Multiple Sclerosis Research 2017: Predictions Revisited

On January 10, 2017, I wrote an opinion piece about what I thought would be the biggest developments in multiple sclerosis research in 2017.  Now, 345 days later, it seems like a good opportunity to revisit those predictions and see how well I did!  I will also be doing a Facebook Live video soon to discuss all of these topics in more detail, as well as provide an overview on multiple research in 2017.  Let’s get to the predictions!

PREDICTION:  “I believe that 2017 will continue to see growing interest in the area of lifestyle modifications as a way of managing MS”

In all fairness, I probably wasn’t going out on a limb too much when I made this prediction.  However, I think it is reasonable to grade this prediction as an A+.  We have seen a number of studies that have shown the benefits of a healthy diet for people with multiple sclerosis, including one from Johns Hopkins Medicine.  Similarly, there has been a big focus on the importance of exercise as part of a management plan.  Importantly, I think that there has also been an emphasis placed on finding ways that physical activity can be achieved by all people with multiple sclerosis, regardless of their level of disability.

PREDICTION GRADE:  A+

PREDICTION:  “My big prediction is that ‘infection’ could be the buzzword in MS circles in 2017”

In this case, I was probably a little too ‘enthusiastic’.  I wouldn’t say it has become the ‘buzzword’ that I predicted, but there has certainly been progress in the area.  The year saw Professor Michael Pender from the University of Queensland publish new findings from his work on the role of Epstein-Barr Virus (EBV) in multiple sclerosis.  As well as this, there have been a number of studies talking about the potential role of human endogenous retroviruses (HERVs) in multiple sclerosis.  A number of trials are also ongoing at the moment to assess whether an antibiotic treatment approach could be beneficial for people living with MS.  It is safe to say that the link between infection and multiple sclerosis is still an area of interest for a number of researchers throughout the world, however, it seems to still be somewhat ‘under the radar’.  Maybe I was just a year too early with my prediction and we will see it come to the forefront in 2018?  Time will tell, but for now, I can’t shy away from the fact….

PREDICTION RATING:  C-

PREDICTION:  “On the topic of stem cells, will AHSCT find a place as an MS therapy in 2017? 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”

Autologous Haematopoetic Stem Cell Transplant (or AHSCT) has continued to be a big topic in multiple sclerosis in 2017.  This year has seen more studies showing the significant benefits that can be obtained for some people with multiple sclerosis who undertake this treatment option.  In terms of the prediction, I would say that we have certainly witnessed a positive step in the direction of having a clear message of the potential benefits and risks being presented to the MS community.  This year I believe we have seen organisations all around the world take a much more proactive stance on promoting and sharing AHSCT trial results, as well as providing support and funding for more projects to generate more evidence on the outcomes for people with multiple sclerosis.  As I wouldn’t say that the message is completely unified yet, I’ll be a little conservative on my grade for this one…

PREDICTION GRADE:  B+

PREDICTION:  “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.  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”

Similarly to the prediction about lifestyle factors, this probably wasn’t a difficult suggestion to make.  Indeed, ocrelizumab received FDA approval at the end of March this year.  It was then approved by the TGA in Australia in mid-July and has recently started to be approved throughout Europe.  It will be interesting to see how real-world data for ocrelizumab compares to that generated through the clinical trials.  An easy prediction, but I’m saying this one was very accurate.

PREDICTION GRADE:  A+

PREDICTION:  “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. 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”

Results for the MIS416 Phase II clinical trial were released in July this year.  Unfortunately for all concerned, these results indicated that none of the measurements across the trial showed significant benefits associated with using MIS416.  This was in contradiction to earlier study findings and was a huge disappointment for all, especially people living with secondary progressive MS, for which there are no current treatments that are highly effective.  We will hope to provide some concluding information from the team at Innate Immunotherapeutics in 2018, as a way of updating the community about this trial.  I’m not sure that I made much of a prediction about the outcome of the trial, however, I would say that we were all hopeful that this would be able to proceed to a Phase III trial, so….

PREDICTION GRADE:  D

PREDICTION:  “I believe 2017 will also provide renewed vitality in remyelination research”

If I was to pick a consistent message that has been echoed throughout the multiple sclerosis research world in 2017, it is that remyelination should be the focus of next steps in the treatment of MS.  The year has seen a number of studies that have provided information that has improved our understanding of the process of myelin repair, which will hopefully lead to new avenues for treatments to be developed.  As well as this, results from a small study of clemastine fumarate (an antihistamine) have shown some preliminary evidence for the potential to generate myelin repair in people with multiple sclerosis.  This finding, combined with the volume of other projects in the area, and the messages being communicated throughout organisations and research institutes, suggests to me that this prediction was very accurate.

PREDICTION GRADE:  A+

In terms of my predictions, there were some hits and some misses.   The positive note is that we have seen lots of exciting multiple sclerosis research published this year.  As members of the MS community, what have your thoughts been on the developments in 2017?  Share them with us here, in the comments section under the post on our Facebook page or via Twitter.