MS Research progress for 2017

Important Research Progress in 2017: Stopping MS, Restoring What’s Been Lost, and Ending MS Forever

Significant research advances were made in 2017, offering new leads toward our vision of a world free of MS. The Society’s research portfolio has 360 projects under active management, and in 2017 the Society invested $40 million for new and ongoing research projects and initiatives around the world. We support collaborations and innovation, convene thought leaders, leverage new technologies and data, invest in training to ensure a robust future workforce, and learn from other diseases, funders and people living with MS.

This year, the first therapy specifically for primary progressive MS was approved by the FDA, and progress occurred in many other approaches that will identify solutions for people living with MS today and ultimately lead to prevention and a cure. Here is a brief summary of significant 2017 research progress and initiatives aimed at stopping MS in its tracks, restoring function, and ending MS forever.

STOPPING MS – Toward New Therapies and New Understanding

  • FDA approved Ocrevus™ (ocrelizumab) for people with primary progressive MS or relapsing MS. The Society funded early laboratory and clinical work on B cell therapy that led to this first disease modifying treatment for progressive MS.
  • In the largest clinical trial yet in children and adolescents with MS, oral fingolimod (Gilenya®) reduced the annual number of relapses by 82% over two years, compared to treatment with interferon beta-1a (Avonex®). After two years, 86% of those on fingolimod had not experienced a relapse, compared to 39% of the Avonex group. The trial also showed benefits measured by MRI. Side effects were similar to what have been seen in the adult population. This therapy isn’t currently approved for the treatment of pediatric MS.
  • Results of a phase 2 trial of oral ibudilast (MN-166, MediciNova, Inc.) in people with progressive forms of MS suggested it significantly slowed the rate of brain atrophy (shrinkage), which has been linked to cognitive and physical disability in MS.
  • An international study reported long-term outcomes from bone marrow-derived stem cell transplantation (HSCT) in 261 people with different forms of MS. After 5 years, 46% still had not experienced progression or worsening of symptoms. Eight deaths (2.8%) occurred, most during the early development of the procedure; improvements in patient selection and transplant techniques have reduced mortality. Those with the best outcomes tended to be younger, had relapsing MS, less disability and had used fewer MS therapies prior to the procedure. Additional research is needed to better understand who might benefit from this procedure and how it compares to the benefits of powerful immune-modulating therapies now available.
  • The ‘McDonald Criteria’ for the Diagnosis of MS were revised in hopes of speeding diagnosis and reducing the chance of misdiagnosis. An international panel was convened under the auspices of the International Advisory Committee on Clinical Trials in MS, sponsored by the National MS Society and the European Committee for Treatment and Research in Multiple Sclerosis. The panel published revisions in The Lancet Neurology online on December 21, 2017 (available free, with registration).
  • n a small study conducted at Oregon Health & Science University, the antioxidant lipoic acid was shown to reduce the rate of brain tissue loss (atrophy) compared to placebo in secondary progressive MS. The Society has agreed to help fund a larger, phase 2 clinical trial to further evaluate whether lipoic acid is a safe and effective treatment for progressive MS.
  • A clinical trial in the United Kingdom began with Society co-funding, testing the ability of statins (cholesterol-reducing drugs) to slow secondary progressive MS.

RESTORING WHAT’S BEEN LOST – Myelin Repair, Wellness and Rehabilitation

  • Scientists at Cincinnati Children’s Hospital Medical Center funded by the Society and the NIH, reported that the experimental therapy “miR-219” promoted growth of nerve-insulating myelinand improved function in mice with an MS-like disease. The team is continuing to test this and similar molecules in the lab, a necessary step before testing in people with MS.
  • Gladstone Institutes researchers and collaborators showed that a blood coagulation factor called fibrinogen may enter the brain during MS inflammation and hinder myelin repair. In lab models, reducing fibrinogen enhanced myelin repair, suggesting this may be a future strategy for developing therapies to repair myelin damage caused by MS.
  • Researchers at Queen’s University Belfast reported that immune cells called “Tregs” play a role in promoting myelin repair, and they pinpointed a protein that appears to be responsible, offering a potential target for stimulating myelin repair.
  • Robin Franklin, PhD, a leading scientist at the University of Cambridge focusing on stimulating the brain’s repair mechanisms, was selected as the recipient of the 2017 Barancik Prize for Innovation in MS Research.
  • Two studies by researchers at the University of Illi­nois at Urbana-Champaign and the Shepherd Center, Atlanta provided evidence that even people with moderate to severe movement issues may benefit from exercise, and an international study showed that high-intensity aerobic training improved cognition better than standard exercise. This research shows the importance of physical activity in enabling people with all forms of MS to live their best lives.
  • Healthier diets and lifestyles were associated with lower levels of disability in an analysis of a survey involving more than 6,900 people with MS enrolled in the NARCOMS registry. Further study is needed to determine if a healthy lifestyle actually reduces MS symptoms or whether symptoms interfere with the ability to engage in a healthy diet/lifestyle. The Society is funding several studies of diet and other approaches to advance wellness solutions.
  • Researchers in Amsterdam reported that people with MS, but not healthy controls, showed improvements in working memory, brain activity, and “connectivity” (how parts of the brain interact with one another), after treatment with Repetitive Transcranial Magnet Stimulation (rTMS). This device generates electromagnet pulses that stimulate brain activity. rTMS may have a future role in cognitive rehabilitation in people with MS, but further studies are needed.
  • The 2017 John Dystel Prize for MS Research went to Alan J. Thompson, MD, Dean of the University College London Faculty of Brain Sciences, for pioneering research in ways to address symptoms and improve quality of life for people with MS, and as a leader and driver of the International Progressive MS Alliance.

ENDING MS – Exploring Risk Factors to Understand and Prevent MS

  • A large-scale study in Sweden suggested that teens who experience head trauma leading to concussion, especially more than once, are significantly more likely to develop MS. This finding does not mean that all teens who experience concussion will develop MS.
  • Researchers in Denmark and Boston, funded in part by the National MS Society, reported that newborns with low blood levels of vitamin D were at increased risk of developing MS later in life, adding to growing evidence for low vitamin D levels as a potential risk factor for MS.
  • New studies from the U.S. and Germany, funded in part by the National MS Society, add mounting evidence to the potential role that intestinal bacteria play in the brain inflammation that underlies MS. This offers hope that probiotic approaches may be developed and tested to help reduce MS activity. The Society supports the International MS Microbiome Consortium and other projects to advance this research.

RESEARCH COLLABORATIONS AND LEADERSHIP

  • The International Progressive MS Alliance launched three Collaborative Network Awards focused on finding breakthroughs for progressive MS, with co-funding and leadership from the Society, and engaged in strategic planning of additional activities to accelerate the pace of progressive MS research.
  • Research papers were published from Society-led initiatives focusing on wellness research, patient cohorts/registries, stem cell therapies, and clinical measures for tracking MS progression and benefits of therapies.
  • The Society convened the Tykeson Fellows Conference to build collaborations and cement the commitment of promising young investigators to finding solutions to MS.
  • With funding from the Society, the International MS Microbiome Consortium began recruiting more participants in their efforts to identify the influences of good and bad gut bacteria on MS.
  • Several initiatives around the world are tracking people with MS to:
    • Better understand disease and its underlying pathology;
    • Identify drivers of progression;
    • Make progress toward personalized medicine: who will respond to which therapy best?
  • PCORI (Patient Centered Outcomes Research Institute) made new commitments of $38 million for studies comparing the benefits and risks of MS therapies and rehabilitation, including two studies comparing early aggressive treatment vs. gradual escalation – a key question for treating MS.

 

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