Advancements in Pharmacotherapy and Mobile Health Applications for Self-Management in Multiple Sclerosis: A Comprehensive Review.

INTRODUCTION

Multiple sclerosis (MS) is a chronic autoimmune demyelinating disorder of the central nervous system, affecting nearly three million individuals worldwide. Long-term pharmacotherapy and treatment adherence remain major determinants of relapse prevention and disability progression.

METHODS

Following PRISMA guidelines, a narrative review compared FDA and EMA approved disease-modifying therapies (DMTs) for MS. Clinical, real-world, and patentbased data were synthesized to evaluate efficacy, adherence, and safety profiles. Digital health applications supporting self-management were also assessed.

RESULTS

Injectable therapies such as interferons and glatiramer acetate showed approximately 30% ARR reduction with excellent safety. Oral agents (fingolimod, dimethyl fumarate, teriflunomide, cladribine) achieved 45-55% ARR reduction and markedly better adherence, though periodic laboratory monitoring was required. Monoclonal antibodies (natalizumab, ocrelizumab) reached up to 68% relapse reduction, representing the highest efficacy while demanding close surveillance for PML and infection risks.

DISCUSSION: While newer high-efficacy agents yield stronger disease control, the balance between potency, adherence, and practicality remains crucial. Oral DMTs provide the most realistic compromise for long-term management. Digital self-monitoring through validated m-health applications could substantially improve adherence and disease awareness. Integration of biotechnology with tele-neurology and AI-supported analytics represents the next step toward personalized MS care.

CONCLUSION

Monoclonal antibodies define the upper limit of efficacy in current MS therapy, but sustainability depends on safety oversight and patient engagement. Oral formulations remain clinically pragmatic first-line options. The synergy between pharmacotherapy and mobile health technology offers a pathway to transform adherence, monitoring, and outcome optimization in future MS management.