Disease-modifying treatment for multiple sclerosis in Poland in a European context: current practices and therapeutic strategies

Multiple sclerosis (MS) is a chronic, immune-mediated disease of the central nervous system and the leading cause of non-traumatic disability in young adults. In Poland, MS represents a significant neurological and public health challenge. Although treatment principles for MS are largely based on international guidelines, their implementation varies across countries due to differences in healthcare organization and access to therapies. Current treatment algorithms in Poland include both platform agents, such as interferon beta, glatiramer acetate, fumarates, and teriflunomide, as well as high-efficacy therapies, including monoclonal antibodies (e.g., ocrelizumab, ofatumumab, ublituximab, alemtuzumab, natalizumab) and oral agents (e.g., fingolimod, cladribine, ozanimod, ponesimod). Therapeutic decisions typically follow either an escalation strategy or an early intensive approach, depending on disease activity, prognostic factors, and reimbursement criteria. In addition, treatment priorities vary depending on the disease phenotype: in relapsing-remitting MS (RRMS), the aim is to reduce relapse rates and delay disability progression, whereas in progressive forms, such as primary progressive MS (PPMS) and secondary progressive MS (SPMS), the goal is to slow disease progression and preserve daily functioning. With an expanding range of therapeutic options, European clinical experience in the management of different MS phenotypes, particularly RRMS, reflects an individualized treatment approach. In routine practice, therapeutic decisions are primarily guided by disease activity, with high-efficacy therapies considered early in selected patients; similar principles inform real-world clinical practice in Poland. This review offers practical guidance for clinicians and provides therapeutic algorithms designed to support the management of patients with MS. The future development of MS management in Poland will depend on expanding access to innovative therapies, advancing biomarker research, and implementing the latest diagnostic criteria for MS. European treatment recommendations will continue to provide an important framework supporting high-quality care and early intervention for people with MS.