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Title: | Managing multiple sclerosis in individuals aged 55 and above: a comprehensive review | Authors: | Fernandez, Oscar Sorensen, Per Soelberg Comi, Giancarlo Vermersch, Patrick Hartung, Hans-Peter Leocani, Letizia Berger, Thomas VAN WIJMEERSCH, Bart Oreja-Guevara, Celia |
Issue Date: | 2024 | Publisher: | FRONTIERS MEDIA SA | Source: | Frontiers in Immunology, 15 (Art N° 1379538) | Abstract: | Multiple Sclerosis (MS) management in individuals aged 55 and above presents unique challenges due to the complex interaction between aging, comorbidities, immunosenescence, and MS pathophysiology. This comprehensive review explores the evolving landscape of MS in older adults, including the increased incidence and prevalence of MS in this age group, the shift in disease phenotypes from relapsing-remitting to progressive forms, and the presence of multimorbidity and polypharmacy. We aim to provide an updated review of the available evidence of disease-modifying treatments (DMTs) in older patients, including the efficacy and safety of existing therapies, emerging treatments such as Bruton tyrosine kinase (BTKs) inhibitors and those targeting remyelination and neuroprotection, and the critical decisions surrounding the initiation, de-escalation, and discontinuation of DMTs. Non-pharmacologic approaches, including physical therapy, neuromodulation therapies, cognitive rehabilitation, and psychotherapy, are also examined for their role in holistic care. The importance of MS Care Units and advance care planning are explored as a cornerstone in providing patient-centric care, ensuring alignment with patient preferences in the disease trajectory. Finally, the review emphasizes the need for personalized management and continuous monitoring of MS patients, alongside advocating for inclusive study designs in clinical research to improve the management of this growing patient demographic. | Notes: | Fernández, O (corresponding author), Reg Univ Hosp Malaga, Fac Med, Dept Pharmacol, Malaga, Spain.; Fernández, O (corresponding author), Reg Univ Hosp Malaga, Inst Biomed Res Malaga IBIMA, Malaga, Spain.; Fernández, O (corresponding author), Univ Malaga, Fac Med, Dept Pharmacol & Pediatry, Malaga, Spain. oscar.fernandez.sspa@gmail.com |
Keywords: | multiple sclerosis;aging;management;disease-modifying treatments;symptomatic treatment | Document URI: | http://hdl.handle.net/1942/42884 | ISSN: | 1664-3224 | e-ISSN: | 1664-3224 | DOI: | 10.3389/fimmu.2024.1379538 | ISI #: | WOS:001204939900001 | Rights: | 2024 Ferna´ndez, Sörensen, Comi, Vermersch, Hartung, Leocani, Berger, Van Wijmeersch and Oreja-Guevara. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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