Pharmacological treatment options for inhibiting progression independent of relapse activity in multiple sclerosis

The article presents an overview of current pharmacotherapeutic options for inhibiting relapse-independent progression in multiple sclerosis. It discusses the paradigm shift in multiple sclerosis treatment, which stems from the growing awareness of progression independent of relapse activity. The mechanisms of action and clinical trial results for several drugs, including ocrelizumab, siponimod, natalizumab, ibudilast, simvastatin, biotin, masitinib, and others, are presented. The complexity of progression independent of relapse activity pathophysiology translates into the need for a multidirectional therapeutic approach. Developing effective therapies is challenging due to the complexity of pathomechanisms in the course of the disease and the need for long-term observations. The evolution of methods for assessing disease progression and the importance of identifying reliable biomarkers are also discussed. A promising direction is the possibility of using combination therapies and personalization of treatment.