Barcelona — Multiple sclerosis (MS) is the eighth most common neurologic disorder in Europe, affecting more than 500,000 people, most of them young adults aged 20 to 40 years, and costing the economy some 14.6 billion euros (that's $16.45 billion) every year.

MS is also the second leading cause of disability in Europe, but as traffic accidents become less common in an ever more safety-conscious society, it's now the leading cause of disability in some countries, Xavier Montalban, MD, PhD, professor, neurology, Autonomous University of Barcelona, Spain, and president, European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), told a press conference here today.

Dr David Miller addresses the ECTRIMS kickoff press conference. Marco Ansaloni

Among other things, this year's ECTRIMS congress will focus on personalized therapy, an "unmet need" in the field of MS, he said.

"We didn't have any treatments for MS at all in 1995; now we have 10 drugs for the treatment of relapsing and remitting MS, which is very, very good," Professor Montalban said.

"But we need to know how to use these drugs — which is the best drug for a specific person — and it's also very important to identify when a drug is not going to work."

Dr Xavier Montalban

Biomarker research will be an important highlight of the meeting, he said. Using RNA, microRNA, and DNA sequencing, researchers may be able to identify candidates with the potential to become disease activity biomarkers.

Previous work shows that a biomarker assay based on the combination of two cerebrospinal fluid proteins can classify patients according to their conversion to MS. Research also correlates brain and cervical spinal cord atrophy with clinical measures of disability progression, suggesting that they may be clinically meaningful surrogates.

David Miller, professor, clinical neurology, Institute of Neurology, University College London UK and ECTRIMS vice president, chair of the Scientific Congress Committee, called this year's scientific program "very exciting" and "topical" and said that it reflects "the progress and research" in the field.

Dr David Miller

In addition to timely lectures on primary progressive MS and on evolving concepts in MS treatment, sessions will feature the complex interactions between genetic predisposition and environmental triggers, said Dr Miller.

As well, he said, factors influencing risk for MS that will be discussed during the conference include:

  • Low sunlight exposure and vitamin D deficiency;

  • Viral infections;

  • Hygiene;

  • Salt intake;

  • Cigarette smoking;

  • Individual gut microbiome; and

  • Intake of fatty acids.

Another topic of interest will be the increasing prevalence of MS. One session will feature reports from various regions around the world, including Australia, Latin America, and the Middle East.

In the area of clinical trials, the congress will feature results from "important, large industry-funded phase 3 trials," said Dr Miller. These will include OPERA 1 and 2 findings for the efficacy and safety of the investigational monoclonal antibody ocrelizumab (Genentech, a member of the Roche Group) compared with interferon β-1a. The drug is being tested in both relapsing-remitting and progressive MS.

There will also be results from other trials comparing and contrasting existing therapies for MS and results from trials using "repurposed" treatments, for example the antibiotic minocycline, in MS.

According to Per Soelberg Sørensen, professor, neurology, University of Copenhagen, ECTRIMS secretary, and chair, Teaching Course Committee, as the number of MS treatments increases, so too does the complexity of the hunt to find the correct treatment for each patient. The search must consider not only efficacy but also convenience and cost, he said.

Dr Per Soelberg Sørensen

In addition to targeting neuroprotection and remyelination, teaching courses during ECTRIMS will focus on issues such as MS comorbidities (patients with MS have a relatively high risk for cardiovascular and cerebrovascular disease), how to treat advanced states of disease, and MS and reproduction (more and more research points to hormones as an important trigger in MS).

"We know that two to three times more women than men are getting MS and this gap is widening for reasons we don't know," said Dr Sørensen.

Over 8000 experts from around the world are expected to attend this year's meeting, making it the biggest to date. Medscape Neurology coverage begins today, and the Medscape Neurology booth can be found at #B44. Follow us on Twitter at @MedscapeNeuro.


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