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Facing the urgency of therapies for progressive MS — a Progressive MS Alliance proposal

Nature Reviews Neurology volume 17, pages 185–192 (2021)Cite this article

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Abstract

Therapies for infiltrative inflammation in multiple sclerosis (MS) have advanced greatly, but neurodegeneration and compartmentalized inflammation remain virtually untargeted as in other diseases of the nervous system. Consequently, many therapies are available for the relapsing–remitting form of MS, but the progressive forms remain essentially untreated. The objective of the International Progressive MS Alliance is to expedite the development of effective therapies for progressive MS through new initiatives that foster innovative thinking and concrete advancements. Based on these principles, the Alliance is developing a new funding programme that will focus on experimental medicine trials. Here, we discuss the reasons behind the focus on experimental medicine trials, the strengths and weaknesses of these approaches and of the programme, and why we hope to advance therapies while improving the understanding of progression in MS. We are soliciting public and academic feedback, which will help shape the programme and future strategies of the Alliance.

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Fig. 1: Balancing innovation with comparability.
Fig. 2: Markers of biological and paraclinical efficacy.
Fig. 3: Proposed set of core measures to obtain information on clinical, paraclinical and immunological effects.

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Acknowledgements

The authors thank Dr Robert J. Fox for critically reading the manuscript.

Author information

Author notes

  1. Representative of Industry Forum members of the International Progressive MS Alliance: Fernando Dangond

Authors and Affiliations

  1. EMD Serono, Billerica, MA, USA

    Fernando Dangond

  2. Department of Computer Science, O’Reilly Institute, Trinity College, Dublin, Ireland

    Alexis Donnelly

  3. Institute of Clinical Neuroimmunology, Biomedical Center and Hospital of the Ludwig Maximilians Universität München, Munich, Germany

    Reinhard Hohlfeld

  4. Munich Cluster for Systems Neurology (Synergy), Munich, Germany

    Reinhard Hohlfeld

  5. Neurology Department, Sorbonne University, Pitié-Salpêtrière Hospital, Paris, France

    Catherine Lubetzki

  6. Multiple Sclerosis Society UK, London, UK

    Susan Kohlhaas

  7. Vita-Salute San Raffaele University, Milan, Italy

    Letizia Leocani

  8. Neurorehabilitation Department and Experimental Neurophysiology Unit, INSPE, Scientific Institute Hospital San Raffaele, Milan, Italy

    Letizia Leocani

  9. Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK

    Olga Ciccarelli & Jeremy Chataway

  10. National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK

    Olga Ciccarelli & Jeremy Chataway

  11. Sorbonne University, Brain and Spine Institute, ICM, Pitié-Salpêtrière Hospital, Paris, France

    Bruno Stankoff

  12. Department of Health Sciences (DISSAL), University of Genova, Genova, Italy

    Maria Pia Sormani

  13. IRCCS Ospedale Policlinico San Martino, Genova, Italy

    Maria Pia Sormani

  14. Italian Multiple Sclerosis Society, Genoa, Italy

    Federico Bozzoli

  15. Dipartimento di Scienze Biomediche, Università di Sassari, Sassari, Italy

    Francesco Cucca

  16. MS Research Australia, North Sydney, New South Wales, Australia

    Lisa Melton

  17. National Multiple Sclerosis Society, New York, NY, USA

    Timothy Coetzee

  18. Department of Neurosciences, Mental Health and Sensory Organs, Centre for Experimental Neurological Therapies (CENTERS), Faculty of Medicine and Psychology, Sapienza University, Rome, Italy

    Marco Salvetti

  19. IRCCS Istituto Neurologico Mediterraneo (INM) Neuromed, Pozzilli, Italy

    Marco Salvetti

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Contributions

F.D., S.K., L.M. and M.S. researched data for the article. F.D., A.D., R.H., C.L., S.K., L.L., O.C., B.S., M.P.S., J.C., T.C. and M.S. contributed to writing of the manuscript. All authors made substantial contributions to discussion of the content and reviewed and edited the manuscript before submission.

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Correspondence to Marco Salvetti.

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Nature Reviews Neurology thanks B. Wienstock-Guttman, H. Weiner and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Related links

International Progressive MS Alliance: https://www.progressivemsalliance.org/

Immune Tolerance Network: https://www.immunetolerance.org

Sage Bionetworks: http://sagebionetworks.org/

The MULTI-ACT project: https://www.multiact.eu/

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Dangond, F., Donnelly, A., Hohlfeld, R. et al. Facing the urgency of therapies for progressive MS — a Progressive MS Alliance proposal. Nat Rev Neurol 17, 185–192 (2021). https://doi.org/10.1038/s41582-020-00446-9

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