Multiple sclerosis treatment

Description

At present, the challenge is to offer the appropriate drug for patients, i.e. ‘personalised’ or ‘precision medicine.’ It is also key to quickly detect patients who do not respond to a specific treatment. This is why there are different ways of addressing the disease.

Primary treatment line or moderate efficacy treatments:

These types of treatment are indicated in patients with low inflammatory load, in whom it is expected to control inflammation with drugs of moderate effectiveness. These are drugs that have an acceptable safety profile, with adverse effects that are usually mild. Deciding between different front-line drugs depends on the method of administration, the profile of adverse effects, gestational desire or the patient’s medical history. You can find:

• Interferons.
• Glatiramer acetate.
• Teriflunomide.
• Dimethylfumarate.
• Ponesimod.
• Ozanimod.

Second line of treatment or highly effective treatment:

In this case, treatments are indicated in patients with high inflammatory load or persistent inflammation, despite moderate treatment. These are drugs that can potentially cause adverse effects such as systemic or central nervous system infections. The choice of drugs is based on the safety profile, gestational desire, pathological history and degree of inflammation of patients. The most common are:

• Cladribine
• Ocrelizumab
• Ofatumumab
• Alemtuzumab
• Natalizumab

Treatment due to progression with inflammatory activity:

There are two specific medications: ocrelizumab is used in patients with progressive multiple sclerosis, the only progressively available treatment, while siponimod is used in patients with progression after a remission-recurring phase.

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