Treatment of Multiple Sclerosis: A Review
Open accessAbstract
Multiple sclerosis (MS) is an autoimmune demyelinating and neurodegenerative disease of the central nervous system, and the leading cause of nontraumatic neurological disability in young adults. Effective management requires a multifaceted approach to control acute attacks, manage progressive worsening, and remediate bothersome or disabling symptoms associated with this illness. Remarkable advances in treatment of all forms of MS, and especially for relapsing disease, have favorably changed the long-term outlook for many patients. There also has been a conceptual shift in understanding the immune pathology of MS, away from a purely T-cell-mediated model to recognition that B cells have a key role in pathogenesis. The emergence of higher-efficacy drugs requiring less frequent administration have made these preferred options in terms of tolerability and adherence. Many experts now recommend use of these as first-line treatment for many patients with early disease, before permanent disability is evident.
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The findings may partly explain why immunosuppressive therapies have thus far had little or no effect on disability accumulation in progressive MS trials.
“It may also partly explain why immunosuppressive therapies have thus far had little or no effect on disability accumulation in progressive MS trials4.”
From Locus for severity implicates CNS resilience in progression of multiple sclerosis (2023) · cites this paper as [4]
Disease-modifying therapies have significantly improved prognosis for relapsing forms of multiple sclerosis (RMS).
“While disease-modifying therapies have significantly improved prognosis for relapsing forms of multiple sclerosis (RMS), effective treatments for the progressive, neurodegenerative phase are lacking.”
From Insights and challenges on animal models for progressive multiple sclerosis (2026) · cites this paper as [17]
Most disease-modifying therapies are approved for treatment of relapsing multiple sclerosis (RMS).
“Most DMTs are approved for treatment of relapsing MS (RMS) [17], a smaller number have shown benefit in some SPMS populations [19, 22, 23], but only one DMT has shown efficacy for treatment of PPMS, underlining the unmet need of treatment options for these patients [20] (Table 2).”
From Insights and challenges on animal models for progressive multiple sclerosis (2026) · cites this paper as [17]
IFN-γ has been proposed to play both stimulatory and suppressive roles in cancer, and type I IFNs are used both as an immunosuppressant to treat multiple sclerosis and as immunostimulatory adjuvant treatments for cancer and chronic viral infection.
“For example, IFN-γ has been proposed to play both stimulatory and suppressive roles in cancer, and type I IFNs are used both as an immunosuppressant to treat multiple sclerosis and as immunostimulatory adjuvant treatments for cancer (for example melanoma) and chronic viral infection (for example HCV)48–50.”
From Causal identification of single-cell experimental perturbation effects with CINEMA-OT (2023) · cites this paper as [50]
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Adıgüzel, E., & Ülger, T. G. (2024) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2024.176706 · Cited by 27 · see citing works
Mazziotti, V., Crescenzo, F., Turano, E., Guandalini, M., Bertolazzo, M., Ziccardi, S., Virla, F., Camera, V., Marastoni, D., Tamanti, A., et al. (2024) · Journal of Neuroinflammation · doi:10.1186/s12974-024-03193-6 · Cited by 30 · see citing works
Sleep and cognitive outcomes in multiple sclerosis; a systematic review
Golabi, B., Razmaray, H., Sahebari, S. S., Bandehagh, H., Hakimzadeh, Z., Khosroshahi, A., Moghaddamziabari, S., Aghaei, N., Sanaie, S., Talebi, M., et al. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-06103-5 · Cited by 29 · see citing works
Extracellular vesicles as drug and gene delivery vehicles in central nervous system diseases
Shi, X., He, W., Gupta, A. B., To, K., Clark, L., Mirle, N., Wynn, T., Wang, D., Ganesh, A., Zeng, H. M., et al. (2025) · Biomaterials Science · doi:10.1039/d4bm01394h · Cited by 27 · see citing works
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Impact of Vitamin D Supplementation on Multiple Sclerosis
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Role of fenofibrate in multiple sclerosis
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Self-citation
- Authors
- Hauser, S. L., & Cree, B. A. C.
- Affiliations
- University of California, San Francisco (US)
- Corresponding author
- Hauser, Stephen L.
- Venue
- The American Journal of Medicine
- Publisher
- Elsevier BV
- Published
- 2020-12
- Volume
- 133
- Issue
- 12
- Pages
- 1380-1390.e2
- ISSN
- 0002-9343 (ISSN-L)
- PMC
- PMC7704606
- OpenAlex
- W3042308502
- Cited by
- 969
- References
- 81
- Citations by year
- 2026: 149 · 2025: 208 · 2024: 229 · 2023: 175 · 2022: 135 · 2021: 64 · 2020: 7
- FWCI
- 14.61
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The American Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- Novartis
- Roche
- National Institute of Neurological Disorders and Stroke (R35NS111644)
- TG Therapeutics
- Valhalla Foundation
- National Multiple Sclerosis Society (RR 2005-A-13)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Oncology › Polyomavirus and related diseases
- Life Sciences › Immunology and Microbiology › Immunology › Psoriasis: Treatment and Pathogenesis
- Keywords
- multiple sclerosis, relapsing-remitting multiple sclerosis, disease-modifying therapy, B-cell therapy, T cell-mediated autoimmunity, neurodegeneration, disability progression, symptom management, first-line therapy, long-term prognosis
- MeSH terms
- Antibodies, Monoclonal, Humans, Immunosuppressive Agents, Multiple Sclerosis, Physical Therapy Modalities
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