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Progressive MS Research

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In this article
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.
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The Next Frontier: Understanding and Treating Progressive MS

A panel of experts discusses challenges and potential in progressive MS research during this hour-long webcast.

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, Gilenya, ocrelizumab, masitinib, and siponimod.
  • The Progressive MS Alliance – an ever-expanding alliance of organizations from around the world – is working to connect resources and experts to find the answers that will lead to new treatments and ultimately, end progressive MS.  
  • 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 to reduce MS damage:
    • Lipoic acid, an antioxidant that may help block nerve fiber damage in MS
    • Phenytoin, which reduces entry of sodium into nerve fibers (with MS Society of the U.K.)
    • A complementary study to a trial of oxcarbazepine (epilepsy therapy) in people with secondary-progressive MS, to determine if a “biomarker” can monitor tissue damage and benefits of therapy
    • 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.)
    • Co-funding a unique collaboration between NIH's NeuroNEXT Network and MediciNova for a phase II clinical trial (SPRINT-MS) of ibudilast, an oral anti-inflammatory agent, in 250 people with progressive forms of MS. It is being led by Robert Fox, MD (Cleveland Clinic Foundation).
  • Studies investigating complementary and non-traditional therapies to combat specific symptoms, such as the whether a “medical food” can improve cognition, or 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, improve balance, spasticity and cognitive function, rand 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.

We are making progress in ending progression and restoring function

  • An international team led by Harvard researchers co-funded by the Society has found that levels of vitamin D in serum early on in MS may predict later disease activity and progression.
  • Researchers co-funded by the Society found a possible biomarker or indicator that may help predict MS disease progression. Tob1, a molecule associated with immune cells, may ultimately be used to identify people who are likely to progress to full-blown MS after an initial attack.
  • Researchers at Brigham and Women’s Hospital funded by the Society found in a large-scale, long-term study of women that progression changed at or around menopause toward a more rapid accumulation of disability, offering clues to further research and intervention
  • Society-sponsored researchers at the University of Rochester and in Milan, Italy have shown recent success transplanting stem cells in mice, promoting recovery of function.
  • Researchers at institutions around the world are reporting success using novel exercise and rehabilitation techniques to improve walking, reduce fatigue, reduce disability due to dizziness, and improving learning and memory in 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.

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