Multiple sclerosis today can be addressed with diagnostic and therapeutic tools that have substantially transformed how the disease is managed. Quicker diagnoses, high-efficacy medications, and increasingly personalized strategies are enabling a growing number of patients to preserve independence, quality of life, and the ability to plan for the future. This is the picture outlined by specialists from the Italian Society of Neurology (SIN) ahead of World MS Day, set for Saturday, May 30.
According to Massimo Filippi, head of SIN’s Multiple Sclerosis Study Group: «The real revolution of recent years concerns the possibility of intervening much earlier than in the past. Multiple sclerosis remains a serious, progressive disease if not addressed with appropriate therapies. But today it has become a controllable disease».
A New Approach to the Disease
Among the most significant steps highlighted by the specialists are the new international diagnostic criteria, published in October 2025, which allow for a much faster diagnosis. «Today we can make a diagnosis within about a month, thanks to the integration of MRI markers and biomarkers from biological fluids», emphasizes Filippi. – The early diagnosis makes sense because we now have effective therapies: intervening promptly helps prevent the disease mechanisms from fueling themselves and disability from accumulating.
Meanwhile, there has also been a deep shift in our biological understanding of the disease. «We have learned that neuroinflammation and neurodegeneration begin at the very earliest stages, – notes the neurologist. – There is not only an external autoimmune attack on the central nervous system, but also internal processes orchestrated by resident cells, such as microglia.
In this scenario, for specialists the early use of high-efficacy drugs becomes central. «Giving very effective therapies right away means bending the disability accumulation curve, – says Filippi. The goal today is not yet definitive cure, but to allow patients to live well for decades.
An equally relevant aspect is the therapeutic results in recent years. «With high-efficacy drugs we achieve about a 90% reduction in relapses and the accumulation of new brain lesions, – explains Nicola De Stefano, elected president of the SIN. – It is a profoundly important impact that concretely alters the course of the disease.
The treatments currently available mainly address the inflammatory component, responsible for relapses and the brain damage detectable on MRI. The neurodegenerative side, however, remains more complex. «Currently we do not yet have therapies that directly target neurodegeneration, – clarifies De Stefano, – however, reducing inflammation remains fundamental to limit future degenerative damage,» notes the neurologist. “That’s why drastically lowering inflammatory activity also improves the patient’s long-term outlook.”
For De Stefano the current challenge is to use therapies in the most appropriate way and at the right times. «It does not mean giving powerful drugs to everyone indiscriminately, but being able to choose the most suitable treatment based on individual prognostic characteristics,» he emphasizes. – Today we have tools that allow us to adequately stratify patients.
The direction urged by the specialists is toward an ever more personalized management of multiple sclerosis, as highlighted by Claudio Gasperini, vice president of the SIN.
«In recent years we have gained a much deeper understanding of the disease’s pathogenic mechanisms and the ways drugs work, – explains Gasperini. – This allows us to identify with greater precision the therapies most appropriate for each patient.
Today neurologists can integrate clinical data, neuroimaging information, and innovative biomarkers, such as neurofilaments, to define the disease’s evolving risk and guide treatment decisions. «The goal is to target treatment strategies with increasing precision», stresses the expert.
Care, however, does not end with pharmacological therapy. Attention is growing toward neuroplasticity, the brain’s ability to activate compensatory mechanisms in response to neurological damage.
«Today we know that lifestyle can also favor neuroplasticity and help delay the onset of disability», explains Gasperini. – For years patients were advised against physical activity. Today we know that exercise stimulates the brain to form new neuronal connections and functional compensatory mechanisms.
Physical activity, the neurologist notes, does not directly reduce inflammation, but it supports the brain’s ability to compensate for damage caused by the disease. «Exercise promotes the formation of new synapses, which helps maintain more efficient transmission of nerve impulses».
Even some clinical taboos of the past have been revised. «There was a time when sun exposure was discouraged, recalls Gasperini. – Today we know, instead, that adequate vitamin D levels are a protective factor in neurodegenerative diseases and multiple sclerosis.
In the message addressed to patients, the specialists emphasize the need to view the disease with a perspective different from the past. «Be active», says De Stefano. «The disease can accompany a person for life, but it should not define them. Today more and more patients are able to work, participate in sports, build a family, and pursue their goals».
A perspective made possible by the integration of early diagnosis, innovative therapies, ongoing monitoring, and multidisciplinary management. «The current vision of multiple sclerosis, – concludes the SIN president, Mario Zappia, – goes far beyond merely clinical management of the disease and aims to guarantee people a quality of life, a forward-looking outlook, and a level of autonomy as close to normal as possible. Today neurology has diagnostic and therapeutic tools unimaginable just a few years ago, but the real challenge is to ensure that this innovation becomes truly accessible and sustainable for all patients, in a uniformly distributed way across the country. MS is one of the areas where scientific progress has clearly shown how research can change people’s lives. It is essential to continue investing in clinical research, in specialized care networks, and in multidisciplinary management, so that every patient can promptly benefit from the best available therapies. Truly useful innovation is the kind that translates scientific evidence into real-life value for people’s daily lives, while strengthening equity, efficiency, and sustainability of the healthcare system».
Abbonati a Karla Miller
