What's Hot at ECTRIMS-ACTRIMS 2017?

October 18, 2017

The 7th Joint European Committee for Treatment and Research in Multiple Sclerosis-Americas Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS-ACTRIMS) 2017 meeting is to be held next week from October 25 to 28, 2017, in Paris, France.

The meeting, also known as MSParis2017, will be held at Palais des Congrès, in the center of the beautiful city, near the iconic Arc de Triomphe.   

The conference website notes that Paris is an especially appropriate venue for the conference because it is the city of Jean-Martin Charcot, who identified and named multiple sclerosis (MS) in his famous Salpêtrière lecture of 1868. 

Chair of the conference is Catherine Lubetzki, MD, PhD, professor of neurology at Pierre and Marie Curie University and head of the Department of Neurology in Salpêtrière Hospital, Paris.

Dr Catherine Lubetzki

"I am very happy to welcome the meeting to Paris," she commented to Medscape Medical News. "It will be a great conference with around 10,000 delegates expected. This is more than usual. The numbers attending ECTRIMS are increasing every year, and this year it is a joint meeting with ACTRIMS so we will have more North Americans than usual."

"We have a good balance between basic science and clinical research, including epidemiology, imaging, and therapeutic trials, so the meeting attracts people involved in all the different specialties within the MS field who are able to gather together," she added.

"The conference venue is very special — right in the center of our magnificent city," she noted. "We also have a networking event at the Musée d'Orsay on the first evening (Wednesday). This art gallery has the largest collection of Impressionist paintings in the world, and they will be able to be viewed with colleagues and new friends. I hope delegates will join us at this extraordinary location in the heart of Paris." Participation in the networking event requires registration in advance.

A new feature of the conference is an event for patients. This will be held the day before the main meeting starts, Tuesday, October 24, and has been organized by Fondation ARSEP, a French MS foundation. "At this meeting, experts will present to patients recent advances in the field," Dr Lubetzki said. "We are expecting several hundred patients to attend, mostly from France as it will be conducted in French."

The main meeting then starts on Wednesday, October 25, and runs through until lunchtime on Saturday, October 28. 

Some of the major new therapeutic trials being presented at the meeting include detailed results from phase 3 trials with new drugs, including ozanimod, a selective sphingosine 1-phosphate 1 (S1PR1) and 5 (S1PR5) receptor; the SUNBEAM trial; and laquinimod, an aryl hydrocarbon receptor activator in the CONCERTO trial in relapsing-remitting MS. Topline results from these trials have been released previously, but this will be the chance to delve further in to the details.

And there is a study of fingolimod in pediatric MS. This is important, Dr Lubetzki said, "as this one of the first 'new generation' drugs to be tested in a pediatric population, so it will be particularly exciting to see these results."

Another study to be presented focuses on the novel strategy of using a new drug targeting a human endogenous retrovirus (HERV), which is thought to possibly play a role in the evolution of MS. "This hypothesis has been around for some time, but now there is a drug candidate and next week we will get to see if it works," Dr Lubetzki noted.

Another novel approach being reported is a study investigating the effect of physical exercise on MS. "Basic science studies have suggested that exercise is related to plasticity, and stimulating neurons with exercise may trigger remyelination," Dr Lubetzki explained. "This is a whole new area of research."

Among the "Hot Topics" on the program, Dr Lubetzki highlighted the following:

  • Progressive MS. "There is a large focus in this meeting on progressive MS," she said. "There is a Hot Topic session organized by the Progressive MS Alliance, giving details on the development of the (preclinical and clinical) projects supported by this initiative, and there will be new data presented in a different session on therapeutic trials in progressive MS." These include MRI results from the siponimod phase 3 trial in secondary progressive MS and first results from a phase 2 trial of ibudilast in progressive MS, she noted. "There have been many advances for the relapsing-remitting form of the disease but not very many at all for the progressive form. Now we are seeing more activity in this area and that is great."

  • New subgroups of MS disease. "These are related to different antibodies, and there is some controversy here as to whether these should be viewed as different diseases or subtypes of the same disease," she said. 

  • The role of the microbiome. "This session will focus on the bacteria in the gut and how they may influence the disease and possible therapeutic implications."

  • The importance of gray matter in the etiology of MS. "MS has always been considered a disease of the white matter, but now there is evidence that the gray matter is also involved," Dr Lubetzki explained. "As well as neuronal loss and atrophy, there is evidence that functional properties of neurons in the gray matter may also be affected before the neuron dies. The functional parts of the neurons are mainly in the gray matter. This is where the synapses are and the axon initial segments where the action potential is generated."

Other presentations of note include the following:

  • A report focusing on the effect of drug therapy on conversion from a first demyelinating event to the secondary progressive form of the disease. "Very long follow-up times are needed for such an analysis, and we haven't had much data on this before," Dr Lubetzki noted.

  • Several talks on immune cells and the various subsets involved in MS. "New data suggest while some are causing damage and need to be suppressed, others may have a repair role and boosting these phenotypes could be a new approach to therapy."

  • New MS diagnostic criteria. "It is important as it is vital that we get the diagnosis right," she said. "The MS diagnostic criteria have been under review for the last year, and the latest recommendations are being announced at the meeting. They will also be the subject of a publication in Lancet Neurology to coincide with their presentation."

  • New MS guidelines. The guidelines are being announced in two presentations: one on the European perspective and one on the US approach. "MS clinical guidelines are relatively new — it was only last year when we saw the first ones drafted," Dr Lubetzki said. "So these will be the latest refinements and I'm sure this will be a popular session."

  • A session on safety of drug therapy. "We have more and more drugs and they are becoming more and more effective, but this has the downside of more toxic side effects," Dr Lubetzki said. "We therefore thought a whole session on safety would be a good idea."

  • Several sessions will focus on the development of novel imaging outcomes and novel imaging tools. "This is of crucial importance not only to gain better insight into disease pathophysiology but also to improve the accuracy of surrogate markers for therapeutic efficacy," Dr Lubetzki noted.

Two plenary lectures will be featured: one at the beginning of the meeting and one at the end. The introductory lecture, is "New Pathophysiological Concepts and Clinical Perspectives" by Professor Hans Lassmann from Vienna, Austria. Professor Per Sorensen from Copenhagen, Denmark, will bring the meeting to a close with his talk: "How to Treat Patients With Suboptimal Response to Therapy." Both of these are "very important subjects," Dr Lubetzki commented.  

As well as all this, there will be a range of teaching courses (mainly on thefirst day) covering all aspects of MS, young investigator presentations, and two sessions especially for nurses. "Nurses are becoming increasingly important in the management of MS patients, and we are getting more and more nurses attending ECTRIMS every year," Dr Lubetzki said.

In addition, there are about 1900 posters, selected from more than 2500 submitted.

7th Joint European Committee for Treatment and Research in Multiple Sclerosis-Americas Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS-ACTRIMS) 2017. To be held October 25-28, 2017.

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