Major Research Findings

Multiple sclerosis (MS) is an autoimmune disease that affects the central nervous system, mainly affecting young adults (women are two to three times more likely to develop the disease than men) and causes significant disability after onset. The treatment of MS has always been a focus of neurological research. To date, the US Food and Drug Administration (FDA) has approved 15 medications for modifying the course of multiple sclerosis. 34 examined the effects of disease-modifying therapies (DMTs) on clinical outcomes. 43 examined the adverse effects of immunotherapies for MS. 23 examined patient education for people with MS-associated fatigue. 13 examined immunomodulators and immunosuppressants for MS. 2 evaluated the effects of mitoxantrone (Mx) in progressive MS on MRI. 38 determined whether ibudilast has an effect on brain volume and new lesions in progressive forms of MS. 10 examined neuropsychological rehabilitation for MS. 28 examined computer-assisted cognitive rehabilitation in persons with MS. 35 conducted a meta-analysis of clinical trials on the effect of nonpharmaceutical treatments on outcomes for MS. 1 examined locomotor reeducation and MS. 39 examined music-based therapy in rehabilitation of people with MS. 9 examined the effects of rivastigmine on processing speed and brain activation in patients with MS and subjective cognitive fatigue. 4 conducted a meta-analysis of nocebo effects in MS trials. 41 identified disease-modifying drugs used to control multiple sclerosis attacks and progress. 22 examined changing EDSS progression in placebo cohorts in relapsing MS. 29 assessed whether natalizumab slows disease progression in secondary progressive MS, independent of relapses. 15 evaluated the relationship between treatment effects on relapse rates and active T2 lesions to differences in disease progression in trials evaluating patients with clinically isolated syndrome (CIS), RRMS, and secondary progressive MS (SPMS). 30 assessed whether second-generation disease-modifying therapies (DMT) are associated with adverse psychiatric effects. 27 examined the use of noncontrast quantitative MRI to detect gadolinium-enhancing multiple sclerosis brain lesions. 37 evaluated the differential effects of DMTs on cognitive test performance in relapsing-remitting MS (RRMS). 24 reviewed some basic concepts about network meta-analyses. 11 examined statins for MS. 17 examined neuropsychological rehabilitation for MS. 25 investigated a potential influence of sex on immunomodulatory therapeutic effects in patients with MS. 14 examined neuropsychological rehabilitation in MS. 12 examined MRI lesions as a surrogate for relapses in MS. 3 examined the effects of rivastigmine on memory and cognition in MS. 19 assessed the effects of cognitive interventions in MS. 40 conducted a randomized controlled trial of a web-based mindfulness programme for people with MS. 32 summarized the current evidence on remyelination promoting therapies for MS. 36 examined whether diet is associated with physical capacity and fatigue in persons with MS. 8 conducted a randomized placebo-controlled cross-over study using a low frequency magnetic field in the treatment of fatigue in MS. 21 evaluated whether there are subgroups of relapsing-remitting MS (RRMS) patients who are more responsive to treatments. 7 examined sustained improvement in Expanded Disability Status Scale as a new efficacy measure of neurological change in MS. 31 assessed efficacy and tolerability of medicinal cannabinoids in patients with MS. These studies provide information on various treatment approaches for MS and their efficacy and safety.

Benefits and Risks

Benefit Summary

These studies have revealed various treatments that may be helpful for symptom management and disease progression suppression in patients with MS. Specifically, disease-modifying therapies, neuropsychological rehabilitation, music therapy, dietary therapy, and low-frequency magnetic field therapy have shown potential efficacy. 34 , 10 , 39 , 36 , 8

Risk Summary

Some treatments carry the risk of side effects. For example, disease-modifying therapies may pose a risk of mental side effects, and immunotherapies may pose a risk of serious infections. 43 , 30

Comparison Across Studies

Commonalities Among Studies

These studies are investigating various treatment methods that may be helpful in managing symptoms and suppressing disease progression in MS patients. Furthermore, these studies are investigating various treatment methods that may be helpful in managing symptoms and suppressing disease progression in MS patients.

Differences Across Studies

These studies differ in terms of the treatments they target, the symptoms they investigate, and their research designs. Therefore, direct comparison of the results is not possible.

Consistency and Contradictions in Results

There is both consistency and contradiction in the findings of these studies. For example, disease-modifying therapies have been shown to be effective in slowing down MS progression, but they have also been shown to pose a risk of mental side effects in some patients. Additionally, neuropsychological rehabilitation has been shown to improve cognitive function in MS patients, but more research is needed to determine the duration of its effects.

Considerations for Real-World Application

While these studies highlight various treatment approaches that may be beneficial for symptom management and disease progression suppression in MS patients, the optimal treatment for each individual will vary based on their symptoms, condition, and other factors. Therefore, it is crucial to choose the appropriate treatment under the guidance of a doctor.

Limitations of Current Research

These studies have several limitations, including a small number of participants, a short follow-up period, and research design biases. Therefore, it is necessary to consider these limitations when interpreting the results of these studies.

Future Research Directions

Future research should focus on conducting larger-scale studies with longer follow-up periods to more clearly evaluate the efficacy and safety of various treatments for MS. Additionally, research is needed that takes into account individual patient symptoms, conditions, and other factors to identify the optimal treatment for each individual.

Conclusion

These studies demonstrate the potential of various treatment approaches for MS. Based on these findings, efforts to manage symptoms and suppress disease progression in MS patients are promising. However, it is essential to consider the limitations of these studies when interpreting their results. Further research, including larger-scale studies and those with longer follow-up periods, is necessary to more accurately assess the efficacy and safety of various treatments for MS.