The National MS Society is focused on achieving breakthroughs to cures for multiple sclerosis. Our progress will be hastened with a roadmap that describes the knowledge gaps, milestones and research priorities that will lead to cures for everyone living with MS. The roadmap was developed in consultation with scientific experts, health care providers and people affected by MS. We believe the Pathways to Cures Roadmap will inspire the alignment of global resources on the most pressing questions in MS research and accelerate scientific breakthroughs that lead to cures for everyone living with MS.
The Roadmap includes three Pathways: STOPPING MS disease activity, RESTORING function by reversing damage and symptoms, and ENDING MS by preventing new cases.
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for executive summaries outlining key aspects of research needed to drive the Stop, Restore and End pathways. If you would like advice about whether and how your research may fit with these priorities, please reach out to a Society research staff person.
Goal 1: STOP pathway -- No more disease activity
Stopping MS is defined as achieving a state of no new disease activity, no worsening of daily living or quality of life, and no change in disease manifestations or clinical activity in people living with either relapsing or progressive forms of MS. Understanding disease heterogeneity across diverse populations of people with all forms of MS over time is important to stopping disease activity and protecting the central nervous system from further assault, and to create a permissive environment for myelin repair and other restoration efforts. Achieving a better understanding of the mechanism of progression as MS evolves over time will inform future therapeutic strategies. People with MS will play an active role in the pathway. As digital tools and technologies advance, data may be used to improve detection of changes in disease course, to monitor and measure neuroprotective processes, and to advance toward precision medicine tailored to individuals. Similarly, these tools might aid in supporting lifestyle modifications to benefit wellness.
Goal 2: RESTORE Pathway -- reverse symptoms, and recover function to enable full participation in society
MS can result in many different symptoms, including vision loss, pain, fatigue, sensory loss, impaired coordination, mobility, and cognitive and mood changes. Symptom severity and duration varies from person to person. Historically, rehabilitation aims to improve symptoms, with medical management of the disease kept separate. There is data supporting the idea that restoration of function, not only symptom management, is possible in MS.
Preserving and repairing myelin is likely to be one of the best ways we can prevent neurodegeneration. Exploring additional ways to slow down or stop neurodegeneration should reveal strategies that mitigate progressive forms of MS. In addition, the integration of repair and maintenance of repaired tissue with rehabilitation efforts is critical.
Translation of knowledge from basic mechanisms to functional impact is needed to optimize treatment, manage symptoms, and ultimately restore function for people living with both relapsing and progressive forms of MS. For this to occur, translational research using animal models of MS focused on understanding pathophysiological mechanisms as well as the study of human behavior and symptomatic therapies will be needed.
Goal 3: END Pathway -- No new cases of MS (prevention)
Ending MS is defined as no new cases of MS. Preventing new cases of MS will require population-based public health initiatives and individual-based interventions. Primary prevention involves identifying causal risk factors and limiting exposures to those MS risk factors in the general population. Secondary prevention focuses on individuals at high risk for MS and developing and deploying interventions in the period prior to clinical stages of disease to reduce or eliminate the risk for developing MS. While efforts will be made to advance both objectives, a focus on Secondary Prevention could potentially lead to the development of approaches with benefits for people living with MS in the near term.
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for additional details.