Open Our Minds

An MStranslate Opinion Piece – by Brett Drummond

“Is there anyone so wise as to learn by the experience of others?” – Voltaire

“Human beings, who are almost unique in having the ability to learn from the experience of others, are also remarkable for their apparent disinclination to do so” – Douglas Adams

There is no questioning the fact that multiple sclerosis is a unique condition.  Indeed, every individual diagnosed with it has a very personal journey that may differ significantly from another’s experience.  Despite this, we are increasingly seeing crossovers between MS and other neurological disorders.  This happens in a variety of ways, but primarily it is either through learning from research or for repackaging treatments that have been developed for other diseases to trial in MS.  Is this good, bad or otherwise?

Research

In terms of research, I think there is a growing understanding of the necessity to form collaborations and learn from what has been discovered in other disorders.  Whilst there are certainly unique components to the disease process in MS, there may also be common themes amongst these disorders, such as neuroinflammation and neurodegeneration.  As an example of this, at the beginning of 2015, Keystone Symposia organised a conference under the banner of “Neuroinflammation in Disease of the Central Nervous System”.  This conference allowed for researchers from a variety of disease areas to gather and share their findings and thoughts.  This openness and willingness to transfer information and think ‘outside the box’ can only be beneficial in helping to accelerate our understanding of MS.

Treatments

So what about when it comes to treatments that have been used in other diseases?  Ocrelizumab has been a huge topic of interest as a new therapy for MS recently, with Roche reporting data from a Phase 3 trial that has suggested it is the first drug to potentially benefit people with primary progressive MS.  However, ocrelizumab was originally developed as a treatment for another autoimmune disease, rheumatoid arthritis (RA).

Whilst showing promising data in these trials as well, the process was discontinued due to the fact that the potential safety concerns outweighed the benefits seen for people with RA.  However, as the mechanism behind the action of the drug was thought to also be useful in treatment of MS, these trials have also been undertaken.  As the potential benefits (especially for PPMS) are perceived to be greater, it is thought that the safety risks are more acceptable.  Another example is HSCT, chemotherapy followed by a bone marrow transplant, which has been a treatment for blood cancers for decades.  Many studies have recently shown that this type of approach, due to it’s ability to ‘reboot’ the immune system, can have significant benefits to people with MS.

Learning from multiple sclerosis

Similarly, the process can also go the other way.  Recently, studies have shown that a metabolite of dimethyl fumarate (marketed as Tecfidera) could also be effective as a treatment for Parkinson’s disease.  This presents another example of how an understanding of an action in one disease can be used to increase knowledge and provide better treatments for another.

In essence, opening ourselves up to learning from the experience of others is critical to make progress.  However, especially when it comes to the new therapies, it is important that this is done on the basis of strong scientific rationale, with a view to adding benefit to the currently available treatments.

As always, we would love for you to share your thoughts with us – either here or through our social media.