Multiple Sclerosis

Multiple sclerosis (MS) is a chronic disease of the central nervous system. MS is characterized by an inflammatory process caused by cells belonging to the immune system: such an inflammatory process causes a damage of the myelin (the coating that protects the nerve fibers of the central nervous system) in many areas (hence the word: “multiple”) of the central nervous system. The areas of myelin loss (called “demyelination”) can be of different sizes and are called “plaques”.
Chronic inflammation and demyelination cause the death of neural cells (neurodegeneration) which determines the disability that usually characterizes the more advanced forms of disease.
There are about 2.5-3 million people suffering from MS in the world; of them, 450,000 are estimated to live in Europe and about 65,000 in Italy. The onset of MS can occur at any age, but is more frequent between the ages of 20 and 40 years, with a 2-3 times greater incidence in women than in men. MS is the second most frequent neurologic disease of the young adult, and imparts a huge economic burden with a major impact on the health system.
The evolution of the disease varies among affected subjects. There are four main types of disease course: relapsing-remitting, secondary progressive, primary progressive and the so-called benign MS. The most frequent disease course is the relapsing-remitting (RR) course: about 85% of people upon diagnosis suffer from this form of the disease, characterized by acute episodes (called relapses) followed by periods of complete or partial recovery (remissions).
Secondary progressive (SP) MS is an evolution of the RR form and is characterized by persistent disability which evolves gradually over time. About 30-50% of people with RR MS develop the SP MS  form within 10 years.
The primary progressive (PP) form is characterized by slow progression from onset in the absence of relapses; it affects less than 10% of subjects with MS. Finally, a number of affected individuals (10%) suffer from a scarcely evolving form of MS, with minimal disability 15 years after onset: this form of MS is called “benign MS”.
Until now, there is no cure for MS; however, drugs are available that decrease the incidence and the severity of attacks in most cases. The main objectives of treatment of MS are:

  • To shorten the duration of relapses and decrease their severity (steroids);
  • To prevent relapses and prevent or delay the progression of disease (immunomodulating and immunosuppressive drugs)