Therapeutic Strategies in Multiple Sclerosis Management

Multiple sclerosis (MS) is a chronic autoimmune disorder characterised by immune-mediated demyelination, axonal injury and neurodegeneration within the central nervous system. Therapeutic approaches have evolved from broad immunosuppression to more targeted immunomodulation, aiming both to reduce relapse frequency and to slow long-term disability. First-line disease-modifying therapies (DMTs) include injectable agents that modulate lymphocyte trafficking, while second-generation oral and monoclonal antibody treatments offer higher efficacy through selective cell depletion or receptor blockade. Emerging small-molecule inhibitors of Bruton's tyrosine kinase (BTK) seek to attenuate B-cell and microglial activation. In parallel, autologous haematopoietic stem cell transplantation is under investigation for aggressive relapsing MS, with the goal of immune system “reset”. Beyond immunotherapy, remyelination-promoting strategies are in preclinical and early clinical stages, including agents that stimulate oligodendrocyte precursor cells or enhance neuroprotective pathways. Symptomatic management remains essential, addressing spasticity, pain, fatigue and bladder dysfunction to improve quality of life. Stratified medicine approaches, incorporating biomarkers and advanced imaging, are guiding personalised choice of therapies. Together, these developments reflect a dual aim: to suppress aberrant immune responses and to repair or protect nervous tissue, offering hope for both relapse reduction and progression delay.

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Therapeutic Strategies in Multiple Sclerosis Management publication trend

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

Technical terms

Disease-modifying therapy: A treatment that alters the underlying immune pathology of MS to reduce relapse rate and slow disability progression.

Remyelination: The process by which oligodendrocyte precursor cells restore myelin sheaths around demyelinated axons.

Neuroprotection: Strategies or agents aimed at preserving neuronal and axonal integrity independent of immune modulation.

Bruton’s tyrosine kinase inhibitor: A small molecule that blocks signalling in B cells and myeloid cells to reduce inflammation.

Haematopoietic stem cell transplantation: A procedure to ablate and rebuild the immune system using a patient’s own stem cells.

References

1. Seeking neuroprotection in multiple sclerosis: an ongoing challenge. Journal of Clinical Investigation (2023).
2. Therapeutic Advances in Multiple Sclerosis. Frontiers in Neurology (2022).
3. Review of multiple sclerosis: Epidemiology, etiology, pathophysiology, and treatment. Medicine (2024).
4. A Personalized Approach in Progressive Multiple Sclerosis: The Current Status of Disease Modifying Therapies (DMTs) and Future Perspectives. International Journal of Molecular Sciences (2016).
5. Promising Nanotechnology Approaches in Treatment of Autoimmune Diseases of Central Nervous System. Brain Sciences (2020).
6. Multiple Sclerosis: Focus on Extracellular and Artificial Vesicles, Nanoparticles as Potential Therapeutic Approaches. International Journal of Molecular Sciences (2021).
7. Molecular Biomarkers in Multiple Sclerosis and Its Related Disorders: A Critical Review. International Journal of Molecular Sciences (2020).