UNLOCKING HOPE: OVERCOMING THERAPEUTIC CHALLENGES IN PROGRESSIVE MULTIPLE SCLEROSIS

Abstract

Progressive forms of multiple sclerosis (MS) present significant therapeutic challenges, underscoring the pressing need for effective treatments in this domain. While relapsing-remitting MS (RRMS) transitions to secondary progressive MS (SPMS) for many patients, others experience primary progressive MS (PPMS) from the diseases onset. Despite similarities in pathophysiology and clinical progression between SPMS and PPMS, treatment options remain limited. The recent approval of ocrelizumab for PPMS marks a notable advancement, though its efficacy is modest. This retrospective study, conducted at the Neurology Department of Mohammed VI University Hospital, evaluates the tolerance and therapeutic efficacy of various treatments in progressive MS. Nineteen patient records spanning six years were analyzed, with therapeutic interventions including Fingolimod, Rituximab, cyclophosphamide-solumedrol, and ocrelizumab. Assessments utilizing the Expanded Disability Status Scale (EDSS) revealed stabilization or improvement in 15.7% of secondary progressive MS and 21% of primary progressive MS patients after 12 months of treatment. The duration of the progressive phase emerged as a key predictor of therapeutic response. Despite the approval of ocrelizumab in Morocco for PPMS, its utilization remains limited, suggesting the need for targeted studies focusing on early-stage clinical progression. Overall, this study underscores the unmet need for effective treatments in progressive MS and highlights ongoing research efforts aimed at addressing this challenge.