Therapeutic Advances and Challenges in the Treatment of Progressive Multiple Sclerosis

摘要: Despite the fact that majority of patients with multiple sclerosis (MS) have relapsing-remitting disease, many transition to secondary progressive disease (SPMS) over time. This is thought be related neurodegenerative processes increasingly predominating inflammatory as driving forces disability. However, some initially present primary (PPMS) characterized by a gradual accumulation neurological symptoms and subsequent disability accumulation. The treatment both PPMS SPMS, collectively referred MS, has proven quite challenging due multifactorial poorly understood pathophysiology in general, specifically disease. purpose this article discuss important clinical pathophysiologic differences between relapsing forms review previous notable trials drugs examine current literature regarding recent promising MS treatments, future considerations for therapeutics management. Specifically, evidence ocrelizumab, simvastatin, ibudilast, alpha-lipoic acid, high-dose biotin, siponimod, cell-based therapies are discussed.