Mellen Center for MS Treatment and Research, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, USA.
Lou Ruvo Center for Brain Health, Cleveland Clinic, 888 W. Bonneville, Las Vegas, NV, USA.
Neurotherapeutics. 2017 Oct;14(4):952-960. doi: 10.1007/s13311-017-0548-5.
Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system, and the most common cause of nontraumatic disability in young adults. Most patients have a relapsing-remitting course, and roughly half of them will eventually enter a degenerative progressive phase, marked by gradual accrual of disability over time in the absence of relapses. Early initiation of treatment has delayed the onset of disability progression. Thus, there is increased interest in treating to target in MS, particularly targeting no evidence of disease activity. This review will describe the most common treatment goals in MS: the Rio scores, disease-free survival, and no evidence of disease activity. We will also cover how well current disease-modifying therapies achieve no evidence of disease activity, and discuss future options for improving MS treatment targets.
多发性硬化症（MS）是一种中枢神经系统自身免疫性脱髓鞘疾病，也是导致年轻人非外伤性残疾的最常见原因。大多数患者表现为复发缓解病程，其中约一半患者最终将进入退行性进展阶段，在没有复发的情况下，随着时间的推移逐渐出现残疾累加。早期开始治疗可延迟残疾进展的发生。因此，人们对多发性硬化症的靶向治疗越来越感兴趣，特别是针对无疾病活动证据的靶向治疗。本综述将描述多发性硬化症中最常见的治疗目标：里约评分、无疾病生存和无疾病活动证据。我们还将介绍目前的疾病修正治疗在实现无疾病活动证据方面的效果，并讨论改善多发性硬化症治疗目标的未来选择。
