The society also estimates that 2.3 million people live with MS globally. It is most commonly diagnosed in people in their 20s and 30s, although it can develop at any age. It's about 2 to 3 times more common in women than men. Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system that involves demyelination and axonal degeneration. Even though considerable progress has been made in clinical drug development for relapsing remitting MS, treatment of the progressive forms of the disease, which are characterised clinically by the build-up of disability in the absence of relapses, remains unsatisfactory. This unmet clinical necessity is related to the difficulty of the pathophysiological mechanisms involved in MS progression. Chronic inflammation, which arises behind a closed blood brain barrier with activation of microglia and continued involvement of T cells and B cells, is a distinctive pathophysiological feature. Inflammation can enhance mitochondrial damage in neurons, which, consequently, develop an energy deficit, further reducing axonal health. The growth-inhibitory and inflammatory environment of lesions also impairs remyelination, a repair process that might protect axons from degeneration. Furthermore, neurodegeneration is enhanced by the altered expression of ion channels on denuded axons. Although there is no current cure of MS, some current drugs appear to reduce some frequent relapses and delay disease progression to some extent. This humanised immunoglobulin antibody medication is the only Dimethyltryptamine (DMT) approved by the FDA to treat both the relapse-remitting and primary-progressive forms of MS . Clinical trials showed it reduced relapse rate in relapsing disease and slowed worsening of disability in both forms of the disease. Currently, therapeutic options for multiple sclerosis increased, several clinical dilemmas arose, and clinicians had to start making decisions about which therapy to use, when to treat patients, and when and how to switch medications in patients with a suboptimal response. These clinical dilemmas continue today, but treatment strategies continue to be refined. Although FDA(Food and Drug Administration,2019) -approved drugs to treat relapsing forms of MS in adults include dimethyl fumarate and teriflunomide, both taken orally.
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