While treatment for multiple sclerosis (MS) has improved over the past 20 years, there’s still no cure. Most people living with MS have a form of the disease called relapsing-remitting MS (RRMS) with cycles of relapses (when symptoms flare up) followed by periods of remission (times of little or no symptoms). But researchers now better understand the pathways that contribute to MS relapses, and that knowledge is driving the development of new treatments.
During this year’s MS Awareness Month (March), we spoke with Bruce Bebo, Ph.D., executive vice president of Research at the National MS Society, to understand the questions driving MS research today and the progress being made.
The National MS Society is funding more than 300 research projects and invests about $50 million in MS research each year. What are some of the most exciting recent advances?
Advances in repairing the myelin sheath, which protects nerve cells and is destroyed by MS, are encouraging. This approach has tremendous promise to work with immunotherapies to stop the disease from getting worse. MS is an autoimmune disorder in which the body’s immune system attacks and destroys nerve cells; so immunotherapies may ultimately slow down or halt the neurodegeneration in MS. A better understanding of the role of B cells (a type of immune cell) play in this destruction will likely lead to new and improved treatments for this type of MS.
Most of the 2.3 million people worldwide with MS have a type called relapsing-remitting MS (RRMS). What are the big questions that are driving research in RRMS?
We still don’t know the precise targets that the immune system recognizes in RRMS, the environmental risk factors and triggers or how the estimated 200 genes that have been associated with MS actually contribute to the disease.
How will answering these questions help lead to more effective treatment options for patients with RRMS?
Immunotherapies today often affect immune cells that fight infection as well as those that cause MS. Knowing the targets will allow us to develop more precise therapies that will prevent the immune system from attacking nerve cells but not interfere with fighting infections. Understanding the environmental lifestyle factors and genetic factors will also reveal pathways and strategies for treatment and prevention.
There will always be some people who respond and others who do not. Having more options will allow doctors to personalize therapies for people living with RRMS.
With over a dozen available treatment options, why do we need more for RRMS?
There will always be some people who respond to specific treatments and others who do not. Having more options will allow doctors to personalize therapies for people with RRMS. Another reason is that our best treatments today only inhibit relapses by about 50 percent. We can do better than that! And more targeted immunotherapies could help stop the progression of RRMS without leaving a person with MS vulnerable to infections.
How important is a person with MS’s role in RRMS research and clinical trials?
The only way we can make progress in MS is by studying people with the disease. Patient-centered research efforts are gaining momentum. One of those efforts is the iConquerMS program, which is collecting data from 20,000 people about their lives with MS and their treatment responses. This will help answer questions about how environmental and lifestyle factors influence MS. People with MS can also take part in clinical trials of new MS therapies. They can find out about these at the National MS Society website.
The vision of National MS Society-funded research is to move us closer to a “World Free of MS.” While we are still searching for a cure, what does freedom from MS mean for people with the disease in real-life terms?
Freedom means something different to every individual living with MS. To some it simply means having the energy to enjoy dinner with their family at the end of the day. For others, it means being able to enjoy activities such as hiking, biking or painting.