Modern aspects of immunomodulatory therapy for multiple sclerosis

Rationale. Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system characterized by demyelination, axonal damage, and progressive neurological impairment. Objective. The aim of this study is to analyze current literature data addressing the use of immunomodulatory therapy in the management of MS symptoms. Methods. A literature review was conducted using sources published from 2019 to 2025 in PubMed, Scopus, Web of Science, and eLIBRARY.RU databases. The analysis included systematic reviews, meta-analyses, original research articles, and randomized controlled trials reporting data on the efficacy and safety of immunotherapy. Results. It has been established that therapy with immunomodulatory agents and interferon-based drugs reduces the frequency of relapses and lesion activity on magnetic resonance imaging without significant adverse effects. Sphingosine-1-phosphate modulators have demonstrated efficacy in limiting lymphocyte migration and reducing inflammation in the central nervous system. Anti-CD20 monoclonal antibodies significantly reduce the risk of disability progression as well as the level of neurofilament light chain, which is considered a marker of neuroaxonal damage. Adverse effects associated with most therapies did not exceed control group values. Conclusion. Immunomodulatory therapy in MS is effective in reducing the activity of the disease and the rate of progression of neurological deficits. Its effect on persistent symptoms such as cognitive impairment and fatigue requires further study.