Neurology, Professor Comi from Caltanissetta: “Soon new guidelines on Multiple Sclerosis”

“In a few days on the occasion of the Ectrims (European Committee for Treatment and Research in Multiple Sclerosis) congress, the guidelines for the therapy for Multiple Sclerosis will be presented. I am part of the group of about 25 people, including four Italian researchers, who developed it and we will give some indications on how to use this large availability of drugs we have ”. This was announced from Caltanissetta by professor Giancarlo Comi, founder and former director of the Institute of Experimental Neurology of the IRCCS San Raffaele Hospital in Milan, as part of the Highlights in Neurology congress organized by the regional president of the Italian Society of Neurology Michele Vecchio.
“Multiple Sclerosis – explains Comi – was the one in the neurological field that more than all the others has had a powerful development of therapies in the last 15 years. So it was necessary to do a bit of order and understand what were the most appropriate ways to optimize use and minimize risks. This year there are no new drugs but we have a better definition on how to use them. The disease in people with multiple sclerosis is extremely variable and therefore all our treatment decisions must be tailored to each person. To do this job well, you need to have an organizational model that is adequate. So the other big news is that a European and global campaign is being promoted to follow the sick through a very specific organizational aspect which is called Multiple Sclerosis Care Unit very similar to the Stroke Unit. The European Charcot Foundation, which I have the honor of presiding for a few years, has just launched a campaign to be able to offer every person who has this disease the possibility of being followed by specialized centers interconnected so that in any area of ​​the country can guarantee the same possibility of health “.
During the conference it emerged that cases of multiple sclerosis are increasing in people over 60. “It remains a disease of the young person – explains Comi – but more and more often we see cases that begin late. The first reason this is happening is that we have more refined diagnostic tools and therefore this allows us to track down even those forms that have late onset that we did not previously suspect and therefore tended to ignore. The second is that the disease is increasing. If once there were cases that could remain subclinical for life, today they tend to reveal themselves. And those that reveal themselves later are lighter cases. A disease that appears at this age has its own peculiarities in the context of deciding on therapies “.
And finally the causes of the disease. “We now know with certainty – explains Comi – that it is a concomitance of individual propensity together with exposure to environmental factors including atmospheric pollution and smoking. There is certainly our intestinal microbiome at stake and therefore an impact of nutrition, as well as low levels of vitamin D. There are also some factors of an infectious nature at play. For example, the disease responsible for infectious mononucleosis may be able to increase the risk of later developing multiple sclerosis. Another factor that has emerged is childhood obesity. We are therefore identifying these factors one by one as modifiable factors ”.