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 and progress
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. Because disease progression is difficult to measure and happens over a long period of time in progressive MS, developing therapies for progressive MS has been a challenge.
However, thanks in part to National MS Society investments and collaborations, we’ve made many strides in delivering more treatment solutions and pushing research in progressive MS:
- Current breakthroughs in FDA approved disease-modifying therapies include:
- Oral cladribine (brand named Mavenclad®- EMD Serono) based on clinical trials showing it could decrease the number of relapses and slow the accumulation of physical disability caused by MS, compared to placebo.
- Ocrevus™ (ocrelizumab - Genentech, a member of the Roche Group) based on clinical trials showing significant benefits against MS relapses and progression.
- Oral siponimod (brand named Mayzent®, Novartis International AG) for the treatment of those with active secondary progressive MS.
- The Society is funding several clinical trials to better understand and treat progressive MS:
- Determining whether a biomarker can monitor the benefits of oxcarbazepine (epilepsy therapy) in people with secondary-progressive MS.
- The National MS Society has committed $1 million over three years to help support a Phase II clinical trial of using an individuals’ own stem cells to treat progressive MS.
- Results of a phase 2 trial of oral ibudilast (MN-166, MediciNova, Inc.) suggest it significantly slowed the rate of brain atrophy (shrinkage), which has been linked to cognitive and physical disability in progressive forms of MS. Ibudilast has been designated by the FDA as a “Fast Track Product” in terms of its development as a possible treatment of progressive MS.
- A multicenter trial in the UK is testing whether a repurposed cholesterol-lowering therapy can slow the course of secondary progressive MS.
- Large clinical trials are ongoing in progressive MS, including tests of masitinib and high-dose biotin (MD1003, MedDay Pharmaceuticals SA).
- We are consistently funding research to find breakthroughs:
- The Progressive MS Alliance is bringing together the world’s leading experts in multiple sclerosis to change the world for people with progressive MS. In 2017, work began on the Collaborative Network Awards, multi-year grants that fuel international networks of researchers and institutions, working together to make crucial breakthroughs in understanding and treating progressive MS.
- The Society has just committed more than $14.6 million to support 43 new multi-year MS research projects around the world, many of which focus on questions related to progressive MS, including cognition and identifying genes.
- Researchers at Johns Hopkins University found that molecules called bile acids were reduced in people with MS, particularly those with progressive disease. Bile acids have anti-inflammatory and neuroprotective properties. This team is planning a trial of bile acid supplementation in people with progressive MS.
- Read the latest news on progressive MS:
- A team at the National Institutes of Health has found that certain areas of MS activity or damage are linked with a more severe course of MS. Findings may help direct the development of new treatments targeted to these specific brain lesions to stop progression.
- University College London reports that early MRI signs may give insight into disease progression. Findings also report that active inflammation and spinal cord involvement in early MRI scans were linked to eventually developing secondary progressive MS.
- Researchers from New York City have contributed growing evidence that nerve cells’ mitochondria malfunction during the course of progressive MS.
- Recent meetings of neurological professionals, such as the Annual Meeting of the American Academy of Neurology, have focused heavily on progressive MS.
- Experts were convened by the National Institute of Neurological Disorders and Stroke and the National MS Society to evaluate how MS “cohorts” – studies designed to track people with MS over time – might be leveraged to answer urgent questions about what causes progressive MS and how to stop it.
- A trial at University College London, funded by the MS Societies of the US and UK, showed that people with inflammation of the optic nerve who were taking the epilepsy treatment phenytoin had 30% less optic nerve damage compared to placebo. The results need confirmation in a larger study.
- The MS-SMART trial tested three therapies that may have nerve-protecting properties in secondary-progressive MS (with the MS Society of the U.K.) Although none of the therapies slowed brain atrophy, the results confirm the feasibility of this innovative multi-arm trial design, enabling much quicker assessments of potential therapies for progressive MS in the future.
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 progression risk.
- 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 inflamed and scarred nerve tissue.
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.