Tratamiento de la esclerosis múltiple

  1. Izquierdo, A. Yusta
  2. Palomo, M.J. Sánchez
  3. Herán, I. Sánchez
  4. Monteiro, G. Carvalho
Revista:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Año de publicación: 2019

Título del ejemplar: Enfermedades del sistema nervioso (IX)Enfermedades desmielinizantes del sistema nervioso central

Serie: 12

Número: 78

Páginas: 4598-4605

Tipo: Artículo

DOI: HTTPS://DOI.ORG/10.1016/J.MED.2019.05.011 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Medicine: Programa de Formación Médica Continuada Acreditado

Resumen

Resumen La esclerosis múltiple es una enfermedad inflamatoria y neurodegenerativa del sistema nervioso central que puede presentarse con múltiples síntomas neurológicos. Se produce a la vez un proceso inflamatorio y neurodegenerativo. Al inicio va a predominar la inflamación y, según avanza la enfermedad, va a tomar más preponderancia la neurodegeneración. Aunque no se ha llegado a la cura, con los nuevos tratamientos modificadores de la enfermedad ha mejorado el pronóstico de manera significativa, así como la esperanza de vida de estos pacientes. Se ha logrado también enlentecer la progresión de la enfermedad al disminuir el número de brotes y la actividad inflamatoria, y evitar la progresión de la discapacidad. Es importante tratar lo antes posible la enfermedad, ya que, por ahora, los tratamientos modificadores de la enfermedad actúan en la fase inflamatoria y no en la neurodegenerativa. También es importante el tratamiento sintomático de la enfermedad, ya que es la base para una mejora en la calidad de vida y que el paciente siga integrado en el mundo laboral y en sus actividades familiares y sociales. Multiple sclerosis is an inflammatory, neurodegenerative disease of the central nervous system that can present with multiple neurological symptoms. An inflammatory and neurodegenerative process occurs simultaneously. At the onset, inflammation will predominate; as the disease progresses, the neurodegeneration will grow in prominence. Although a cure has not yet been found, new disease-modifying therapies have improved the prognosis significantly, as well as these patients’ life expectancy. The disease's progression has also been slowed by decreasing the number of flare-ups and the inflammatory activity and by preventing the progression of disability. It is important to treat the disease as soon as possible because disease-modifying therapies currently act in the inflammatory phase and not in the neurodegenerative phase. Symptomatic treatment of the disease is also important because it is the basis for improving the patient's quality of life and for allowing the patient to continue being part of the workforce and engaged in family and social activities.

Referencias bibliográficas

  • Andrews KL, Husmann DA. Bladder dysfunction and management in multiple sclerosis. Mayo Clin Proc. 1997;72:1176-83.
  • Birnbaum G, Iverson J. Dalfampridine may activate latent trigeminal neuralgia in patients with multiple sclerosis. Neurology. 2014;83(18):1610-2.
  • Bowling AC, Stewart TM. Dietary supplements and multiple sclerosis: a Health Professional’s Guide. New York: Demos Medical Publishing Inc; 2004.
  • Burton JM, O ́connor PW, Hohol M, Beyene J. Oral versus intravenous steroids for treatment of relapses multiple sclerosis. Co-chrane Database Syst Rev. 2012;1 2: CDOO6921.
  • Calabresi PA, Kieseier BC, Arnold DL, Balcer LJ, Boyko A, Pelletier J. Pergyleited interferon beta 1a for relapsing remitting multiple sclerosis (ADVANCE): a randomised, phase 3, double blind study. Lancet Neurol. 2014;13:657-65.
  • Coles AJ, Twyman CL, Arnold DL, Cohen JA, Confavreux C, Fox EJ. Alentuzumab for patients with relapsing multiple sclerosis after disease , disease modifying therapy: a randomised controlled phase III trial. Lancet Neurol. 2012;380:1829-39.
  • Consentino M, Zaffaroni M, Trojano M, Giorelli M, Pica C, Rasini E. Dopaminergic modulation of CD4+CD25(high) regulatory T lym-phocytes in multiple sclerosis patients during interferon-beta therapy. Neuroimmunomodulation. 2012;19(5):283-92.
  • Davis SR, Moreau M, Kroll R, Bouchard C, Panay N, Gass M. Testosterone for low libido in postmenopausal women not taking estrogen. N Engl J Med. 2008;359:2005-17.
  • Derecki NC, Cardani AN, Yang CH, Quinnies KM, Crihfield A, Lynch KR. Regulation of learning and memory by meningeal immunity: a key role for IL-4. J Exp Med. 2010;207(5):1067-80.
  • Fischer JS, Priore RL, Jacobs LD, Cookfair DL, Rudick RA, Herndon RM. Neuropsychological effects of interferon beta-1a in relapsing multiple sclerosis. Ann Neurol. 2000;48:885-92.
  • Frohman EM, Zhang H, Dewey RB, Hawker KS, Racke MK, Frohman TC. Vertigo in multiple sclerosis: utility of positional and particle repositioning maneuvers. Neurology. 2000;55:1566-8.
  • García Merino A, Ara Callizo JR, Fernández Fernández O, Lan-dete Pascual L, Moral Torres E, Rodríguez-Antigüedad Zarrant A. Consenso para el tratamiento de la Esclerosis Múltiple 2016. Sociedad Española de Neurología. Neurología. 2017;32:113-19.
  • Giovanni G, Butzkueven H, Dhib-Jalbut S, Hobart J, Kobelt G, Pepper G. Brain health. The matters in the multiple sclerosis. Multiple Sclerosis Related Disorders. 2016;9:S5–S48.
  • God R, Stangel M, Dalskas MC. Drug insight: the use of intravenous immunoglobulin in neurology-therapeutic considerationsand practical issues. Nat Cil Pract Neuron. 2007:3(1):36-44.
  • Gold R, Kappos L, Arnold DL, Bar-Or A, Giovannoni G, Selmaj K, et al. Placebo controlled phase 3 study ora BG-12for relapsing multiple scle-rosis. N Engl J Med. 2012;367(12):1098-107.
  • Hauser SL, Bar-Or A, Comi G, Giovannoni G, Hartung HP, Hemmer B. Ocrelizumab versus interferon beta-1a in relap-sing multiple sclerosis. N Engl J Med. 2017;376(3):221-34.
  • Horton L, Conger A, Conger D. Effect of 4 aminopyridine on vision in multiple sclerosis patients with optic neuropathy. Neu-rology. 2013;80(20):1862-6.
  • Kapos L, Freedman MS, Polman CH, Edan G, Hartung HP, Miller DH. Effect of early versus delayed interferon beta-1b treatment on disability after a first clinical event suggestive of multiple sclerosis: a 3-year follow-up analysis of the BENEFIT study. Lancet. 2007;370:389-97.
  • Kapos L, De Stefano N, Freedman MS. Inclusion of brain volumen loss in a revised meseaure of «no evidence of disease activity» (NEDA-4) in relapsing-remitting multiple sclerosis. Must Scler. 2016;22:1297-305.
  • Kapos L, Radue EW, O’Connor P, Polman C, Hohlfeld R, Calabresi P. A placebo controlled trial of oral fingolimod in relap-sing multiple sclerosis. N Engl J Med. 2010;362(5):387-401.
  • Karaszewski JW, Reder AT, Anlar B, Kim WC, Arnason BG. Increased lymphocyte beta-adrenergic receptor density in progressive multiple sclerosis is specific for the CD8+, CD28- suppressor cell. Ann Neurol. 1991;30:42-7.
  • Khan O, Rieckmann P, Boyko A, Selmaj K, Ashtamker N, Davis MD. Three times weekly glatiramer acetate in relapsing remitting multiple sclerosis. Ann Neurol. 2013;73(6):705-13.
  • Krupp LB, Christodoulou C. Fatigue in multiple sclerosis. Curr Neurol Neurosci Rep. 2001;1:294-8.
  • Krupp LB, Christodoulou C, Melville P, Scherl WF, Pai LY, Muenz LR. Multicenter randomized clinical trial of donepezil for memory im-pairment in multiple sclerosis. Neurology. 2011;76(17):1500-7.
  • Le Page E, Veillard D, Laplaud DA, Hamonic S, Wardi R, Lebrun C. Oral versus intravenous methylprednisolone for treatment of relapses in patients with multiple sclerosis (COPOU-SET): a randomized controlled double-blind, noninferiority trial. Lancet. 2015;386(9997):974-8.
  • Meca-Lallana JE, Rodríguez-Hilario H, Martínez-Vidal S, Saura-Luján I, Carretón-Ballester A, Escribano-Soriano JB. Plasmapheresis its use in multiple sclerosis and other demyelinizanting process of central nervous system. An observation study. Rev Neurol. 2003;37:917-26.
  • Miller DH, Khan OA, Sheremata WA, Blumhardt LD, Rice GP, Libonati MA. A controlled trial of natalizumab for relapsing multiple sclerosis. N Engl J Med. 2003;348:15-23.
  • Mohr DC, Goodkin DE, Islar J, Hauser SL, Genain CP. Treatment of depression is associated with suppression of nonspecific and antigen specific TH1 responses in multiple sclerosis. Arch Neurol. 2001;58:1081-6.
  • Patti F, Morra VB, Amato MP, Trojano M, Bastianello S, Tola MR. Subcutaneous interferon beta-1a may protect against cognitive impair-ment in patients with relapsing-remitting multiple sclerosis: 5 year follow up of the COGIMUS Study. PLoS One. 2013;8(8):e74111.
  • Pliskin NH, Hamer DP, Goldstein DS, Towle VL, Reder AT, Noronha A. Improved delayed visual reporduction test performance in multiple sclerosis patients receiving interferon b-1b. Neurology. 1996;47(6):1463-8
  • Reder AT. Interferon therapy of multiple sclerosis. New York: Marcel Dekker; 1997. p. 549.
  • Reynolds EH. Multiple sclerosis and vitamin B12 metabolism. J Neuroimmunol. 1992;40:225-30.
  • Robles-Cedeno R, Ramio-Torrenta L. Cladribine in the treatment of relapsing multiple sclerosis. Rev Neurol. 2018;67(9):343-54.
  • Ross C, Clemmesen KM, Svenson M, Sørensen PS, Koch-Henriksen N, Skovgaard GL. Immunogenicity of interferon-beta in multiple sclerosis patients: influence of preparation, dosage, dose frequency, and route of administration. Danish multiple sclerosis Study Group. Ann Neurol. 2000;48:706-12.
  • Rotsein DL, Healy BC, Malik MT, Chitnis T, Weiner HL. Evaluation of no evidence of disease activity in a 7 year longitudinal multiple sclerosis cohort. JAMA Neurol. 2015;72:152-8
  • Schapiro R. Managing the symptoms of multiple sclerosis. 4th ed. New York: Demos; 2003.
  • Smith PF, Darlington CL. Recent developments in drug therapy for multiple sclerosis. Mult Scler. 1999;5:110-20.
  • Sumowski JF, Chiaravalloti N, Erlanger D, Kaushik T, Benedict RH, Deluca J. L-amphetamine improves memory in multiple sclerosis patients with objective memory impairment. Mult Scler. 2011;17(9):1141-5.
  • Tintoré M, Rovira A, Río J, Otero-Romero S, Arrambide G, Tur C. Defining high, medium and low impact prognostic factors for developing multiple sclerosis. Brain. 2015:138;1863-74.
  • Zajicek JP, Hobart JC, Slade A, Barnes D, Mattison PG; MUSEC Research Group. Multiple sclerosis and extract of cannabis: results of the MUSEC trial. J Neurol Neurosurg Psychiatry. 2012;83(11):1125-32.
Fuente de los datos: Dialnet