Division of Multiple Sclerosis and Neuroimmunology Department of Neurology, McGovern Medical School (UT Health), University of Texas Health Science Center at Houston, Houston, TX,USA.
Department of Neurology, Southern Illinois university, Springfield, IL, USA; Department of Neuropsychiatry, Minia University, Egypt.
J Neuroimmunol. 2024 May 15;390:578315. doi: 10.1016/j.jneuroim.2024.578315. Epub 2024 Feb 17.
The article highlights upcoming potential treatments, which target different phases of inflammation and offer remyelinating strategies as well as direct and indirect neuroprotective and oligodendrocyte protective effects, providing a hopeful outlook for patients with primary and secondary progressive multiple sclerosis (PPMS and SPMS).
The review aims to identify potential treatments and ongoing clinical trials for PPMS and SPMS, and compare their mechanisms of action, efficacy, and side effects with current treatments.
We reviewed ongoing clinical trials for PPMS and SPMS on the NIH website, as well as articles from PubMed, Embase, and clinicaltrails.gov since 2010.
BTKIs like, tolebrutinib, and fenebrutinib are being explored as potential PMS treatments. Vidofludimus calcium, an orally available treatment, has shown a reduction of active and new MRI lesions. Other treatments like simvastatin, N-acetylcysteine (NAC), and alpha-lipoic acid are being explored for their antioxidant properties. AHSCT and mesenchymal stem cell therapy are experimental options for younger patients with high inflammatory activity.
SPMS and PPMS are being studied for new treatments and future trials should consider combination therapies targeting inflammation, demyelination, and neuronal death, as the pathogenesis of PMS involves complex factors.
本文重点介绍了即将出现的潜在治疗方法，这些方法针对炎症的不同阶段，提供了髓鞘再生策略，以及直接和间接的神经保护和少突胶质细胞保护作用，为原发性和继发性进行性多发性硬化症（PPMS 和 SPMS）患者带来了希望。
本综述旨在确定 PPMS 和 SPMS 的潜在治疗方法和正在进行的临床试验，并将其作用机制、疗效和副作用与现有治疗方法进行比较。
我们在 NIH 网站上审查了正在进行的 PPMS 和 SPMS 的临床试验，以及自 2010 年以来来自 PubMed、Embase 和 clinicaltrails.gov 的文章。
BTKIs，如 tolebrutinib 和 fenebrutinib，正被探索作为潜在的 PMS 治疗方法。Vidofludimus 钙，一种口服治疗药物，已显示出减少活跃和新的 MRI 病变。其他治疗方法，如辛伐他汀、N-乙酰半胱氨酸（NAC）和α-硫辛酸，因其抗氧化特性而被探索。AHSCT 和间充质干细胞治疗是针对炎症活动度高的年轻患者的实验选择。
正在为 SPMS 和 PPMS 研究新的治疗方法，未来的试验应考虑针对炎症、脱髓鞘和神经元死亡的联合治疗方法，因为 PMS 的发病机制涉及复杂的因素。
