What Does It Really Mean to ‘Cure’ Multiple Sclerosis?
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The European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) recently concluded its 2023 annual meeting. This international conference brings together world leaders in the fields of multiple sclerosis (MS) research and patient advocacy. This year, it had 9,000 participants from 110 countries, 240 faculty presentations, and 1,500 scientific paper abstracts over the course of just three days.
I attended an ECTRIMS conference in London a number of years ago, and I can tell you that it takes weeks, if not months, to dig out from the avalanche of information presented at one of these things.
There are always highlights and headline grabbers at these events. I also like to sieve through the posters and abstracts to see what interesting studies are upcoming and who the new players are on the MS research pitch.
MS Cure ‘on the Horizon’
One headline that captured my attention was the theme of the keynote address by Stephen Hauser, MD, of the University of California in San Francisco. You might remember that Dr. Hauser recently published a book about his experience researching our disease.
Hauser is a preeminent researcher, and the stage ECTRIMS sets is not one for flippant comment. So when I read in Medpage Today that he’d said a path to a cure for multiple sclerosis was on the horizon, I sat up and took notice.
He spoke of the significant advances that have been made in the past decade, according to Medpage Today. Not just what the doctor called “the low-hanging fruit” of early intervention (as in at onset of first symptoms), but the realistic opportunity to cure MS, particularly in some scenarios.
Advancing science in imaging, genetics, and immunology gives hope that there may soon be biomarkers and tools that help researchers move from symptom suppression to that holy grail of words, cure.
Important in attaining that goal will be defining exactly what a cure will look like.
What Might a Cure Look Like?
Back in March 2006, when I first began writing the Life With Multiple Sclerosis column, I interviewed John Richert, MD, who headed up science and research for the National MS Society at the time. He saw a cure as three different things to three different sets of MS patients:
- Arresting progression: stopping symptoms where they are
- Remyelination: reversing the damage done by the disease to the central nervous system
- Prevention: eliminating the disease from the next generation by developing a vaccine
The Current Goal of Treatment: NEDA
Many would consider that the current treatment goal of “no evidence of disease activity” (NEDA), as explained by the Multiple Sclerosis Trust, could be considered (nearly) ticking the first box, but we’ve a distance to go on the next two — but they’re not out of sight for Hauser.
“We should take the lead from cancer therapeutics,” he said, noting that the complete response in B-cell leukemia, for example, is based on no evidence of disease, off treatment, for four years. “A complete response equivalent for MS could be developed,” he said.
Many people with MS could fit into the category of NEDA while on our disease-modifying therapies. I’m not sure we’re at the point to expect the same results off treatment — or while not taking those therapies — for four years, but there is reason to hope.
Hope, without a plan, is just a dream … but I read the room as talking of a plan.
Wishing you and your family the best of health.
Cheers,
Trevis
My book Chef Interrupted is available on Amazon. Follow me on the Life With MS Facebook page, and read more on Life With Multiple Sclerosis.
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