Department of neurology, Pitié-Salpêtrière hospital, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
Rev Neurol (Paris). 2018 Jun;174(6):441-448. doi: 10.1016/j.neurol.2018.01.370. Epub 2018 May 17.
Management of progressive multiple sclerosis (MS) is one of the main challenges of the new century. Based on our knowledge of pathophysiology, three therapeutic strategies are proposed: anti-inflammatory (ocrelizumab, siponimod…); remyelinating (opicinumab); and neuroprotective (high-dose biotin, ibudilast, simvastatin…). Nevertheless, despite recent promising positive clinical trials, new methodological approaches for therapeutic protocols with adaptable outcomes to assess progression are still needed.
多发性硬化症(MS)的治疗管理是新世纪的主要挑战之一。基于我们对病理生理学的认识,提出了三种治疗策略:抗炎(奥瑞珠单抗、西尼莫德等);髓鞘再生(奥昔单抗);和神经保护(高剂量生物素、伊布地尔、辛伐他汀等)。然而,尽管最近有一些有前景的临床试验,但仍需要新的方法学方法来制定治疗方案,以适应评估进展的可调整结果。