Smolders Joost, Smets Ide, Wokke Beatrijs
Department of Neurology, MS Center ErasMS, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 40, 3015GD Rotterdam, The Netherlands.
Department of Immunology, MS Center ErasMS, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Ther Adv Neurol Disord. 2025 Sep 20;18:17562864251359002. doi: 10.1177/17562864251359002. eCollection 2025.
The development of novel therapy classes such as Bruton's tyrosine kinase (BTK) inhibitors, which target disability progression independent of relapses and largely independent of new lesion formation, requires a reappraisal of strategies in the treatment of multiple sclerosis (MS). We argue that this novel class of treatment further emphasizes the need for early and aggressive treatment with classical disease-modifying compounds for the prevention of both relapses and new MRI lesion formation and their associated disability accrual. This will extend the window to recognize early progressive disability accumulation independent of acute focal inflammatory activity, and for people with MS to benefit from novel therapies such as BTK inhibition, which target damaging pathophysiological processes independent of peripherally driven focal inflammation.
新型治疗类别（如布鲁顿酪氨酸激酶（BTK）抑制剂）的开发，其针对的是与复发无关且在很大程度上与新病灶形成无关的残疾进展，这需要重新评估多发性硬化症（MS）的治疗策略。我们认为，这类新型治疗进一步强调了使用经典疾病修饰化合物进行早期积极治疗的必要性，以预防复发和新的MRI病灶形成及其相关的残疾累积。这将扩大识别与急性局灶性炎症活动无关的早期进行性残疾累积的窗口，使MS患者能够受益于诸如BTK抑制等新型疗法，这些疗法针对的是与外周驱动的局灶性炎症无关的破坏性病理生理过程。
