Frontiers in MS Research: ECTRIMS 2024 Highlights

ECTRIMS – The European Committee for Treatment and Research in Multiple Sclerosis – marked its 40^th anniversary in September at an annual conference in Denmark. Each year, ECTRIMS hosts a conference where researchers, trainees, and healthcare professionals meet to share new findings, advancements and clinical practices about MS. This was one of the largest ECTRIMS meetings to-date with more than 8,500 participants from 103 countries!

This year’s theme, “Dedicated to the dedicated,” celebrated the collective journey and unwavering dedication of the MS community in advancing research and enhancing the lives of those affected by MS. The conference featured cutting-edge topics, like advances in MS diagnosis, emerging therapies for MS, and current perspectives on aging and MS, and we’re excited to share some of these research highlights below! 

Advances in MS Diagnosis

MS & Allied Diseases 

The opening presentation was given by Dr. Jacqueline Palace (University of Oxford, UK), which focused on advances in the diagnostic criteria and diagnostic tests for MS and allied diseases, like neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). Dr. Palace also highlighted key differences in the prevalence, clinical features, and treatment targets for MS, NMOSD and MOGAD, showing that these are separate conditions that need different treatment approaches. Advances in the field will allow for more effective differential diagnosis to ensure earlier treatment of MS and allied conditions. Learn more from Dr. Palace’s presentation. 

Updates to MS Diagnostic Criteria 

Dr. Xavier Montalban (Vall d’Hebron University Hospital, Spain) gave updates to the McDonald Diagnostic Criteria for MS. The process for updating the criteria was a comprehensive multi-step approach led by the International Advisory Committee on Clinical Trials in MS and included over 55 international experts and people living with MS over the past 2 years. Dr. Montalban highlighted that the proposed changes will allow for a quicker and more accurate diagnosis of MS, which should lead to more timely access to available treatments. More information on the new MS diagnostic criteria will be published soon, along with a strategic plan to engage the MS community, train users, educate the broader community, and refine the criteria, where needed. Learn more about the updates to the McDonald criteria.

Therapeutic Advancements in Progressive MS 

Advances in Bruton’s Tyrosine Kinase (BTK) Inhibitor Trials

Drs. Jiwon Oh (St. Michael’s Hospital, Canada) and Robert Fox (Cleveland Clinic, USA) shared results from phase 3 clinical trials involving the BTK inhibitor, tolebrutinib. Tolebrutinib binds to the BTK protein to reduce the activation of B cells that contribute to brain and spinal cord inflammation in MS. Some BTK inhibitors can also enter the brain and prevent the activity of specific immune cells called microglia, which have been linked to MS progression. 

Results from the GEMINI trials showed that although tolebrutinib was not more effective in reducing relapses in people with relapsing MS compared to teriflunomide, it was able to delay disability progression. Results from another study called HERCULES showed that tolebrutinib was effective in slowing disability progression in people with non-relapsing secondary progressive MS compared to placebo. These early results are encouraging because there are limited treatment options available for secondary progressive MS. More analyses of the phase 3 data are ongoing, but these findings provide hope for future progressive MS treatments. Learn more about the tolebrutinib trial results. 

Results from Simvastatin Trial

Dr. Jeremy Chataway (University College London, UK) presented findings from a large phase 3 clinical trial MS-STAT2, to test whether treatment with simvastatin, a cholesterol-lowering drug, was effective in people with non-relapsing secondary progressive MS. This study was based on encouraging results from the phase 2 trial, which showed that simvastatin decreased brain atrophy (shrinkage) in people with secondary progressive MS. Unfortunately, the phase 3 results showed that simvastatin was not able to slow disability progression in people with non-relapsing secondary progressive MS. Learn more from Dr. Chataway’s presentation. 

New Targets for Neuroprotection

Dr. Francisco Quintana (Brigham and Women’s Hospital, USA) talked about a promising drug-like compound that could block interactions between astrocytes and microglia, cells which are involved in driving harmful brain inflammation in MS and neurodegeneration. His team is in the process of further developing this compound and others, and testing them in pre-clinical mouse models of progressive MS along with Dr. Alexandre Prat (Centre de Recherche du CHUM, Canada). This work, which we’re supporting through the International Progressive MS Alliance, could help accelerate the development of effective therapies for people with progressive MS. Learn more about this research.

Preventing MS

Understanding Risk Factors of MS

Dr. Ingrid Kockum (Karolinska Institutet, Sweden) spoke about current lifestyle factors associated with MS, including low vitamin D levels, obesity, low physical activity, smoking, exposure to environmental pollutants, and viral infections. She indicated that the duration and amount of exposure to these factors, especially at a young age, can greatly impact the risk of developing MS. More research is needed to understand how these factors work to influence MS risk in order to develop early targeted strategies for preventing MS. 

Vitamin D Supplementation in Early MS 

Dr. Eric Thouvenot (University Hospital of Nimes, France) shared findings from the phase 3 D-Lay-MS trial, where they found that taking high doses of vitamin D as a supplement (100,000 international units taken every two weeks for up to two years) was able to delay the development of MS in people with clinically isolated syndrome. The study also reported a decrease in disease activity and brain lesions in people who received high-dose vitamin D compared to placebo. Results from this study and others, while conflicting, have provided a greater understanding of the role vitamin D may play in modifying the MS disease course, although more research is needed to determine optimal timing and dosing of vitamin D supplementation in MS. Learn more about vitamin D in MS. 

Aging and MS

The conference also had a session about aging and MS, which highlighted the need to understand how to best support the aging population in MS, as there are currently more older people living with MS (over 50 years old) and limited studies involving this group of people. 

Dr. Kristen Krysko (St. Michael’s Hospital, Canada) shared different ways to understand and measure age along with specific biomarkers linked with each one – chronological age (based on date of birth), biological age (based on cells in your body), and reproductive age. There’s some evidence showing that MS may be involved in speeding up the aging process, and adopting a healthy lifestyle and maintaining good brain health may combat the negative effects of aging. 

Dr. Elisabeth Maillart (Pitié Salpêtrière Hospital, France) discussed the impact of aging on the MS disease course. While people with MS experience fewer relapses as they age, they have a greater risk of incomplete recovery following a relapse and faster disability progression. With age, there is also more cases of other health problems or comorbidities like high blood pressure, hyperlipidemia, depression and anxiety, which can further increase the chance of getting more disabilities over time in people with MS. To better understand and treat MS in this group, there’s a need for real-world studies in older people living with MS. 

Additional Resources: 

Our overview only captures a few of the latest breakthroughs in MS research presented at ECTRIMS 2024. For more information, you can access the research abstracts published in the Multiple Sclerosis Journal. 

Learn more about ECTRIMS in this video.