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Part 2 of 2016 Symposium: Debate – Do we still have unmet needs in MS treatment?

Gavin Giovannoni, Heinz Wiendl

The symposium “Do we still have unmet needs in MS therapy?” was sponsored by Merck KGaA, Darmstadt, Germany. It was recorded at ECTRIMS 2016 in London.

Question 1: Is there an unmet need for a therapy without continuous immunosuppression? The speakers compare and contrast the ‘old’ immunomodulating therapies with the ‘new’ immunosuppressing treatments. They discuss the risk versus benefit balance that must be addressed for each patient when older therapies fail and newer drugs are prescribed. They conclude that we are still searching for that ‘perfect’ safe and effective therapy. Question 2: Do we need low frequency and low monitoring burden? The speakers debate the old therapies (low monitoring burden) with the newer drugs (high monitoring burden).

They also note in some instances old drugs continue to be prescribed despite patients relapsing to avoid the monitoring burden of newer drugs. Question 3: Do we need a drug that will penetrate the CNS? With an early diagnosis MS can be managed well. But over time, progression often occurs, indicating changes in the CNS. There is an unmet need to target the pathophysiology within the CNS for non-relapsing, progressive MS. The investigational therapy cladrabine is discussed in this context.