Current Status of Oral Disease-Modifying Treatment Effects on Cognitive Outcomes in Multiple Sclerosis: A Scoping Review
Introduction. Cognitive impairment represents one of the most hidden and disabling clinical aspects of multiple sclerosis (MS). In this regard, the major challenges are represented by the need for a comprehensive and standardised cognitive evaluation of each patient, both at disease onset and during...
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| Format: | Article |
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MDPI AG
2023-07-01
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| Series: | Bioengineering |
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| Online Access: | https://www.mdpi.com/2306-5354/10/7/848 |
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| author | Vincenzo Carlomagno Massimiliano Mirabella Matteo Lucchini |
| author_facet | Vincenzo Carlomagno Massimiliano Mirabella Matteo Lucchini |
| author_sort | Vincenzo Carlomagno |
| collection | DOAJ |
| description | Introduction. Cognitive impairment represents one of the most hidden and disabling clinical aspects of multiple sclerosis (MS). In this regard, the major challenges are represented by the need for a comprehensive and standardised cognitive evaluation of each patient, both at disease onset and during follow-up, and by the lack of clear-cut data on the effects of treatments. In the present review, we summarize the current evidence on the effects of the available oral disease-modifying treatments (DMTs) on cognitive outcome measures. Materials and Methods. In this systematised review, we extract all the studies that reported longitudinally acquired cognitive outcome data on oral DMTs in MS patients. Results. We found 29 studies that evaluated at least one oral DMT, including observational studies, randomised controlled trials, and their extension studies. Most of the studies (<i>n</i> = 20) evaluated sphingosine-1-phosphate (S1P) modulators, while we found seven studies on dimethyl fumarate, six on teriflunomide, and one on cladribine. The most frequently used cognitive outcome measures were SDMT and PASAT. Most of the studies reported substantial stability or mild improvement in cognitive outcomes in a short-time follow-up (duration of most studies ≤2 years). A few studies also reported MRI measures of brain atrophy. Conclusion. Cognitive outcomes were evaluated only in a minority of prospective studies on oral DMTs in MS patients with variable findings. More solid and numerous data are present for the S1P modulators. A standardised cognitive evaluation remains a yet unmet need to better clarify the possible positive effect of oral DMTs on cognition. |
| first_indexed | 2024-03-11T01:17:19Z |
| format | Article |
| id | doaj.art-216b6ea04be94ee1a240478ef7bad7a2 |
| institution | Directory Open Access Journal |
| issn | 2306-5354 |
| language | English |
| last_indexed | 2024-03-11T01:17:19Z |
| publishDate | 2023-07-01 |
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| record_format | Article |
| series | Bioengineering |
| spelling | doaj.art-216b6ea04be94ee1a240478ef7bad7a22023-11-18T18:22:11ZengMDPI AGBioengineering2306-53542023-07-0110784810.3390/bioengineering10070848Current Status of Oral Disease-Modifying Treatment Effects on Cognitive Outcomes in Multiple Sclerosis: A Scoping ReviewVincenzo Carlomagno0Massimiliano Mirabella1Matteo Lucchini2Fondazione Policlinico Universitario Agostino Gemelli IRCCS, UOC Neurologia, 00168 Rome, ItalyFondazione Policlinico Universitario Agostino Gemelli IRCCS, UOC Neurologia, 00168 Rome, ItalyFondazione Policlinico Universitario Agostino Gemelli IRCCS, UOC Neurologia, 00168 Rome, ItalyIntroduction. Cognitive impairment represents one of the most hidden and disabling clinical aspects of multiple sclerosis (MS). In this regard, the major challenges are represented by the need for a comprehensive and standardised cognitive evaluation of each patient, both at disease onset and during follow-up, and by the lack of clear-cut data on the effects of treatments. In the present review, we summarize the current evidence on the effects of the available oral disease-modifying treatments (DMTs) on cognitive outcome measures. Materials and Methods. In this systematised review, we extract all the studies that reported longitudinally acquired cognitive outcome data on oral DMTs in MS patients. Results. We found 29 studies that evaluated at least one oral DMT, including observational studies, randomised controlled trials, and their extension studies. Most of the studies (<i>n</i> = 20) evaluated sphingosine-1-phosphate (S1P) modulators, while we found seven studies on dimethyl fumarate, six on teriflunomide, and one on cladribine. The most frequently used cognitive outcome measures were SDMT and PASAT. Most of the studies reported substantial stability or mild improvement in cognitive outcomes in a short-time follow-up (duration of most studies ≤2 years). A few studies also reported MRI measures of brain atrophy. Conclusion. Cognitive outcomes were evaluated only in a minority of prospective studies on oral DMTs in MS patients with variable findings. More solid and numerous data are present for the S1P modulators. A standardised cognitive evaluation remains a yet unmet need to better clarify the possible positive effect of oral DMTs on cognition.https://www.mdpi.com/2306-5354/10/7/848multiple sclerosiscognitive impairmentfingolimodsiponimodozanimodcladribine |
| spellingShingle | Vincenzo Carlomagno Massimiliano Mirabella Matteo Lucchini Current Status of Oral Disease-Modifying Treatment Effects on Cognitive Outcomes in Multiple Sclerosis: A Scoping Review Bioengineering multiple sclerosis cognitive impairment fingolimod siponimod ozanimod cladribine |
| title | Current Status of Oral Disease-Modifying Treatment Effects on Cognitive Outcomes in Multiple Sclerosis: A Scoping Review |
| title_full | Current Status of Oral Disease-Modifying Treatment Effects on Cognitive Outcomes in Multiple Sclerosis: A Scoping Review |
| title_fullStr | Current Status of Oral Disease-Modifying Treatment Effects on Cognitive Outcomes in Multiple Sclerosis: A Scoping Review |
| title_full_unstemmed | Current Status of Oral Disease-Modifying Treatment Effects on Cognitive Outcomes in Multiple Sclerosis: A Scoping Review |
| title_short | Current Status of Oral Disease-Modifying Treatment Effects on Cognitive Outcomes in Multiple Sclerosis: A Scoping Review |
| title_sort | current status of oral disease modifying treatment effects on cognitive outcomes in multiple sclerosis a scoping review |
| topic | multiple sclerosis cognitive impairment fingolimod siponimod ozanimod cladribine |
| url | https://www.mdpi.com/2306-5354/10/7/848 |
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