Neurológia pre prax 3/2025
Changes in the pathophysiology of multiple sclerosis are agedependent: DMT methods in patients over 55 years
With a rapidly aging global population and the advent of highly effective disease-modifying treatments (DMT) for multiple sclerosis (MS), the epidemiology of MS has changed. Currently, the largest group are patients aged 55–65. Changes in the pathophysiology of MS are agedependent. After 50 years of life, reparative processes in the CNS fail, the level of oxidative stress increases, the phenotype of the immune system changes to a pro-inflammatory one. All these changes contribute to an accelerated increase in neurological disability. Due to the modification of the immune system due to aging, the effectiveness of DMT may decrease, while the risk of adverse effects increases. Selective immune reconstitution treatment with cladribine with proven efficacy and a favorable safety profile in patients over 55 years of age is an optimal alternative for the management of elderly patients with MS.
Keywords: multiple sclerosis, aging, selective immune reconstitution therapy, cladribine
