Global initiative targets progressive multiple sclerosis

Zephyr/SPL

New drugs for multiple sclerosis are of no use in treating the disease's progressive form.

When Carol Steinberg was diagnosed with multiple sclerosis (MS) in 1995, there was only one drug approved by the US Food and Drug Administration to treat the disease. Now there are eleven.

Yet none of these agents can help Steinberg. She suffers from progressive MS, a form of the disease that is characterized by steadily worsening neurological function. All eleven approved drugs combat the unpredictable symptom outbreaks that are associated with the relapsingremitting form of MS. Around 85% of newly diagnosed patients have the relapsingremitting form; after 10 to 20 years, most of them develop the progressive type.

The lack of good treatment options for progressive MS weighs heavily on Steinberg. She uses a wheelchair, but continues to work as a trial lawyer in Newton, Massachusetts. Im constantly afraid of my disease getting worse, she says.

A global initiative called the Progressive MS Alliance now hopes to kick-start the development of therapies specifically for Steinberg and the million or so people worldwide living with progressive MS. On 11 September, at a joint meeting of the European and Americas Committees for Treatment and Research in Multiple Sclerosis, the alliance announced an inaugural round of research awards part of a six-year, 22-million (US$28.5-million) programme that is the first concerted effort to tackle the diseases less-common form.

We need a new focus on progressive MS, says Neil Scolding, a specialist in MS at the University of Bristol, UK, who is not involved in the initiative. This alliance will provide a huge stimulus not only in terms of the research it will fund, but in terms of raising the profile of progressive MS and in helping the pharmaceutical industry realize what a priority this is.

All approved MS drugs work by combating the inflammation that occurs when the bodys immune cells attack the nervous system the primary cause of relapsingremitting MS. Yet, unlike relapsingremitting disease, inflammation has only a minor role in progressive MS, in which steady nerve degeneration is the major pathological factor. Some researchers have even questioned whether progressive MS is one end of a wide spectrum or a separate disease entity.

No medications seem to make a dent in the physical declines experienced by the 1015% of patients with MS whose disease progression is continuous from diagnosis. And only one drug is approved to help patients who develop progressive MS after first experiencing relapsingremitting disease. But this agent, an immunosuppressant originally developed to treat certain forms of cancer, comes with such harsh side effects, particularly on the heart, that most doctors are loath to prescribe it.

The 22 pilot grants unveiled last week at the Boston meeting are designed to fill knowledge and infrastructure gaps in scientists understanding of progressive MS. Some grants involve studying genetics, biomarkers or responses to experimental treatments in human patients. For example, Anders Svenningsson, a neurologist at Ume University in Sweden, received funding to determine whether administering a drug called rituximab directly into the spinal cord could be effective. In past trials, injections into the bloodstream have not been beneficial.

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Global initiative targets progressive multiple sclerosis