Source:
https://www.nature.com/articles/s41582-018-0127-3
In 2018, the distinguishing pathological features of white matter lesions in patients with progressive multiple sclerosis (MS) were refined, and serological and MRI biomarkers of clinical worsening and evolution to progressive MS were identified. We also saw therapeutic advances in progressive MS with the emergence of new neuroprotective strategies and putative markers of neurodegeneration.
Key advances:
A pathological study showed that substantial white matter lesion activity, in the form of mixed active–inactive, smouldering and slowly expanding lesions, persists and correlates with disease severity in patients with long-standing progressive multiple sclerosis (MS)1.
Levels of serum neurofilament light chain, a marker of neuroaxonal damage, were found to be higher in progressive MS than in relapsing MS, to correlate with current and future clinical disability, and to predict accelerated brain and spinal cord atrophy4.
In patients with relapse-onset MS, a high cortical lesion count at disease onset predicted conversion to secondary progressive MS5, and in patients with primary progressive MS, baseline grey matter damage was predictive of clinical worsening after 15 years6.
Integration of MRI measures into the clinical evaluation of patients with MS would allow earlier prognostication of long-term clinical outcomes6, leading to possible improvements in treatment decision-making and optimization of overall costs.
In a phase II trial in patients with progressive MS, ibudilast treatment was associated with slower progression of brain atrophy but also had some adverse effects10; this study provides the impetus for future trials of neuroprotection in progressive MS.
Targeting progression in MS (PPMS+SPMS)
A forum to discuss research on the origins of MS and its development.
Return to “MS Etiology and Pathogenesis”
Jump to
- Multiple Sclerosis
- ↳ General Discussion
- ↳ Introductions
- ↳ Drug Pipeline
- ↳ Regimens
- ↳ Undiagnosed
- ↳ MS Etiology and Pathogenesis
- Treatments
- ↳ Chronic Cerebrospinal Venous Insufficiency (CCSVI)
- ↳ Low Dose Naltrexone
- ↳ Tysabri (Antegren, Natalizumab)
- ↳ Copaxone
- ↳ Glatopa
- ↳ Avonex
- ↳ Rebif
- ↳ Betaseron
- ↳ Plegridy
- ↳ Novantrone
- ↳ Aimspro
- ↳ Diet
- ↳ Stem Cells
- ↳ Antibiotics
- ↳ Campath (Lemtrada, Alemtuzumab)
- ↳ Gene Therapy
- ↳ Natural Approach
- ↳ Biotin (Qizenday, Cerenday, MD1003)
- ↳ Coimbra High-Dose Vitamin D Protocol
- ↳ Statins
- ↳ Tcelna (Tovaxin)
- ↳ Revimmune (Cyclophosphamide, Cytoxan)
- ↳ Medical Devices
- ↳ Rituxan (Rituximab)
- ↳ Ocrevus (Ocrelizumab)
- ↳ Kesimpta (Ofatumumab)
- ↳ Briumvi (Ublituximab-xiiy)
- ↳ General Medications
- ↳ Tecfidera (BG-12, Dimethyl fumarate)
- ↳ Vumerity (Diroximel fumarate)
- ↳ Bafiertam (Monomethyl fumarate)
- ↳ Gilenya
- ↳ Aubagio (Teriflunomide)
- ↳ Mayzent (Siponimod)
- ↳ Zeposia (Ozanimod)
- ↳ Ponvory (Ponesimod)
- ↳ Mavenclad (Cladribine)
- ↳ Ampyra (Dalfampridine)
- ↳ Medical Marijuana
- ↳ Sativex
- ↳ Chiropractic Treatment
- Life
- ↳ Daily Life
- ↳ Veterans and MS
- ↳ Trigeminal Neuralgia in MS
- ↳ Reading Nook
- ↳ Humor
- ↳ Shopping
- ↳ Friends and Family
- ↳ Mental & Spiritual Health
- ↳ Exercise and Physical Therapy
- ↳ Under 25 with MS
- ↳ MS in the Golden Years
- ↳ Parenting Kids With MS
- ↳ Parents with MS
- ThisIsMS.com
- ↳ Site Support
- ↳ Suggestions