Recent advances in the management of multiple sclerosis

Abstract

Every 5 minutes, someone somewhere in the world is diagnosed with an inflammatory, demyelinating, neurodegenerative disorder known as multiple sclerosis (MS). MS was historically known as "La sclèrose en plaques" which involves the central nervous system (the brain and the spinal cord). It is always considered to be a disease of adulthood but nowadays pediatric MS is also gaining popularity. It is the most common non-traumatic chronic disabling disease of adults. MS is said to have etiology of multifactorial origin. of the myelin structure thereby producing a dysregulated immune system. MS is an ongoing disease with episodes of relapses and remissions whereas the basic pathophysiology remains increasing over time. Since the pathophysiology of MS is very complex, it makes the pharmacotherapy part bit difficult. MS therapy is disease subtype-specific. The drugs which were previously approved for MS lacks efficacy and sometimes possess serious adverse effects and thereby creating lacunae in treating MS patients include the need for a drug with better efficacy especially it should be evidence-based. There are several new drugs approved for the treatment of MS in recent times especially over the past 5-8 years and 'n' number of new molecules being tried in clinical trials. In this review, an effort was made to discuss MS epidemiology, potential etiological factors, pathophysiology, clinical aspects of MS before moving on to pharmacotherapy and other non-pharmacological management of MS. A special elaborative note on recently approved drugs and drugs under pipeline has been discussed in this review.