Introduction

Multiple sclerosis (MS) is a chronic immune-mediated neurodegenerative disease of the central nervous system. It causes inflammation, demyelination and plaque formation in the brain and spinal cord, leading to an array of neurological deficits.1–3 MS is defined by4:

  • The extent of disease activity as evidenced by clinical relapses and new or enlarging lesions on imaging.
  • Its clinical course where disease progression denotes clinical deterioration and increasing disability.

Learning objectives

After successful completion of this CPD activity, pharmacists should be able to:

  • Discuss treatment strategies for MS in the context of comorbidities and vice versa.
  • Explain the pathophysiology of MS.
  • Summarise the role of the pharmacist in managing MS and comorbidities.

Competency standards addressed (2016): 1.1, 1.5, 2.1, 2.2, 2.3, 3.1

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Epidemiology, pathophysiology and risk factors

Relapsing remitting MS (RRMS) is the most prevalent disease course, accounting for about 85% of all initial diagnoses, affecting more females than males.2,3 Secondary progressive MS (SPMS) is the secondary phase of RRMS and is characteri

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