EVALUATION OF THE FIRST-LINE IMMUNOMODULATING THERAPY EFFICACY IN PATIENTS WITH RELAPSING-REMITTING AND SECONDARY-PROGRESSIVE TYPES OF MULTIPLE SCLEROSIS
The lack of relevant first-line treatment of multiple sclerosis (glatiramer acetate and beta interferon 1b) leads to disease progression, exacerbation of irreversible neurological disorders and increasement of treatment costs. Evaluation of multiple sclerosis activity, its progression rate, efficacy of immunomodulating therapy based on magnetic resonance imaging may not be enough to select the appropriate treatment. The interrelation between microcirculation features, neuropsychological disorders, depressive disorders and disease activity, lack of an optimal response to the first-line therapy was studied. Microcirculation disorders in patients with suboptimal response to immunomodulating therapy of relapsing-remitting multiple sclerosis corresponded to the spastic type (1 and 2 degree of severity), and in secondary-progressive patients it corresponded to the stagnant type (2 degree of severity). In the lack of a response to the first-line therapy of relapsing-remitting multiple sclerosis, microcirculation disorders developed in the spastic type (2 and 3 degree of severity), and in the secondary-progressive type it developed in the stagnant type (2 and 3 degree of severity). The inefficiency of immunomodulating therapy was observed in patients with a high level of personal anxiety (45 points or more on the Spielberger scale), and depressive disorders (17.5 ± 2.5 points on Beck scale). Analysis of the features of microcirculation, neuropsychological and depressive disorders in multiple sclerosis patients may be useful for developing a therapeutic strategy for each patient.