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Is a Cure for MS on the Horizon? | by heidi


 


Multiple sclerosis (MS) is a chronic and progressive autoimmune disease. Approximately 2.8 million people around the world have the condition. The average age at diagnosis is 32 years old.1


MS is not fully understood, but there have been significant advancements in treatment, some of which successfully slow the progression of the disease in many people.


Research on the direct cause of MS as well as better treatments is underway. Read on to find out more about the latest research on MS, including the efforts to find a cure for the condition.



person wearing goggles and gloves looking in a microscope in a lab


 How Multiple Sclerosis Is Treated

Latest Treatments

Experimental therapies are being explored, as MS treatments and various clinical trials have shown promise. One medication, ibudilast, completed a phase 2 clinical trial in 2018 that showed it can slow the progression of the disease.2


Ibudilast is an anti-inflammatory medication that works by reducing inflammation in the body and decreasing the action of a specific enzyme known as phosphodiesterase. Phosphodiesterase breaks down certain organic molecules and, in the process, relaxes muscles and enhances blood flow.


Studies found that while not able to prevent the development of new MS lesions, ibudilast was able to reduce brain atrophy over time compared to a placebo.


The medication can also inhibit certain actions of the immune system that are believed to be behind the nerve cell damage that occurs in the brains of people with MS.2



There have also been recent advancements in the use of stem cell therapy for MS. Stem cells are the cells that all other cells in the body are generated from. These cells help the body essentially repair itself.


In 2020, a clinical trial followed patients for one year. In that time:3


About 60% of the patients treated with intrathecal (injected into their spinal fluid) mesenchymal stem cell therapy had no evidence of disease.

About 40% of the patients treated with intravenous (given in a vein) mesenchymal stem cell therapy had no evidence of disease.

About 10% of patients in the control group (that did not get a real treatment) had no evidence of disease.


 How Multiple Sclerosis Is Treated

New FDA Approvals

One of the main treatments used to help manage the symptoms and progression of MS is disease-modifying therapies (DMTs). These medications are designed to change the course of MS progression, which ultimately helps reduce its symptoms.



Several new DMT therapies have been approved by the Food and Drug Administration (FDA) to treat and manage MS, including:



Fingolimod (Gilenya): First used to treat MS in adults, Gilenya became the first DMT therapy approved by the FDA for use in children with pediatric MS in 2018.4 

Diroximel fumarate (Vumerity): This medication is similar to an older type of DMT known as Tecfidera. It was approved for use in 2019 after it was shown to possess the same medicinal benefits with fewer side effects.5

Ozanimod (Zeposia): This medication has been approved to treat three types of MS: clinically isolated syndrome, relapsing-remitting MS, and active secondary progression MS. It received FDA approval in March 2020.6

Ofatumumab, Novartis (Kesimpta): This injectable medication was approved in 2020 after it demonstrated the ability to reduce MS symptom relapses more effectively than previously used DMTs. It was also shown to reduce disease activity in the brains of people with MS, as seen with scans taken by an MRI machine.7

Ponesimod (Ponvory): In March 2021, the FDA approved this medication after it was shown to help reduce MS symptom relapses by more than 30%.8


New DMTs

Two other oral DMTs were approved in 2019: siponimod (Mayzent) and cladribine (Mavenclad). Both of these treatments were shown to reduce the relapse rate of people with MS.9


Cladribine was the first oral medication approved for use as a short-course oral DMT, which means that it is taken for a shorter duration of time. Specifically, people with MS take cladribine in two short-term courses that are one year apart.10


Recent Research

Another type of stem cell therapy that is being investigated for MS is called hematopoietic stem cell transplantation (AHSCT). The main goal of this type of therapy is to reset the immune system by using chemotherapy to get rid of harmful immune cells that are causing damage and replace them with healthy immune cells (that were harvested prior to chemotherapy) that can reconstitute the immune system.


This method of treating MS is being explored in clinical trials. According to the National Multiple Sclerosis Society, a call for participants in a new trial was sent out in May 2021.11


BEAT-MS Trial

The study is referred to as BEAT-MS, and the participants chosen for the trial will be assigned a specific treatment plan—either AHSCT or another effective treatment called best available therapy (BAT). Once the study begins, each participant will be treated and monitored for six years.12


 What Happens in a Clinical Trial?

Risk Factors

Research on the risk factors associated with the development of the disease is also underway. While some risk factors are known, others have yet to be discovered.


Some unproven theories that medical researchers have theorized might play a role in the onset of MS include:13


Environmental allergies

Exposure to house pets

Heavy metal toxicity

Exposure to organic chemicals

Viruses and MS

According to the National Multiple Sclerosis Society, researchers are also looking at the possible role of viruses in a person’s risk of developing MS. Several viruses are being investigated, including:14


Epstein-Barr virus

Human herpes virus 6

Varicella-zoster virus

Cytomegalovirus

John Cunningham virus

Human endogenous retroviruses

Sex Differences

Research has shown that women are more likely than men to develop MS. However, studies have also found that the type of MS that is more common also varies between the sexes.



While women are more at risk for the disease overall, men are more often diagnosed with a specific type of MS known as primary progressive MS.15 Men with MS are also more likely to experience a faster disease progression and cognitive impairment than women.16 


Finding out why these sex-related disparities exist would help medical researchers develop an optimal treatment for everyone with MS.


 7 Surprising Facts About Multiple Sclerosis

Genetic Research

Genetics may play a role in why some people develop MS but others do not. The role of genetic variants in MS is another key research area. A study published in 2018 added four new genes to the more than 200 genetic variants already associated with MS.17


Genetic Research and MS

Understanding which genes might increase a person’s risk of developing MS would give medical researchers the information they need to create clinical tools that could help providers treat and possibly prevent MS.


Lifestyle Changes

Research has shown that there are several lifestyle factors associated with developing MS. For example, smoking cigarettes, being overweight as a child, and having low levels of vitamin D have all been identified as potential triggers for the disease.18


Understanding how other lifestyle influences might affect MS risk could assist researchers in identifying new ways to treat and prevent the disease.


Diet and Gut Health

Diet and chronic disease often go hand in hand. “Gut microbiome” is the term used to describe the collection of living organisms that inhabit the intestines.


The gut microbiome has been a main area of interest for MS researchers. Studies have found that there might be a connection between the state of a person’s gut microbiome and their risk for developing MS.


A study published in 2020 showed that the diversity of the organisms in the guts of people with MS and people without MS were not significantly different. However, there were marked dissimilarities which the researchers said mean that a more long-term and extensive review of MS and the gut microbiome’s possible role in its development is needed.19


Summary

MS treatments and management techniques have come a long way. The latest advancements in DMTs have given people with MS more options than ever, some providing even fewer side effects than older treatments.


Aside from oral and injectable DMTs—typically the first-line therapies for MS—other experimental treatments such as stem cell therapy have been showing great promise in helping people with MS manage the disease.


The more educated medical researchers become about the potential genetic risk factors and lifestyle choices that may play a role in the development of MS, as well as what causes the disease in the first place, the more equipped they will be to find better treatments.

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