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Here we have the central nervous system, the blood and the blood-brain barrier.
There are drugs such as rituximab, [...] which prevent that lymphocytes make their way
from the blood to the central nervous system.
Other drugs like fumaric acid favour the re-immunisation or reduce the inflammatory response.
As you see, we have several mechanisms.
Thus, the fact of thinking of combined therapies is not an illusion, but something that is going to happen.
In the current economic situation, it is difficult.
However, if they manage to reduce the price of drugs, it could help.
In conclusion, there are several effective biological molecules that improve the disease control,
increase the adhesion so that the patient takes the drug in a continuous manner
-because the fact of pricking oneself every day or three times a week
during 15 or 20 years is really complicated-, and increase the efficiency.
Nevertheless, pharmaceutical expenditure and side effects are also higher.
Some things still are pending: the progressive forms,
what I always say about the 'Poor Sisters', where we do not get treatments;
the neurodegenerative phase, which we do not treat -we only treat inflammation
and do not treat the patient when he or she is already disabled, when we can do little-;
and finally, we need activity biomarkers, because I do not think patients must have a lifelong treatment.
I think they must have treatment while the disease causes inflammation, and later it must be withdrawn.
We should have a marker which indicated when there is inflammation -and the patient must have treatment-,
and when there is not -and the treatment must be withdrawn-.
In this way, we would prevent side effects and infections.