The National MS Society is pursuing all promising research paths and collaborating worldwide to drive progress in research in progressive MS, for which few therapies exist.
Finding Solutions for Progressive MS
In progressive stages of MS, there are few or no relapses, and few or no recovery or remission periods when major symptoms improve. Some of the burning questions that are being addressed through research include:
• What factors influence the transition from relapsing stages of MS to progressive MS?
• Can the disease-modifying therapies prevent, delay, or slow long-term MS progression?
• What new therapies will stop progressive MS?
• What causes degeneration of nerve fibers—thought to be the cause of long-term disability—and how can that be stopped or reversed?
Driving treatment solutions
A common question is, “Why aren’t there more treatments for progressive MS?” Virtually every therapy approved for relapsing MS has been tested, or is now in testing, in people with progressive forms of the disease. Clinical trials involving people with relapsing MS often rely on counting relapses or doing MRI scans to detect immune activity. Progression is less easily measured, and usually happens over long periods of time. This important difference makes it hard to quickly detect whether a therapy is impacting progression, and thus has made therapy development for progressive MS a challenge.
But the landscape is changing, thanks to National MS Society investments and collaborations:
Large clinical trials are going on RIGHT NOW in progressive MS, including tests of Tysabri, ocrelizumab, masitinib, laquinimod, fingolimod, and siponimod.
The Progressive MS Alliance – an ever-expanding alliance of organizations from around the world – is funding research studies in 9 countries as part of a €22 million global effort to end progressive MS. www.EndProgressiveMS.org
The Society-supported MS Outcome Assessments Consortium is working on a new measure of MS disability to improve the chances of successful clinical trials in MS, including progressive MS.
The Society is funding several clinical trials of nervous system-protecting approaches:
Lipoic acid, an antioxidant that may help block nerve fiber damage in MS
Determining whether a biomarker can monitor the benefits of oxcarbazepine (epilepsy therapy) in people with secondary-progressive MS
The MS-SMART trial is testing three therapies that may have nerve-protecting properties in secondary-progressive MS (with the MS Society of the U.K.)
A unique collaboration between NIH's NeuroNEXT Network and MediciNova for a trial (SPRINT-MS) of ibudilast, an oral anti-inflammatory agent, in 250 people with progressive forms of MS.
Studies investigating complementary and non-traditional therapies to combat specific symptoms, such as whether leg cycling can improve spasticity.
More than 30 studies investigating benefits of novel programs of exercise, rehabilitation and other non-pharmaceutical strategies to enhance wellness, and address other symptoms that can interfere with quality of life.
Understanding what drives progression and how to stop it
Researchers are exploring mechanisms that drive injury to the brain and spinal cord to expose new potential therapeutic targets along the injury pathways that may stop the damage. These include:
Large-scale studies tracking people with MS to identify factors that contribute to the risk of progression.
Advanced imaging and laboratory studies seeking to define and track the full measure of MS disease activity, MS lesions, and atrophy (shrinkage) in the brain and spinal cord.
Exploring the potential of different types of stem cells to repair the nervous system in models of the disease, and ways to enhance the survival of repair cells in the inflamed and scarred nervous system of people with MS.
What are the solutions for people with progressive MS?
We are relentlessly pursuing the answer to this question each and every day. Identifying and moving solutions forward is how we will succeed in stopping the progression of MS.