The Shifting Landscape of Disease-Modifying Therapies for Relapsing Multiple Sclerosis

The document reviewed the evolution of disease-modifying therapies (DMTs) for relapsing multiple sclerosis (MS), noting a shift from injectable agents to more potent oral agents and monoclonal antibodies. These newer therapies aim to improve efficacy and patient adherence but come with risks of severe adverse events. The paper discussed the benefits of early treatment in reducing the risk of relapses and the emerging goal of achieving no evidence of disease activity (NEDA). It covered various DMTs, including dimethyl fumarate, which reduces relapses but may cause adverse reactions; alemtuzumab, which induces remission but has a risk of secondary autoimmune diseases; ocrelizumab, which reduces relapses but may increase malignancy risk; and cladribine, which offers long-lasting remission but can lead to lymphopenia and infections. The document highlighted the need for personalized treatment plans that balance the goal of NEDA with the minimization of adverse events.