Multiple sclerosis in 2018: new therapies and biomarkers

[frodo]

Multiple sclerosis in 2018: new therapies and biomarkers

https://www.sciencedirect.com/science/a ... via%3Dihub

From my point of view, there are two remarkable advances:

- Ibudilast, a phosphodiesterase inhibitor that crosses the blood–brain barrier, reduced the rate of brain atrophy by about 48% compared with placebo. This trial is important among other things because provided data from five advanced imaging biomarkers for monitoring the evolution of the disease:

- transverse diffusivity in the corticospinal tract
- longitudinal diffusivity
- magnetisation transfer ratio in normal-appearing tissue
- thickness of the retinal nerve fibre layer
- and cortical thickness

As far as I know, never before was monitorized this carefully a drug in MS.

- New biomarkers for neurodegeneration. Whole-brain atrophy on MRI is driven mainly by grey matter atrophy. The sequence in which grey matter regions became atrophic on MRI was similar across multiple sclerosis subtypes, and atrophy spread to involve more regions over time. The progression of atrophy through different stages was associated with disability accumulation. This marker of progression could be used at the individual level for automatic assessment of patients and for monitoring the course of multiple sclerosis, with the hope of enabling personalised treatment choices.