Health 4.0: The case of multiple sclerosis

Multiple sclerosis is a chronic and variable disease in matters of symptoms, clinical course and outcome. The ultimate goal of currently used drugs and therapeutic strategies is the control of disease activity and the delay of the ongoing disability. During the last decades, a number of disease-modifying drugs (DMDs), all products of advanced biotechnology are being used. However, these DMDs are yet partially effective since the ongoing disability progression may hardly be prevented. There is growing evidence that these DMDs might be more effective if more accurate monitoring of the disease itself throughout a period of time might be available. In the new era of MS treatment and on the basis of our current knowledge about MS management, it became pretty clear that the overall therapeutic strategy should always be scheduled on strictly individualized basis. To this, MS patients should be encouraged to take control over their own disease and collaborate more effectively with their doctors. The advent of the IoT (Internet of Things) and 5G mobile technologies can support patients in this direction. Since a snapshot of the overall patient's condition during a regular follow-up visit may not represent the every day reality of the patient, the advice given under these conditions may not be that effective. However, if hard data on the patient's motoric and cognitive performance were available “theragnostics” might be much more effective and efficient and a typical flare-up of the condition might be recognized much earlier - or even anticipated. Health 4.0 is the translation of Industrie 4.0 design principles into the health domain [36]. Health 4.0 is based on the utilization of the Internet of Things (IoT) and the use of cyber-physical systems to connect the physical and the virtual world. The use of smart pharmaceuticals bio-sensors and cyber-physical systems in the management of MS could optimize the accuracy and allow for a precise mapping of symptoms over time which is an inevitable prerequisite for personalization of care. Ideally captured data would be processed in real time in order to flag problems up to the care team and on an individual basis anticipate motoric and / or cognitive deficits in an attempt to compensate for neurological deficits. 5G networks are expected to provide the infrastructure and ease in supporting various parameters recording on a real time basis. Relevant clinical studies may further highlight the need of information communication technology in MS management, thus contributing to the overall improvement of patent's quality of life (QoL). This is an absolute necessity for a variable, fluctuating and largely unpredictable disease such as MS.