualitative markers which are not yet currently available or practicable routine diagnostics. The evaluation of an individual patient is based on the profile of disease activity.Within the neurology field, PMS is one of the fastest-moving going into the future.

Luto e enfrentamento em portadores de esclerose múltipla: Diálogo com a teoria de Kübler-Ross

“…voso Central (SNC) (D'Amico, Patti, Zanghì, & Zappia, 2016). As lesões afetam os axônios irreversivelmente e geram perdas neurológicas persistentes e incapacitantes.…”

Cost-effectiveness of interferon therapy for multiple sclerosis in Peru: impact of treatment adherence

“…In the past 20 years, treatment for MS has been developed using drugs whose mechanism of action suppresses or modulates the immune response, termed disease‐modifying therapies (DMTs). This type of treatment affects the course of the disease by suppressing the autoimmune response . DMTs have shown favourable results mainly in relapsing‐remitting MS, so they are often recommended in this case .…”

“…DMTs have shown favourable results mainly in relapsing‐remitting MS, so they are often recommended in this case . Treatment with DMTs aims to reduce the frequency of relapses, as well as to slow down the progression of the disease and disability . There are different cost‐effectiveness studies of these drugs, but because costs vary by country and Peru is considered a medium‐prevalence country of MS, a cost‐effectiveness study is needed to determine which treatment would benefit the quality of life of the patient in a cost‐efficient manner.…”

“…This type of treatment affects the course of the disease by suppressing the autoimmune response. [7] DMTs have shown favourable results mainly in relapsing-remitting MS, so they are often recommended in this case. [8] Treatment with DMTs aims to reduce the frequency of relapses, as well as to slow down the progression of the disease and disability.…”

Treatment optimization in multiple sclerosis: how do we apply emerging evidence?

“…In clinical practice today, it is still a common approach to cycle between several first-line therapies with different doses of drug or treatments (so-called horizontal switching) in an active patient instead of trying more efficacious therapies. There are reports that horizontal switching may have positive effects [18]. So, it is still an ongoing discussion which strategy is best for the individual active patient [19,20].…”