Ageing and multiple sclerosis

Abstract

Advances in the treatment of multiple sclerosis in recent decades have allowed an increasing number of people to reach advanced age without significant disability. Most disease-modifying drugs are designed to suppress active inflammation and reduce the risk of relapses; however, as patients age, the pathogenetic mechanisms of the disease change, and progression independent of relapse activity (PIRA) begins to prevail. The prolonged duration of drug-induced immunosuppression, combined with age-related comorbidities, may lead to adverse effects. In this article, we review age-related changes in multiple sclerosis pathogenesis and the associated treatment challenges.

Keywords

• multiple sclerosis
• disease-modifying therapies
• aging