It’s been quite a first day at the biggest MS conference in the world. The European Committee for Treatment and Research in MS and the Americas Committee for Treatment and Research in MS – ECTRIMS-ACTRIMS – have joined forces in Paris in 2017 to deliver a record-breaking conference with over 10,000 delegates.
The day started for me with a meeting of the International Progressive MS Alliance Scientific Steering Committee and Industry Forum to continue the work we started in London in July, were we had an intensive and productive strategic planning meeting. The result was a clear frame-work to help advance the Alliance’s activities to accelerate trials and treatments for progressive forms of MS. Further work will be done to flesh out the details of the plan in the coming months.
Benefits and risks of ‘Induction’ therapies in MS
And then, first full official sessions of the Conference. The European Charcot Foundation brought us a thought provoking session on the benefits and risks of ‘Induction’ therapies in MS. Induction therapies are those in which just one or two rounds of treatment can lead to a prolonged remission for people with relapsing MS. The traditional model of starting with the least risky but potentially lower efficacy medications is giving way to a new paradigm of treating early and aggressively, particularly for younger patients with highly active MS. This is driven by the growing evidence that optimising treatment as early as possible can preserve brain tissue and improve the long-term outcomes for people with MS. Professors Giancarlo Comi, Hans-Peter Hartung, Mark Freedman and Gilles Edan discussed the pros-and cons of such an approach and how we can identify the patients who will benefit the most while also managing the potential risks and side-effects. They noted that our ability to identify people for whom the benefits outweigh the risks is now much more refined with better understanding of the clinical and MRI factors that predict a more aggressive disease course.
Young Investigators Session
A Young Investigators Session followed, with an amazing array of young scientists presenting novel, innovative and practical methods for measuring and predicting disease progression. This included superb work using functional MRI scanning to look at connecting pathways in the brain to predict and understand the basis of cognitive problems in MS. Advanced imaging techniques to accurately measure changes in brain volume and identify the active microglial cells in the brain (these are immune cells found in the brain) that contribute to the smouldering chronic lesions in progressive forms of MS were also presented. Others focussed on the methods looking at the layers of cells in the eye, upper limb function and using a battery of both MRItests and clinical tests to accurately predict who will recover well from relapses and lesions.
A ‘Hot Topic’ Session in the afternoon focussed on the activities of the Progressive MS Alliance with the three lead scientists from the major Collaborative Network Awards presenting their research plans for the next four years and their progress so far. Dr Doug Arnold from Canada spoke about the use of pooled MRI data from registries and clinical trials and using ‘deep machine learning’ and artificial intelligence methods to find hidden patterns in the data that will help us identify the best ways to track progression in clinical trials for progressive MS to see if the drugs are working. Professor Gianvito Martino presented his team’s work using state of the art ‘in silico’ (computer based) mass screening of existing libraries of drugs followed by cutting edge cell culture work to identify and validate drug candidates for myelin repair in MS. Professor Fran Quintana also presented his work on screening and repurposing drugs that target the chronic inflammation within the brain in chronic MS as opposed targeting the systemic inflammation seen in relapsing MS. It is the early stage of his work but it is impressive to see that a number of candidate drugs that they have already been identified to take forward for further testing.
It was also exciting to see Associate Professor Tomas Kalincik from Melbourne, a clinician-researcher who received early career support from MS Research Australia, presenting to a packed hall as part of a panel discussing the tools now available to personalise prognosis and treatment choices thanks to the power of real-world big data.
Article courtesy of MS Research Australia www.msra.org.au