Blizard Institute, Barts and The London School of Medicine and Dentistry and Department of Neurology, Royal London Hospital, Barts Health NHS Trust, Queen Mary University London, London, UK.
Curr Opin Neurol. 2018 Jun;31(3):233-243. doi: 10.1097/WCO.0000000000000561.
The treatment of multiple sclerosis is evolving rapidly with 11 classes of disease-modifying therapies (DMTs). This article provides an overview of a new classification system for DMTs and treatment paradigm for using these DMTs effectively and safely.
A summary of research into the use of more active approaches to early and effective treatment of multiple sclerosis with defined treatment targets of no evident disease activity (NEDA). New insights are discussed that is allowing the field to begin to tackle more advanced multiple sclerosis, including people with multiple sclerosis using wheelchairs. However, the need to modify expectations of what can be achieved in more advanced multiple sclerosis are discussed; in particular, the focus on neuronal systems with reserve capacity, for example, upper limb, bulbar and visual function.
The review describes a new more active way of managing multiple sclerosis and concludes with a call to action in solving the problem of slow adoption of innovations and the global problem of untreated, or undertreated, multiple sclerosis.
多发性硬化症的治疗方法正在迅速发展，目前已有 11 类疾病修正治疗药物（DMT）。本文概述了一种新的 DMT 分类系统和治疗方案，旨在安全有效地使用这些 DMT。
对早期积极治疗多发性硬化症的研究进行了总结，这些研究采用了明确的无明显疾病活动（NEDA）治疗目标。本文讨论了新的见解，使该领域开始治疗更严重的多发性硬化症，包括使用轮椅的多发性硬化症患者。然而，本文还讨论了需要调整对更严重多发性硬化症治疗效果的期望，特别是关注具有储备能力的神经元系统，例如上肢、延髓和视觉功能。
本文综述了一种新的更积极的多发性硬化症治疗方法，并呼吁采取行动，解决创新采用缓慢以及全球多发性硬化症治疗不足或治疗不充分的问题。
