Latest developments in MS research:
1. Learn about the use of ocrelizumab during pregnancy.
2. Gain insights into the de-escalation and discontinuation of disease-modifying therapies from the Annual ECTRIMS Focused Workshop.
3. Discover how a metabolic anomaly in the macrophages of people with MS may hinder remyelination.
These noteworthy MS news highlights and more are included in our recently published ECTRIMS Research Updates – a 30-day snapshot of global news and publications on MS research, treatment, and care.
ECTRIMS Research Updates can be sent to you every month, delivered straight to your inbox, via our free subscription service. Simply select all “topics” that are of interest to you, and when one of those appears in our news and publication cycle, you’ll be sure to hear from us.
Genetics
Multiple sclerosis patient macrophages impaired metabolism leads to an altered response to activation stimuli
Neurology Neuroimmunology Neuroinflammation | November 2024
Macrophages of people with MS display a metabolic anomaly that may hinder remyelination, new study finds.
Researchers from Paris Brain Institute isolated monocytes from blood samples of 47 individuals with multiple sclerosis (MS) and 46 healthy participants, then differentiated them in vitro. The study reveals that monocytes from individuals with MS behave differently compared to those from healthy people. Specifically, monocytes from individuals with MS have a reduced capacity to phagocytose myelin debris and process it effectively after ingestion. This behavior continues even when the macrophages are exposed to pro-regenerative signals, and it becomes worse in response to pro-inflammatory stimuli. Importantly, MS people macrophages display a metabolic anomaly characterised by inefficient energy utilisation in their mitochondria.
Women’s Health
Pregnancy and infant outcomes in women with multiple sclerosis treated with ocrelizumab
Neurology Neuroimmunology Neuroinflammation | January 2025
In utero exposure to ocrelizumab does not appear to increase the risk of complications for the pregnancy or the infant.
Family planning is an important aspect to consider when choosing therapies for women with MS. This study analyses a large dataset of pregnancies in women with MS mostly from US, Germany, and Canada who received ocrelizumab – median age of 32 years. The findings suggest that in utero exposure to ocrelizumab does not increase the risk of adverse outcomes for the pregnancy or the infant compared with the general population.
Gender diversity
Exploring the role of sex hormones and gender diversity in multiple sclerosis
Nature Reviews Neurology | 11 December 2024
What is the effect of gender-affirming hormone therapy on MS outcomes? This perspective discusses the (limited) existing evidence.
Trans people are largely underrepresented in MS research. Including trans individuals in MS studies is essential also for gaining a better understanding of the impact of gender-affirming hormone therapy on MS outcomes. To ensure comprehensive data collection, two key questions should be asked when gathering demographic information: one about gender identity and the other about sex assigned at birth. The present perspective discusses the effects of both endogenous and exogenous sex hormones in MS, also highlighting their potential therapeutic benefits.
Therapeutics
Disease-modifying treatment and disability progression in subclasses of patients with primary progressive MS: Results from the Big MS Data Network
Journal of Neurology, Neurosurgery & Psychiatry | December 2024
Disease-modifying treatment can help reduce the risk of disability worsening in people with MS with aggressive disability trajectory.
Within the framework of the Big MS Data network, researchers investigated 4 datasets – the Observatoire Français de la Sclérose en Plaques (OFSEP), the Swedish and Italian MS registries, and MSBase. They observed that disease-modifying therapies do not slow down the worsening of disability in people with primary progressive MS. However, DMT were associated with a reduced risk of disability accrual – compared to no treatment – in people with a more aggressive disability trajectory.
Guidelines and Recommendations
De-escalating and discontinuing disease-modifying therapies in multiple sclerosis
Brain | 21 December 2024
The Annual Focused Workshop organised by ECTRIMS in 2023 has discussed the question of when and how to de-escalate or discontinue disease-modifying therapies.
“Will I have to take my treatment for the rest of my life?” is a common concern among people with MS starting their treatment. Over an individual’s lifetime, the benefit-risk balance of disease-modifying therapies (DMTs) changes. In some cases, “prudent de-escalation” of treatment may be considered, particularly for individuals aged 55 years or older who have shown no evidence of disease activity for at least 5 years. According to the panel of international experts who participated to the ECTRIMS workshop, any decision to stop treatment should always be made collaboratively.