ADVANCES IN THERAPEUTIC APPROACHES FOR THE TREATMENT OF MULTIPLE SCLEROSIS: CURRENT AND FUTURE PERSPECTIVES.

Main Article Content

Ariana Liseth Jacome Aguilar
Freddy Damián Castillo Solano

Keywords

multiple sclerosis, central nervous system, therapeutic approach, diagnosis

Abstract

Background: multiple sclerosis (MS) is a chronic multifactorial inflammatory disease of the central nervous system (CNS), which causes demyelination and neurodegeneration, can result in severe deterioration in both physical and cognitive functions.


Objective: to describe advances in therapeutic approaches for the treatment of multiple sclerosis: current and future perspectives.


Methodology: study with a qualitative, non experimental, narrative bibliographic approach, based on the review of sources of the different scientific databases, taking into account high impact articles present in digital platforms, linked to health, such as NCBI, Scielo, Science, Sciencedirect, Dialnet, Springerlink among others. The articles used were published from 2018 onwards, in Spanish and English as a priority. The searches were carried out with the help of keywords and Boolean operators AND and OR, guaranteed better results.


Results: The literature review identified that the main therapeutic approaches used are glatiramer acetate, Interferon, Natalizumab, Fingolimod, Teriflunomide, natalizumab, fingolimod, rituximab, azathioprine, mitoxantrora, dimethylfumarate, cladribine, with different levels of efficacy. Few clinical trials were documented, which constitutes a limitation of the use of different therapeutic approaches in the management of multiple sclerosis.


Conclusions: Limited and insufficient studies and research on effectiveness and safety of therapeutic approaches in the management of multiple sclerosis are a challenge and challenge for science

Abstract 297 | Pdf Downloads 127

References

1. Filippi M, Bar-Or A, Piehl F, Preziosa P, Solari A, Vukusic S, et al. Multiple sclerosis. Nat Rev Dis Primers. 8 nov 2018;4(1):43.
2. Zuckerman AD, DeClercq J, Simonson D, Zagel AL, Turco E, Banks A, et al. Adherence and persistence to self-administered disease-modifying therapies in patients with multiple sclerosis: A multisite analysis. Multiple Sclerosis and Related Disorders. July 2023;75:104738.
3. Juanatey A, González-Nafría N, Álvarez-Fernández E, Polo-Martín M, Pérez-Macho L, Blanco-García L. Prevalence study of multiple sclerosis in the Spanish province of Zamora. Neurology Perspectives. 2022 Jan;2(1):21-5.
4. Arteaga A, Cortés E, Castro J. Symptomatological treatment of multiple sclerosis. AVFT [Internet]. 2020;39(2). Available in: https://www.revistaavft.com/images/revistas/2020/avft_2_2020/1_trataiento_sintomatol%C3%B3gico.pdf
5. Baskaran AB, Grebenciucova E, Shoemaker T, Graham EL. Current Updates on the Diagnosis and Management of Multiple Sclerosis for the General Neurologist. J Clin Neurol. 2023;19(3):217.
6. Zhang GX, Carrillo-Vico A, Zhang WT, Gao SS, Izquierdo Ayuso G. Incidence and prevalence of multiple sclerosis in China and Asian countries. Neurology. 2023 Apr;38(3):159-72.
7. Aguilar-Juarez P, Castillo-Lara R, Colorado-Ochoa H. Consensus for the diagnosis and treatment of multiple sclerosis in ISSSTE patients. Med Int Mex. 2019;35(5):721-71.
8. Correa-Díaz E, Jácome-Sánchez E, Torres-Herrán G, Masabanda-Campaña L, Baños-Jiménez G, Altamirano-Brito M, et al. Prognostic factors of Multiple Sclerosis. Rev Ecuat Neurol [Internet]. 2018;27(1). Available in: http://scielo.senescyt.gob.ec/scielo.php?script=sci_arttext&pid=S2631-25812018000100062
9. Moura RP, Sarmento B. Therapeutic Approaches toward Multiple Sclerosis: Where Do We Stand and Where Are We Headed? Adv Therap. 2019 Oct;2(10):1900070.
10. Yang JH, Rempe T, Whitmire N, Dunn-Pyrium A, Graves JS. Therapeutic Advances in Multiple Sclerosis. Front Neurol. June 3, 2022;1:824926 PM
11. Bourque J, Hawiger D. Current and Future Immunotherapies for Multiple Sclerosis. Mo Med. 2021;118(4):334-9.
12. Dobson R, Giovannoni G. Multiple sclerosis – a review. Eur J Neurol. 2019 Jan;26(1):27-40.
13. Pérez-Carmona N, Fernández-Jover E, Pérez-Sempere E. Epidemiology of multiple sclerosis in Spain. Rev Neurol. 2019;(69):32-8.
14. Alshammari Y, Aldoghmi A, Alafif H, Alfayi B, Alrebh A, Alsayafi Z, et al. Multiple Sclerosis Diagnosis and Management: A simple Literature Review. Arch Pharma Pract. 2019;10(4):33-7.
15. Al-Sakran LH, Marrie RA, Blackburn DF, Knox KB, Evans CD. Establishing the Incidence and Prevalence of Multiple Sclerosis in Saskatchewan. Can J Neurol Sci. May 2018;45(3):295-303.
16. Rotstein DL, Chen H, Wilton AS, Kwong JC, Marrie RA, Gozdyra P, et al. Temporal trends in multiple sclerosis prevalence and incidence in a large population. Neurology. 2018 April 17;90(16):E1435-41.
17. Correa-Díaz E, Jácome-Sánchez E, Torres G, Buestán M, Altamirano-Brito M, Caiza-Zambrano F, et al. The Epidemiological and Clinical Profile of Multiple Sclerosis in Ecuador. Rev Ecuat Neurol [Internet]. 2019;28(2). Available in: https://revecuatneurol.com/wp-content/uploads/2019/10/2631-2581-rneuro-28-02-00059.pdf
18. Dighriri IM, Aldalbahi AA, Albeladi F, Tahiri AA, Kinani EM, Almohsen RA, et al. An Overview of the History, Pathophysiology, and Pharmacological Interventions of Multiple Sclerosis. Cureus [Internet]. January 2, 2023 [cited July 13, 2023]; Available in: https://www.cureus.com/articles/131339-an-overview-of-the-history-pathophysiology-and-pharmacological-interventions-of-multiple-sclerosis
19. Wijnands JM, Zhu F, Kingwell E, Zhao Y, Ekuma O, Lu X, et al. Five years before multiple sclerosis onset: Phenotyping the prodrome. Mult Scler. 2019 Jul;25(8):1092-101.
20. Camargo Rojas AP, Gómez López AM, Hernández LF, Palacios Sánchez E. Symptoms present in Multiple Sclerosis: case series. Acta Neurol Colomb. 2018 Jul 19;34(2):108-14.
21. Kupjetz M, Joisten N, Rademacher A, Gonzenbach R, Bansi J, Zimmer P. Cycling in primary progressive multiple sclerosis (CYPRO): study protocol for a randomized controlled superiority trial evaluating the effects of high-intensity interval training in persons with primary progressive multiple sclerosis. BMC Neurol. 2023 Apr;23(1):162.
22. Högg T, Wijnands JMA, Kingwell E, Zhu F, Lu X, Evans C, et al. Mining healthcare data for markers of the multiple sclerosis prodrome. Multiple Sclerosis and Related Disorders. October 2018;25:232-40.
23. Yusuf FLA, Ng BC, Wijnands JMA, Kingwell E, Marrie RA, Tremlett H. A systematic review of morbidities suggestive of the multiple sclerosis prodrome. Expert Review of Neurotherapeutics. 2020 Aug;20(8):799-819.
24. Arteaga A, Cortés E, Castro J, Gutiérrez J. Symptomatological treatment of multiple sclerosis. Venezuelan Archives of Pharmacology and Therapeutics [Internet]. 2020;39(2). Available in: https://www.redalyc.org/journal/559/55969799001/55969799001.pdf
25. Tremlett H, Munger KL, Makhani N. The Multiple Sclerosis Prodrome: Evidence to Action. Front Neurol. January 31 2022;12:761408.
26. Marrie RA, Allegretta M, Barcellos LF, Bebo B, Calabresi PA, Correale J, et al. From the prodromal stage of multiple sclerosis to disease prevention. Nat Rev Neurol. 2022 Sep;18(9):559-72.
27. McGinley MP, Goldschmidt CH, Rae-Grant AD. Diagnosis and Treatment of Multiple Sclerosis: A Review. JAMA. 2021 Feb 23;325(8):765.
28. McGinley MP, Goldschmidt CH, Rae-Grant AD. Diagnosis and Treatment of Multiple Sclerosis: A Review. JAMA [Internet]. 23 February 2021 [cited 13 July 2023];325(8):765. Available in: https://jamanetwork.com/journals/jama/fullarticle/2776694
29. Goldschmidt C, McGinley M. Advances in the Treatment of Multiple Sclerosis. Neurol Clin. 2021;39:21-33.
30. Zhao Y, Wijnands JMA, Högg T, Kingwell E, Zhu F, Evans C, et al. Interrogation of the Multiple Sclerosis Prodrome Using High-Dimensional Health Data. Neuroepidemiology. 2020;54(2):140-7.
31. Thompson AJ, Baranzini SE, Geurts J, Hemmer B, Ciccarelli O. Multiple sclerosis. The Lancet. 2018 Apr;391(10130):1622-36.
32. Chopra M, Kataria S. Multiple Sclerosis : A Review. IJSRST. 2021 February 18;193-211.
33. Barboza A. Discontinuation of disease-modifying therapies in multiple sclerosis. A multidimensional approach. Neurol Arg. 2018;10(4):232-40.
34. García L, Ayerdis M, Giroud J, Martínez J, Ali G. Nicaraguan recommendations on the identification of treatment failure in patients with multiple sclerosis. Rev Cien Sal and Educ Med. 4(6).
35. Aguilar P, Castillo R, Ceballos L, Colorado H, Espinosa J, Flores F. Consensus for the diagnosis and treatment of multiple sclerosis in ISSSTE patients. Med Int Mex. 2019;35(5).
36. Gozzo L, Romano GL, Brancati S, Longo L, Vitale DC, Drago F. The therapeutic value of treatment for multiple sclerosis: analysis of health technology assessments of three European countries. Front Pharmacol. 28 April 2023;14:1169400.
37. Reich DS, Arnold DL, Vermersch P, Bar-Or A, Fox RJ, Matta A, et al. Safety and efficacy of tolebrutinib, an oral brain-penetrant BTK inhibitor, in relapsing multiple sclerosis: a phase 2b, randomised, double-blind, placebo-controlled trial. The Lancet Neurology. 2021 Sep;20(9):729-38.
38. Schneider R, Oh J. Bruton's Tyrosine Kinase Inhibition in Multiple Sclerosis. Curr Neurol Neurosci Rep. November 2022;22(11):721-34.
39. Hamou A, Kamayan A, Sadiq H, Aedh B, Hussain A, Alsayafi Z, et al. Multiple Sclerosis Diagnosis and Management: A simple Literature Review. Arch Pharma Pract. 2019;10(4):33-7.
40. Ríos A, Arteaga A, Henao J, Bagner V, Castro-Alvarez J. Modifying drugs in multiple sclerosis: current therapeutic schemes. Rev Chil Neuropsicol. 2020;15(1):32-7.
41. Reich DS, Lucchinetti CF, Calabresi PA. Treatment of Multiple Sclerosis: A Review. Longo DL, editor. N Engl J Med. 11 Jan 2018;378(2):169-80.