Multiple Sclerosis - Episode 12

Emerging Approaches to Progressive Multiple Sclerosis

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Fred Lublin, MD, explains that progressive multiple sclerosis (MS) is often a retrospective diagnosis. Essentially, diagnosis occurs when a patient with relapsing-remitting MS continues to worsen, but eventually, worsening is not associated with a relapse. Lublin suggests that by following a patient earlier in the course of disease and more closely watching for changes in exams, MRIs, and even biomarkers, the transition to progressive disease can be identified earlier. He states that neurologists have found that earlier treatment of relapsing-remitting MS results in better outcomes. He adds that there is no reason to think that earlier treatment for patients with progressive disease would not reap the same benefits. Thus, treatment approaches in progressive disease is an important focus in MS research.

Various strategies being studied include molecular approaches to repair, such as utilizing molecules, rather than stem cells, to enhance repair of myelin. New anti-inflammatory molecules are another approach, including B-cell—directed therapies. Lublin states that B-cell–directed therapies have worked very well in phase 2 proof-of-concepts trials, and phase 3 studies will be completed in the next couple of years.