An Opinion Piece by Brett Drummond, MStranslate Co-Founder

With a new year beginning, we get a chance to look forward to what will happen in the field of multiple sclerosis research.  Some of this we can predict, some of this we can’t.  Hopefully, there are some big breakthroughs that aren’t even on our radar yet.  Here are some things that we can look forward to…

The end of 2016 ended with another bang from the Kipnis Lab at the University of Virginia.  Following their groundbreaking work identifying lymphatic vessels in the brain that completely rewrote decades of textbooks, they have published another article regarding novel immune cells that may play a significant role in health and disease.  Having talked to Jonathan recently, I am sure that we will be hearing a lot more from them in the first half of 2017, including some significant updates around their MS research.

As well as this, with the trial results for ocrelizumab having been recently published, we are expecting a decision from the FDA about its approval in the first half of the year.  This is slightly delayed from the original timeline, as Roche has provided new information about the manufacturing that the FDA wants to consider.  Roche have made it clear that these new details are not related to either the safety or the efficacy of the treatment.   Ocrelizumab, an anti-B cell treatment, is the first to have shown some benefits for people with progressive MS.   It should be stressed that the effects are moderate (but statistically significant) and it definitely does not represent a cure.  However, the fact that no currently available treatments have proven to be at all useful in progressive MS, combined with the apparent lack of negative side-effects, means that I would expect approval to be granted.  Once this happens, I would expect somewhat of a domino effect to occur in regulatory bodies around the world.

Continuing in the field of progressive MS, we can also expect results from the MIS416 Phase II trial in people with SPMS around the middle of the year.  This therapy, designed by Innate Immunotherapeutics, has shown strong results in earlier clinical trials and uses a novel mechanism of action.  All participants are expected to complete their 52 week trial around April.  The most recent news released indicates that a large proportion (~90%) of participants that have already finished the study have requested to continue on the medication as part of the compassionate use program put in place.  If analysis shows positive results, MIS416 will continue onto a much larger Phase III trial.  We will continue to provide information on these developments as they are released.

I believe 2017 will also provide renewed vitality in remyelination research.  The failed Biogen anti-LINGO trial of 2016 placed a ‘black cloud’ over the field in the eyes of many external viewers.  Personally, I believe this was unjustified and we will see more positive results in this area.  Biogen will reboot their studies, hopefully with a more rigorous trial design in place.  Other researchers, such as Novoron Bioscience, will also continue to pursue this area and we can expect to hear more from them this year.

Myelin repair will also be the focus of the Phase II trial of mesenchymal stem cells being pursued by the team at Tisch MS Research Center of New York.  Hopefully, this trial is fully planned and enrolled this year.  We will hope to provide some updates from the team and may have preliminary results towards the end of the year.

In other clinical trial updates, the CCSVI trial at the Alfred Hospital here in Melbourne, Australia, will continue in 2017, with a new cohort of people to be enrolled. More preliminary results from the trial are expected to be released in the second half of the year.

On the topic of stem cells, will AHSCT find a place as an MS therapy in 2017?  Significant data was published last year regarding this treatment, which showed that some people obtain large, long-term health benefits from it.  It is currently unclear whether the data from the Australian trial will be published in 2017, however, we will continue to monitor this.  Personally, my main hope in this area is that there is a clear and unified message from organisations, neurologists and researchers around the world that has the best interest of people with MS in mind.

My big prediction is that ‘infection’ could be the buzzword in MS circles in 2017.  Late in 2016 we saw some momentum develop around human endogenous retroviruses (HERVs) as triggers for MS.  We originally heard about this from Dr John Kriesel from the University of Utah and we are expecting updates from him in 2017.  Similarly, it is expected that preliminary results of the CHANGE-MS trial will be released in 2017.  This Phase 2b trial being conducted by GeNeuro in Europe is testing the ability of an antibody directed against a HERV to treat people with MS.   Although I haven’t heard of any major announcements scheduled for 2017, I think we may hear more developments in the EBV and C. pneumoniae stories this year as well.

I believe that 2017 will continue to see growing interest in the area of lifestyle modifications as a way of managing MS.  Dr Terry Wahls‘ has received NMSS funding to conduct a study on her dietary approach, which we may see preliminary data for by the end of the year.  Similarly, the OMS and Neuroepidemiology teams, led by Professor George Jelinek, will be continuing their research in 2017 and we hope to see some new findings from the long-term data that they have collected.  Whether this data leads to collective buy-in from the MS community remains to be seen, but will be interesting to observe.

Lastly, what are my predictions for MStranslate in 2017?  We will be bigger and better this year with more news and more unique content.  We will be launching some new initiatives designed to continue to progress MS research, while providing more power to the MS community at the same time.  We will continue to be at the forefront in providing direct access to leading researchers around the world.  Most importantly, we will continue to be the accurate and independent resource that people living with MS deserve.

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