Clinical Management of Multiple Sclerosis Treatments

Multiple sclerosis (MS) is a chronic immune-mediated disorder of the central nervous system characterised by inflammatory demyelination, axonal damage and neurodegeneration. Clinical management spans acute relapse therapy, symptomatic relief and long-term disease modification. High-dose corticosteroids remain the mainstay for managing relapses, while a growing repertoire of disease-modifying therapies (DMTs) aims to reduce lesion burden, delay disability accumulation and slow progression. These include injectable agents (interferon-beta, glatiramer acetate), oral small molecules (fingolimod, dimethyl fumarate, siponimod) and monoclonal antibodies targeting lymphocyte trafficking or activation (natalizumab, ocrelizumab, ofatumumab). Treatment selection is guided by disease severity, risk–benefit assessment and patient preferences, with escalation or de-escalation strategies tailored to individual prognostic factors. Emerging approaches seek to combine immunomodulation with neuroprotective and remyelination-promoting interventions. Biomarkers in blood or cerebrospinal fluid and advanced imaging techniques are refining patient stratification and monitoring of therapeutic response. Global efforts emphasise equitable access, long-term safety surveillance and personalised care pathways to optimise outcomes across diverse healthcare settings.

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Clinical Management of Multiple Sclerosis Treatments publication trend

The graph below shows the total number of articles in clinical management of multiple sclerosis treatments across all publications each year (not limited to Nature Index journals).

Technical terms

Disease-modifying therapy (DMT): A treatment intended to reduce disease activity and delay long-term disability in MS rather than solely relieve symptoms.

Relapsing-remitting MS (RRMS): A clinical course marked by discrete episodes of neurological dysfunction followed by partial or complete recovery.

Progressive MS: A form of MS characterised by steady worsening of neurological function, with or without superimposed relapses.

Demyelination: Loss or damage of the myelin sheath insulating central nervous system axons, leading to conduction deficits.

Remyelination: The repair process in which oligodendrocytes restore myelin sheaths around demyelinated axons.

Experimental autoimmune encephalomyelitis (EAE): An animal model of MS used to study immune-mediated demyelination and evaluate potential therapies.

References

1. An Overview of the History, Pathophysiology, and Pharmacological Interventions of Multiple Sclerosis. Cureus (2023).
2. FGF/FGFR Pathways in Multiple Sclerosis and in Its Disease Models. Cells (2021).
3. Multiple Sclerosis: Inflammatory and Neuroglial Aspects. Current Issues in Molecular Biology (2023).
4. Cerebrospinal fluid in multiple sclerosis. Annals of Indian Academy of Neurology (2009).
5. The modern view of the multiple sclerosis relapses treatment. Meždunarodnyj Nevrologičeskij žurnal (2022).