诱导升级降级停药多发性硬化症的治疗决策

Induction, Escalation, De-Escalation, Discontinuation:Treatment Decisions Over a Lifetime of MSJohn R. Corboy, MDCharles Elliot Morris Chair of Neurology, CU SOMMedical Director, RMMSC at CUApril 6, 2024Disclosures•Grants–NIH/ITN, PCORI, NMSS, EMD Serono•Consulting–CleneNanoscience, Bristol Meyers Squib•Editing–Annals of Neurology•Medical Director–Rocky Mountain MS CenterGoal of MS TherapyLife-Long Brain/Spine Health3Changes Through Lifetime•Pathological•Clinical- less new relapses, some with slow progression•Radiological: MRI w less new active lesions, more SELs•Biomarkers: NfL, GFAP, others•Treatment–Behavioral–Symptomatic–Immunotherapy: Disease Modifying Therapies (DMTs)–Neuroprotection–Remyelination–RegenerationMS Pathogenesis•Inflammation and Neurodegeneration–Inflammation due to adaptive immune dysfunction most marked early in course•Pathologically new, active lesions with trafficking WBCs/adaptive immune system •Relapses, new enhancing MRI lesions early, then diminish over time•