Fernandez O, Tintore M, Saiz A, Calles-Hernandez M C, Comabella M, Ramio-Torrenta Ll, Oterino A, Izquierdo G, Tellez N, Garcia-Merino J A, Brieva Ll, Arnal-Garcia C, Aladro Y, Mendibe-Bilbao M M, Meca-Lallana J E, Romero-Pinel L, Martinez-Gines M L, Arroyo R, Oreja-Guevara C, Costa-Frossard L, Carrascal P, Rodriguez-Antiguedad A
Hospital Regional Universitario de Malaga, Malaga, Espana.
Hospitals Vall d'Hebron, 08035 Barcelona, Espana.
Rev Neurol. 2019 Jun 1;68(11):468-479. doi: 10.33588/rn.6811.2019121.
The Post-ECTRIMS Meeting was held for the eleventh consecutive year in October 2018 in Madrid, with the aim of analysing the advances made in multiple sclerosis that were highlighted at the latest ECTRIMS annual congress. Based on the issues discussed at this meeting, attended by the nation's foremost opinion leaders on multiple sclerosis, two review articles are presented. This second part includes the growing body of evidence confirming the safety of exposure to disease-modifying treatments in women planning a pregnancy, and the beneficial effect of breastfeeding, provided that the disease is not very active. It addresses data showing how the application of the 2017 McDonald criteria in the paediatric population has significantly improved diagnosis compared to the previous criteria. With regard to progressive multiple sclerosis, the results of neuroprotective drugs are inconclusive, but biomarkers are proposed to improve the evaluation of the therapeutic response. Studies on myelin repair treatments suggest that remyelination in multiple sclerosis is possible. Likewise, there are favourable indications for haematopoietic stem cell transplantation, provided that patients are selected appropriately. On the other hand, we also conduct a review of the similarities and differences of the recommendations in the new clinical practice guidelines. Finally, the positive results of cognitive and motor rehabilitation with the use of new technologies point to the systematic incorporation of these tools in the treatment of the disease in the near future.
ECTRIMS会后会议于2018年10月在马德里连续第十一年举行，旨在分析在最新一届ECTRIMS年会上重点介绍的多发性硬化症研究进展。基于本次会议（该国多发性硬化症领域最重要的意见领袖均出席了此次会议）讨论的问题，发表了两篇综述文章。第二部分内容包括越来越多的证据证实，计划怀孕的女性使用疾病修正治疗是安全的，以及在疾病不太活跃的情况下母乳喂养的有益效果。该部分还阐述了数据，表明与之前的标准相比，2017年麦克唐纳标准在儿科人群中的应用显著改善了诊断。关于进展型多发性硬化症，神经保护药物的研究结果尚无定论，但有人提出了生物标志物以改善对治疗反应的评估。髓鞘修复治疗的研究表明，多发性硬化症中的髓鞘再生是可能的。同样，造血干细胞移植也有有利迹象，前提是对患者进行适当的选择。另一方面，我们还对新临床实践指南中建议的异同进行了综述。最后，使用新技术进行认知和运动康复的积极结果表明，在不久的将来，这些工具将系统地纳入该疾病的治疗中。
