Moving forward on progressive MS

Hardly a day goes by when I am not asked the tough question, “When will there be a therapy for my kind of MS?” The people asking this question are talking of course about the type of MS that doesn’t wax and wane, but instead creeps slowly or quickly along, robbing a person of crucial abilities and quality of life.

These are big issues but we are making progress. In the last couple weeks we’ve seen the launch of two new clinical trials that are aiming to stop nervous system damage in people with progressive forms of MS. These trials try to address a seriously unmet need for treatments that can stop or reverse worsening of symptoms.

One trial getting started in secondary-progressive MS is the MS SMART trial in the United Kingdom. It’s using a radically different approach, called an adaptive design, that basically pits three therapies and a placebo against each other at the outset, and then gradually people are moved to the one or two that turn out to be most effective.

The therapies to be tested are already licensed for other conditions (amiloride is licensed to treat heart disease, ibudilast to treat asthma in Japan and riluzole is licensed for ALS) so researchers know their safety profile. Each has to potential as a neuroprotective therapy – something that may protect the nervous system from MS damage to slow or stop progression. I’m excited by this trial because if it works, it could transform how we conduct clinical trials of new and ‘old’ treatments for MS in the future.

The other trial is also testing ibudilast in both primary-progressive and secondary-progressive MS. It’s testing whether this therapy can reduce brain atrophy, or shrinkage, and using other ways of measuring its ability to protect the nervous system from MS injury. 

This large, phase 2 trial of ibudilast is being done in a unique partnership of 28 medical centers (called the NeuroNEXT Network), the National Institutes of Health, and ibudilast’s distributor, MediciNova. As this trial fits well with our strategic focus to address progressive MS, the Society has agreed to kick in some financial support to ensure it is done at the best possible safety standards for people who will be volunteering to participate. 

You might wonder why ibudilast is being tried in two different trials. This is not a duplication of effort – these trials will complement each other’s results by collecting some of the same data in the same way so that we can compare results at the end. The result will speed the potential of getting this therapy – if it’s effective – to people faster.

These collaborative trials, initiated by MS doctors, are taking big leaps in terms of how the studies are being conducted. Because of their clever designs, no matter what their outcomes are, we will have a lot more information about progressive MS and how to test new therapies for it.

These may seem like steps, rather than leaps, for people who feel frustrated by the wait. But with more and more researchers taking steps like these across the globe, we are on our way to making substantial progress in this journey.

Read about other research on progressive MS here
Tags Research, Treatment      1 Appreciate this

Timothy Coetzee, PhD

Dr. Timothy Coetzee, National MS Society Chief Advocacy, Services and Research Officer, has been a leader in the pursuit of innovative ways to move us closer to a world free of MS since receiving his PhD in microbiology and immunology in 1993.