“When I started working on multiple sclerosis, there was no therapy and the disease was a sentence. Some before, some later, many patients ended up in wheelchairs, with an obvious disability. Now that’s no longer the case. Fortunately, for the most part. of cases, we are able to keep it under control, like many other autoimmune diseases, but you have to use the right drugs, highly effective in the beginning. There are about 20 therapies, currently, authorized for multiple sclerosis, and more will come by now increase quickly. We must give the patient the right one for him. ”This is the picture drawn by Luca Battistini, director of the Neuroimmunology Laboratory of the Santa Lucia Irccs Foundation in Rome, from the 38th Ectrims congress, the most important scientific event dedicated to research on multiple sclerosis, underway in Amsterdam.
“More and more therapy is and will be personalized, different according to the patient, his age, the history of the disease and the historical context – underlines Battistini – We study the patient’s immune profile at 360 degrees to find biomarkers capable of giving an answer as to what might be the best therapy for that patient before administering the drug. There are many variables to be taken into consideration in the choice of therapy “. Even for multiple sclerosis, the focus is on increasingly tailor-made, personalized treatments. “Already today – he explains – we have markers, in addition to the resonance, that can be used to try to understand how that patient’s disease will evolve and which therapeutic strategy to adopt. Multiple sclerosis is a chronic inflammatory disease, this overly lively immune response must always be kept under control, without however eliminating the immune system, balancing the risks “.
For the immunologist, the key word is “early treatment: using the right drugs, highly effective at the beginning. We know that neuro-inflammation is subtle, in the 90s there was talk of benign multiple sclerosis, there was the idea that if new lesions are not found with the MRI, it means that the disease is stopped. We now know that this is not the case, there is no benign multiple sclerosis. The disease may be silent, but it does not stop ”.
“We understood that using ineffective therapies, such as the so-called first-line ones – says Battistini – is not a good strategy: it stops for a while and with a variable success rate the formation of new lesions, but not neuro-inflammation . There are primarily progressive forms of multiple sclerosis, they are very rare cases. The forms defined as ‘secondary progressive’ were actually in most cases patients not treated immediately in a very aggressive way at the level of the immune system and the disease slowly, but inexorably progressed and worsened. These are obsolete definitions, these distinctions must be abandoned. The different forms of multiple sclerosis are all progressive, faster or slower, but we now know that there is no remitting phase. This disease never stops – he remarks – and the most effective therapies must be started immediately, if possible. Regulatory agencies should take this into account, not just thinking about the problem of costs “.