One of the main topics being covered at ECTRIMS is MS treatment. Treatments for MS, whether disease modifying therapies (DMTs) or rehabilitation strategies, have reached an overwhelming number over the last two decades, before which there was no approved treatment available. With so many options to choose from, new questions begin to arise, such as:

1. Which therapy or therapies should a person with a particular form of MS take?
2. When is the best time to begin a treatment regimen?
3. What are the long term effects of DMTs?

Researchers from around the world have come to ECTRIMS to share new data that is helping to answer some of these questions.

MS treatment – revolution or evolution?

While the management of relapsing-remitting forms of MS has been declared by some as a ‘revolution’, treatment for other, more severe types of MS remain elusive.

“There are, to date, nearly 10 treatments available for relapsing-remitting MS, but there is still no therapy for progressive MS” – says Professor Per Soelberg Sørensen, Chair of 2013 ECTRIMS during a press conference. “This would likely classify progressive MS treatment as more of an ‘evolution’ which requires further research”.

There is, however, a silver lining for people with progressive MS as well as relapsing-remitting MS – early treatment. This is a topic that received much attention over the past few days, as there is growing evidence showing that treating MS as early as possible can have a significant impact in long-term treatment response, quality of life, and disease progression in people with MS. Professor Hans-Peter Hartung from Germany noted at yesterday’s symposium that early diagnosis and treatment is key in reducing disability and maximizing quality of life. Professor Gavin Giovanni, who presented shortly after, added that initiating treatment with DMTs at the first signs of relapse has major benefits. This was demonstrated in trials involving early treatment with natalizumab (Tysabri, Biogen Idec) which led to better relapse recovery, improvements in areas such as cognition, vision and fatigue, and a stable EDSS score (an important measure of disability).

There have been several other presentations discussing the positive outcomes of managing MS in the earlier phase of disease, labeling this period as the ‘window of opportunity in MS treatment’. Data from a presentation by Dr. Aaron Miller from the USA showed that early treatment with teriflunomide (Aubagio, Genzyme, A Sanofi Company) can lower the likelihood that someone with clinically isolated syndrome (a single, isolated neurological episode) will convert to clinically definitive MS and, in patients who are already relapsing, decrease the risk of new relapses and lesions seen on MRI scans. A number of related trials have confirmed the benefits of early treatment in preventing people with CIS from developing MS.

Silencing the disease from the start

During this morning’s opening lecture, Professor Giancarlo Comi from Italy noted that the extent of tissue damage in the brain in late stage MS depends on the events which take place earlier on. Thus, if treated early, people with MS may experience a much more positive outcome. In addition, treating MS at the early signs of tissue damage can avoid exhaustion of the protective mechanisms used by our brains to recover from such trauma.

It’s quite exciting to hear about the new frontiers in MS treatment, and we look forward to hearing more in this area over next few days.

Until next time!