New horizons: from BTK inhibitors to remyelination

The progressive forms of multiple sclerosis – primary progressive MS (PPMS) and secondary progressive MS (SPMS) – have presented neurologists with particular challenges for decades. Unlike relapsing-remitting MS (RRMS), where inflammation control through disease-modifying therapies is now the clinical standard, therapeutic progress in the progressive spectrum remains fragmentary. In recent years, however, new approaches have emerged: from targeted immunomodulators, Bruton’s tyrosine kinase inhibitors and remyelination strategies to innovative cell and gene therapies.