Pioneering proposal for a new framework to describe types of MS

This article has been adapted from one published by the National MS Society (US).

An international panel of MS experts has published a paper that proposes a new approach to how different types of MS are typically described. Currently, we use different descriptors to categorise types of MS, like relapsing-remitting, primary progressive, or secondary progressive MS, but there is growing evidence that MS is better understood as a continuous process. This process varies between individuals and over time, according to the way in which the nervous system is damaged, and how well an individual’s body can repair or compensate for that damage. Moving away from traditional categories of MS may lead to new understanding, research and tools for better and more personalised treatments for MS.

Any future framework for classifying MS will require a huge shift in how individuals with MS, clinicians, drug developers and regulators understand and describe MS. It will be essential to work closely with these groups as a new framework is developed, communicated and implemented. It is important to ensure any new measurements or tests required are practical and feasible across the diversity of global health systems.

Describing MS based on the underlying processes occurring in the nervous system of each person, rather than how it appears clinically (e.g. whether or not an individual experiences relapses), will require a better understanding of how progression occurs in MS. The paper reviews ongoing research in this area, and identifies knowledge gaps.

The panel’s vision is that a new framework will support the development of the tools (for example biomarkers needed to detect an individual’s disease course. In the future, such tools should be made available in clinical settings to inform treatment decisions, leading to better outcomes for people with MS.

The proposal paper, by Tanja Kuhlmann, MD (University Hospital Münster, Germany) and collaborators, was written on behalf of the International Advisory Committee on Clinical Trials in MS. This Committee includes representatives from MSIF’s International Medical and Scientific Board (IMSB), and provides guidance related to planning and implementing clinical trials for new MS treatments. The Committee is jointly supported by the National MS Society (US) and the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS). Professor Takashi Yamamura, one of MSIF’s IMSB members, has also written a commentary on this publication.

You can access the scientific paper here:

“Multiple sclerosis progression: time for a new mechanism-driven framework” by Drs. Tanja Kuhlmann, Marcello Moccia, Timothy Coetzee, Jeffrey A. Cohen, Jorge Correale, Jennifer Graves, Ruth Ann Marrie, Xavier Montalban, V. Wee Yong, Alan J. Thompson, Daniel S. Reich, on behalf of the International Advisory Committee on Clinical Trials in Multiple Sclerosis, was published 18 November 2022 in Lancet Neurology.

Our thanks to the National MS Society who originally published this article.