The most relevant data presented at the 29th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), held in October 2013 in Denmark, were summarised at the sixth edition of the Post-ECTRIMS Expert Meeting held in Madrid in October 2013, resulting in this review, which is being published in three parts. This third part of the Post-ECTRIMS review discusses the effects of immunomodulatory therapy on the natural history of multiple sclerosis, with special attention to the assessment of long-term effects and the use of historical controls as an alternative to randomised trials compared with placebo. This article contains possible future therapeutic strategies to be tested in experimental models and discusses clinical trials that are underway and future treatments. It also summarises the results of recent studies of disease-modifying treatments and developments in symptom management. Briefly, on the horizon are many drugs with different mechanisms of action, although new strategies and treatment algorithms are needed, as are new biomarkers and assessment measures of secondary progression and long-term records to assess safety. As for the symptomatic treatment of the disease, the proposal is a personalised treatment plan and a multidisciplinary approach to improve the quality of life of patients.
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J Neurol
January 2025
Institute of Psychological Medicine and Clinical Neuroscience, Cardiff University, University Hospital of Wales, Heath Park, Cardiff, CF14 4XN, UK.
The first of several phase 3 trials examining efficacy in relapsing MS has not been able to demonstrate a significant benefit and has also raised important safety concerns. More results are on their way and it will be important to understand whether the safety signals identified are drug- or class-specific and whether other BTKi also fail to reach their endpoints for relapsing MS. However, as reported in preliminary data for another BTKi, it may be that they will have more of a role in progressive disease as hinted by the unraveling of relevant molecular mechanisms and pathways.
View Article and Find Full Text PDFJ Cosmet Dermatol
January 2025
Clinical Research Center of the Carolinas, Charleston, South Carolina, USA.
Background: Exosomes are extracellular vesicles, composed of a phospholipid bilayer, that are primarily derived from stem cells. The contents of exosomes can be incorporated into the tissue in which they are introduced, which presents a unique therapeutic option.
Aims: Exosomes have been investigated as a treatment for a number of medical ailments, but the literature supporting these indications is inconclusive.
Mult Scler
January 2025
Rennes University, EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, Rennes, France.
Background: Previous studies have shown that people with multiple sclerosis (MS) had frequent healthcare visits up to 10 years before being diagnosed but with no information from magnetic resonance imaging (MRI) scans of the connection with the radiologically isolated syndrome (RIS).
Objective: To analyze healthcare use 3 years before the RIS diagnosis.
Methods: We examined healthcare usage before the first scan in RIS cases from 2010 to 2019.
J Clin Med
December 2024
IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy.
Olfactory dysfunction (OD) is an underestimated symptom in multiple sclerosis (MS). Multiple factors may play a role in the OD reported by MS patients, such as ongoing inflammation in the central nervous system (CNS), damage to the olfactory bulbs due to demyelination, and the presence of plaques in brain areas associated with the olfactory system. Indeed, neuroimaging studies in MS have shown a clear association of the OD with the number and activity of MS-related plaques in frontal and temporal brain regions.
View Article and Find Full Text PDFInt J Mol Sci
December 2024
Department of Infectology, Rīga Stradiņš University, LV-1007 Riga, Latvia.
Forecasting the progression of the disease in the early inflammatory stage of the most prevalent type of multiple sclerosis (MS), referred to as relapsing-remitting multiple sclerosis (RRMS), is essential for making prompt treatment modifications, aimed to reduce clinical relapses and disability. In total, 58 patients with RRMS, having an Expanded Disability Status Scale (EDSS) score less than 4, were included in this study. Baseline magnetic resonance imaging (MRI) was performed, and brain and spinal cord lesions were evaluated.
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