(Abst.) International Collaborative on Progressive MS

 
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PostPosted: Tue Nov 06, 2012 2:04 pm    Post subject: (Abst.) International Collaborative on Progressive MS Reply with quote

From the Multiple Sclerosis Journal, November 1, 2012:

Quote:
Setting a research agenda for progressive multiple sclerosis: The International Collaborative on Progressive MS

Robert J Fox1
Alan Thompson2
David Baker3
Peer Baneke4
Doug Brown5
Paul Browne4
Dhia Chandraratna4
Olga Ciccarelli2
Timothy Coetzee6
Giancarlo Comi7
Anthony Feinstein8
Raj Kapoor9
Karen Lee10
Marco Salvetti11
Kersten Sharrock12
Ahmed Toosy2
Paola Zaratin13
Kim Zuidwijk14


1Mellen Center for Multiple Sclerosis, Neurological Institute, and Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, USA

2Department of Brain Repair and Rehabilitation, University College London Institute of Neurology, Faculty of Brain Sciences, London, UK

3Centre for Neuroscience and Trauma, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK

4Multiple Sclerosis International Federation, London, UK

5Multiple Sclerosis Society, London, UK

6National MS Society, New York, NY, USA

7Department of Neurology, Scientific Institute San Raffaele, Milan, Italy

8Department of Psychiatry, University of Toronto, Canada

9National Hospital for Neurology and Neurosurgery, London, UK

10MS Society of Canada, Toronto, ON, Canada

11Center for Neurology and Experimental Therapies, Sapienza University, Rome, Italy

12Fast Forward, LLC, New York, NY, USA

13Italian MS Society, Genoa, Italy

14MS Research Foundation, Voorschoten, The Netherlands


Robert J. Fox, Mellen Center for Multiple Sclerosis, Neurological Institute, and Lerner College of Medicine, Cleveland Clinic, 9500 Euclid Ave, U-10, Cleveland Clinic, Cleveland, OH, 44122 USA. Email: foxr@ccf.org

Despite significant progress in the development of therapies for relapsing MS, progressive MS remains comparatively disappointing.

Our objective, in this paper, is to review the current challenges in developing therapies for progressive MS and identify key priority areas for research.

A collaborative was convened by volunteer and staff leaders from several MS societies with the mission to expedite the development of effective disease-modifying and symptom management therapies for progressive forms of multiple sclerosis.

Through a series of scientific and strategic planning meetings, the collaborative identified and developed new perspectives on five key priority areas for research: experimental models, identification and validation of targets and repurposing opportunities, proof-of-concept clinical trial strategies, clinical outcome measures, and symptom management and rehabilitation.

Our conclusions, tackling the impediments in developing therapies for progressive MS, will require an integrated, multi-disciplinary approach to enable effective translation of research into therapies for progressive MS.

Engagement of the MS research community through an international effort is needed to address and fund these research priorities with the ultimate goal of expediting the development of disease-modifying and symptom-relief treatments for progressive MS.



The abstract can be seen here.
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PostPosted: Thu Mar 07, 2013 5:56 pm    Post subject: Update Reply with quote

From the MS International Federation Newsletter, March 7, 2013:

Quote:
The first scientific meeting of the International Progressive MS Collaborative took place on 6-8 February in Milan, Italy.


“There are obvious scientific challenges, and challenges in international efforts. But it is extremely important that this move forward as a global effort.”
Weyman Johnson, MSIF Chairman


More than 170 MS researchers and clinicians from around the world came together at the conference with a common goal of finally bringing treatments to people with progressive MS everywhere. MSIF’s CEO Peer Baneke, Director of Programmes, Ceri Angood, and Head of International Scientific and Medical Research, Dhia Chandraratna, represented MSIF. The CEOs and/or key research staff from the Canadian, Italian, UK and US MS societies, and their scientific advisors, also took part.

The conference, which was hosted by the Italian and US MS societies, exceeded expectations and enabled leading experts to discuss and explore the most promising pathways in finding strategies for advancing the understanding of and treatment options for progressive MS.

The next steps of the International Progressive MS Collaborative will be to assemble a more in-depth scientific review of the meeting, agree upon a common research strategy and further develop the global action plans that will drive efforts toward the solutions needed for progressive MS.

“We are addressing one of the most challenging aspects of research in MS: understanding and treating progressive MS.”
Professor Alan Thompson, Meeting Co-Chair


Five key research priorities were discussed:


Quote:
#1 Identifying Targets and Repurposing
Opportunities for Progressive MS


• Studies of MS susceptibility genes show no
difference between relapsing and progressive
MS, or any genes driving disease severity; while
genetic and environmental factors may influence
relapses and repair mechanisms.

• A different part of the immune system is
more prominent in progressive than relapsing
MS; discovering ways to safely target this
is important; combination therapies may be
appropriate.

• Opportunities may exist for repurposing
therapies approved for other diseases; but there
need to be incentives and a clear pathway to
enable off-patent drugs to be developed for
progressive MS.

#2 Experimental Models for Preclinical
Evaluation of Therapies


• There is urgent need for models of clinical
symptoms and underlying tissue damage in
progressive MS.

• Some models permit the study of myelin repair,
such as toxin models.

• Progressive MS shows unique pathology,
accumulating with advancing age; more
information about progression pathology and
aging can drive the development of new models
for drug testing/

#3 Strategies for Phase II Clinical Trials

• Testing new therapies in relapsing MS is
facilitated by getting MRI signs of positive
response in very short (six month) phase II trials;
there is no equivalent in progressive MS.

• Biomarkers are needed to measure nerve fiber
injury or integrity and other factors contributing
to progression; continued trials are needed to
evaluate a candidate marker of nerve damage in
spinal fluid.

• Emerging imaging biomarkers that can detect
brain and spinal cord integrity may be useful for
both phase II and phase III trials in progressive
MS.

• New clinical trial designs are needed so that
more therapies can be tested more quickly at
lower cost; a secondary-progressive trial using
a novel “adaptive” design is getting underway.

#4 Clinical Outcome Measures and Trial Design

• Better ways to measure improvement and
success of therapies in progressive MS is
needed; ideally sensitive to change over time,
and predictive of future change.

• New technologies may help measure real-time
impacts of treatments.

• Improving favorable outcomes requires better
stratification of different types of progressive
MS.

• It is important to account for co-morbid
diseases of trial participants and environmental/
lifestyle factors.

• Exploring previous clinical trials, patient
registries and databases may be fruitful.

#5 Symptom Management and Rehabilitation


• Research is needed to determine ways to
keep people exercising beyond time-limited
supervised programs.

• Larger, well-controlled trials are needed
to evaluate symptomatic therapies and
rehabilitation methods, particularly cognitive
rehabilitation interventions.

• When testing therapies to treat cognitive
impairment, a person’s lifetime intellectual
enrichment may influence outcomes, since
those with higher “cognitive reserve” may fare
better.

• There is an urgent need for symptom
management and exercise programs to improve
quality of life for those who are severely
impacted by MS progression.
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PostPosted: Thu Aug 22, 2013 10:56 pm    Post subject: Setting a research agenda for progressive MS (article) Reply with quote

An article by this group entitled "Setting a research agenda for progressive MS" is in Multiple Sclerosis Journal, August 21, 2013.
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