The article highlights upcoming potential treatments, which target different phases of inflammation and offer remyelinating strategies as well as direct and indirect neuroprotective and oligodendrocyte protective effects, providing a hopeful outlook for patients with primary and secondary progressive multiple sclerosis (PPMS and SPMS). The review aims to identify potential treatments and ongoing clinical trials for PPMS and SPMS, and compare their mechanisms of action, efficacy, and side effects with current treatments. We reviewed ongoing clinical trials for PPMS and SPMS on the NIH website, as well as articles from PubMed, Embase, and since 2010. BTKIs like, tolebrutinib, and fenebrutinib are being explored as potential PMS treatments. Vidofludimus calcium, an orally available treatment, has shown a reduction of active and new MRI lesions. Other treatments like simvastatin, -acetylcysteine (NAC), and alpha-lipoic acid are being explored for their antioxidant properties. AHSCT and mesenchymal stem cell therapy are experimental options for younger patients with high inflammatory activity. SPMS and PPMS are being studied for new treatments and future trials should consider combination therapies targeting inflammation, demyelination, and neuronal death, as the pathogenesis of PMS involves complex factors.

中文翻译：

---

原发性和继发性进行性多发性硬化症治疗的最新进展

该文章重点介绍了即将推出的潜在治疗方法，这些治疗方法针对炎症的不同阶段，提供髓鞘再生策略以及直接和间接的神经保护和少突胶质细胞保护作用，为原发性和继发性进行性多发性硬化症（PPMS 和 SPMS）患者提供了充满希望的前景。该综述旨在确定 PPMS 和 SPMS 的潜在治疗方法和正在进行的临床试验，并将其作用机制、功效和副作用与当前治疗方法进行比较。我们回顾了 NIH 网站上正在进行的 PPMS 和 SPMS 临床试验，以及 PubMed、Embase 和自 2010 年以来的文章。托布替尼和芬布替尼等 BTKI 正在探索作为潜在的 PMS 治疗方法。维多氟地莫钙是一种口服治疗方法，已显示活动性和新的 MRI 病变减少。其他治疗方法如辛伐他汀、β-乙酰半胱氨酸 (NAC) 和 α-硫辛酸的抗氧化特性正在被探索。 AHSCT 和间充质干细胞疗法是针对炎症活性高的年轻患者的实验选择。 SPMS 和 PPMS 正在研究新的治疗方法，未来的试验应考虑针对炎症、脱髓鞘和神经元死亡的联合疗法，因为 PMS 的发病机制涉及复杂的因素。