Managing multiple sclerosis in individuals aged 55 and above: a comprehensive review
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 increas...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-04-01
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| Series: | Frontiers in Immunology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1379538/full |
| _version_ | 1827292756507099136 |
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| author | Óscar Fernández Óscar Fernández Per Soelberg Sörensen Per Soelberg Sörensen Giancarlo Comi Giancarlo Comi Patrick Vermersch Hans-Peter Hartung Hans-Peter Hartung Hans-Peter Hartung Letizia Leocani Letizia Leocani Thomas Berger Thomas Berger Bart Van Wijmeersch Bart Van Wijmeersch Celia Oreja-Guevara Celia Oreja-Guevara |
| author_facet | Óscar Fernández Óscar Fernández Per Soelberg Sörensen Per Soelberg Sörensen Giancarlo Comi Giancarlo Comi Patrick Vermersch Hans-Peter Hartung Hans-Peter Hartung Hans-Peter Hartung Letizia Leocani Letizia Leocani Thomas Berger Thomas Berger Bart Van Wijmeersch Bart Van Wijmeersch Celia Oreja-Guevara Celia Oreja-Guevara |
| author_sort | Óscar Fernández |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-24T13:10:11Z |
| format | Article |
| id | doaj.art-fa03688ab1d04cc596c383506f8be4b2 |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-04-24T13:10:11Z |
| publishDate | 2024-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-fa03688ab1d04cc596c383506f8be4b22024-04-05T04:43:22ZengFrontiers Media S.A.Frontiers in Immunology1664-32242024-04-011510.3389/fimmu.2024.13795381379538Managing multiple sclerosis in individuals aged 55 and above: a comprehensive reviewÓscar Fernández0Óscar Fernández1Per Soelberg Sörensen2Per Soelberg Sörensen3Giancarlo Comi4Giancarlo Comi5Patrick Vermersch6Hans-Peter Hartung7Hans-Peter Hartung8Hans-Peter Hartung9Letizia Leocani10Letizia Leocani11Thomas Berger12Thomas Berger13Bart Van Wijmeersch14Bart Van Wijmeersch15Celia Oreja-Guevara16Celia Oreja-Guevara17Departament of Pharmacology, Faculty of Medicine; Institute of Biomedical Research of Malaga (IBIMA), Regional University Hospital of Malaga, Malaga, SpainDepartment of Pharmacology and Pediatry, Faculty of Medicine, University of Malaga, Malaga, SpainDanish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, DenmarkCopenhagen and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DenmarkDepartment of Neurorehabilitation Sciences, Multiple Sclerosis Centre Casa di Cura Igea, Milan, ItalyUniversity Vita-Salute San Raffaele, Milan, ItalyUniv. Lille, Inserm U1172 LilNCog, CHU Lille, FHU Precise, Lille, FranceDepartment of Neurology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, GermanyBrain and Mind Center, University of Sydney, Sydney, NSW, Australia0Department of Neurology, Palacky University Olomouc, Olomouc, CzechiaDepartment of Neurorehabilitation Sciences, Multiple Sclerosis Centre Casa di Cura Igea, Milan, ItalyUniversity Vita-Salute San Raffaele, Milan, Italy1Department of Neurology, Medical University of Vienna, Vienna, Austria2Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria3University MS Centre, Hasselt-Pelt, Belgium4Rehabilitation and Multiple Sclerosis (MS), Noorderhart Hospitals, Pelt, Belgium5Department of Neurology, Hospital Clínico Universitario San Carlos, IdISSC, Madrid, Spain6Department of Medicine, Faculty of Medicine, Complutense University of Madrid, Madrid, SpainMultiple 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.https://www.frontiersin.org/articles/10.3389/fimmu.2024.1379538/fullmultiple sclerosisagingmanagementdisease-modifying treatmentssymptomatic treatment |
| spellingShingle | Óscar Fernández Óscar Fernández Per Soelberg Sörensen Per Soelberg Sörensen Giancarlo Comi Giancarlo Comi Patrick Vermersch Hans-Peter Hartung Hans-Peter Hartung Hans-Peter Hartung Letizia Leocani Letizia Leocani Thomas Berger Thomas Berger Bart Van Wijmeersch Bart Van Wijmeersch Celia Oreja-Guevara Celia Oreja-Guevara Managing multiple sclerosis in individuals aged 55 and above: a comprehensive review Frontiers in Immunology multiple sclerosis aging management disease-modifying treatments symptomatic treatment |
| title | Managing multiple sclerosis in individuals aged 55 and above: a comprehensive review |
| title_full | Managing multiple sclerosis in individuals aged 55 and above: a comprehensive review |
| title_fullStr | Managing multiple sclerosis in individuals aged 55 and above: a comprehensive review |
| title_full_unstemmed | Managing multiple sclerosis in individuals aged 55 and above: a comprehensive review |
| title_short | Managing multiple sclerosis in individuals aged 55 and above: a comprehensive review |
| title_sort | managing multiple sclerosis in individuals aged 55 and above a comprehensive review |
| topic | multiple sclerosis aging management disease-modifying treatments symptomatic treatment |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1379538/full |
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