Dubey Divyanshu, Sguigna Peter, Stüve Olaf
Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Neurology Section, VA North Texas Health Care System, Medical Service, Dallas, TX, USA.
Curr Treat Options Neurol. 2016 Jun;18(6):27. doi: 10.1007/s11940-016-0412-7.
Patients with progressive forms of multiple sclerosis have various symptoms which affect their quality of life significantly including depression, cognitive decline, sleep changes, bladder dysfunction, sexual dysfunction, and spasticity. Despite recent promising results on the effects of ocrelizumab on neurological disability in patients with PPMS, currently none of the immunomodulatory therapies are approved for progressive forms of multiple sclerosis. Therefore, clinicians currently mostly focus on management of well-recognized comorbidities of this disease phenotype in order to improve patients' quality of life. There are very few studies evaluating strategies of symptomatic management on progressive forms of multiple sclerosis and most of the data is derived from studies on relapsing forms of multiple sclerosis. Understanding of the risks, benefits, and limitations of these therapies can significantly affect patient care. In this article, we review common comorbidities associated with progressive forms of multiple sclerosis and outline important strategies for their symptomatic management.
进行性多发性硬化症患者有多种症状，这些症状会显著影响他们的生活质量，包括抑郁、认知衰退、睡眠改变、膀胱功能障碍、性功能障碍和痉挛。尽管最近关于奥瑞珠单抗对原发性进行性多发性硬化症（PPMS）患者神经功能障碍的影响取得了令人鼓舞的结果，但目前尚无免疫调节疗法被批准用于进行性多发性硬化症。因此，临床医生目前主要关注这种疾病表型中已被充分认识的合并症的管理，以提高患者的生活质量。评估进行性多发性硬化症症状管理策略的研究非常少，且大多数数据来自复发型多发性硬化症的研究。了解这些疗法的风险、益处和局限性会显著影响患者护理。在本文中，我们回顾了与进行性多发性硬化症相关的常见合并症，并概述了其症状管理的重要策略。
