ADVANCES IN DISEASE-MODIFYING THERAPIES IN MULTIPLE SCLEROSIS

Abstract

Introduction: Multiple Sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system, characterized by demyelination and neurodegeneration. Traditionally, treatment focused on reducing symptoms and exacerbations. However, the development of Disease Modifying Therapies (DMTs) has revolutionized the management of MS, offering new possibilities to alter the natural course of the disease. Objective: This review article aims to summarize and discuss recent advances in the development and application of DMTs for MS, focusing on mechanisms of action, clinical efficacy, safety and treatment personalization. Methodology: A narrative review of the scientific literature was performed, analyzing clinical and preclinical studies published in the last two decades on DMTs in MS. The search covered several databases, such as PubMed and Scopus, with an emphasis on studies that address new therapies and their innovative mechanisms. Results and Discussion: The results indicate that newer DMTs, such as monoclonal antibodies (e.g., ocrelizumab) and sphingosine-1-phosphate receptor modulators, have shown significant efficacy in reducing disease activity and disability progression. Cellular therapies and Bruton Tyrosine Kinase (BTK) inhibitors emerge as promising, with the potential to not only modulate the immune response but also promote neuronal regeneration. However, the efficacy of these therapies varies across different MS phenotypes, and challenges related to safety and accessibility remain. Conclusion: Advances in DMTs for MS represent a paradigm shift in the treatment of the disease, offering new hope for patients and healthcare professionals. Despite the progress, there is a continued need for research to optimize these therapies and make them accessible to all patients. Personalized medicine and the identification of biomarkers will be crucial for the future of MS management.