Precision medicine for multiple sclerosis promotes preventative medicine

Abstract

Multiple sclerosis (MS) is a chronic, lifelong disease, currently without a cure that is responsible for significant neurological injury in young adults. Precision medicine for MS aims to provide a more exacting and refined approach toward management by providing recommendations based on disease subtype, clinical status, existing radiological data, para-clinical data, and other biological markers. To achieve better outcomes, the three stages of care-diagnosis, treatment, and management-should be optimized. However, as the temporal profile of disease behavior is highly variable in MS, and unlike outcomes from other chronic conditions (i.e., hypertension, diabetes mellitus, etc.), should precision medicine for MS be one that focuses more on disease prevention and lifestyle modifications beyond recommendations for the use of disease-modifying therapies? As scientific advancements continue within the field of neuroimmunology, and until reliable biomarkers that predict disease outcomes are available, success may be better achieved by focusing on modifiable factors to reduce future disability.

Digital Twins for Multiple Sclerosis

“…(31)(32)(33)(34)(35), that takes into account individual variability in genes, environment, and lifestyle for each person (32,(36)(37)(38)(39)(40)(41)(42). Precision medicine covers diagnosis, treatment and management to achieve better patient outcomes (43). Through precision medicine, it is possible to break down the complexity of the disease.…”

“…Precision medicine for pwMS involves the classification of disease subtypes based on underlying biology, not just clinical phenotype, and the development of predictive models that incorporate the integration of clinical, biological and molecular as well as current and emerging imaging markers with an understanding of the impact of the disease on the lives of individual patients (58)(59)(60)(61)(62)(63). A complex data set could be the base of the DTMS as part of a digital data cloud that tries to simulate the same or very similar characteristics in terms of health status, risk factors and disease development as the real-world MS patient (43,45).…”

Multiple Sclerosis Biomarker Discoveries by Proteomics and Metabolomics Approaches

“…On the other hand, precision medicine contains the same principles, but genomics and pharmacogenomics are the crucial players. 125 - 127 …”

“… 128 In order to ensure appropriate treatment for patients with MS, considering the numerous clinical and immunopathological subtypes of the disease, profiling and the individual patient’s characterization are critical. 125 , 128 Despite extensive researches on MS, there is no effective treatment for this disease. For RR subtype patients, several disease-modifying drugs (DMDs), classified into first- and second-line therapies, are accessible with different efficacy and safety outlines.…”

Understanding Participation in Genetic Research Among Patients With Multiple Sclerosis: The Influences of Ethnicity, Gender, Education, and Age

“…We examined the frequencies of responses in relation to ethnicity, age, and gender. To date, incorporating genetics into precision medicine for MS is a work in progress (Giovannoni, 2017;Hansen and Okuda, 2018), but there has been considerable progress over the past several years (Matthews, 2015). As these genetic discoveries slowly accrue and become clinically useful, it is equally important that they are applicable across populations (Hindorff et al, 2018;Bonham et al, 2018).…”