期刊
CURRENT OPINION IN NEUROLOGY
卷 31, 期 3, 页码 233-243出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/WCO.0000000000000561
关键词
asynchronous progressive multiple sclerosis; multiple sclerosis is a central length-dependent axonopathy; no evident disease activity; therapeutic lag; treat-2-target
资金
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University London
Purpose of review The treatment of multiple sclerosis is evolving rapidly with 11 classes of disease-modifying therapies (DMTs). This article provides an overview of a new classification system for DMTs and treatment paradigm for using these DMTs effectively and safely. Recent findings A summary of research into the use of more active approaches to early and effective treatment of multiple sclerosis with defined treatment targets of no evident disease activity (NEDA). New insights are discussed that is allowing the field to begin to tackle more advanced multiple sclerosis, including people with multiple sclerosis using wheelchairs. However, the need to modify expectations of what can be achieved in more advanced multiple sclerosis are discussed; in particular, the focus on neuronal systems with reserve capacity, for example, upper limb, bulbar and visual function. Summary The review describes a new more active way of managing multiple sclerosis and concludes with a call to action in solving the problem of slow adoption of innovations and the global problem of untreated, or undertreated, multiple sclerosis.
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