Mark Freedman, MD

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Experts in multiple sclerosis review top data presented at the 8th joint ACTRIMS-ECTRIMS meeting. 

Rapid Readout: Expert Perspectives on Multiple Sclerosis - Data from the 8th Joint ACTRIMS-ECTRIMS Meeting 2020

“It’s no longer a [question of] should we think about this as a treatment option? It is a treatment option.”

Stem cell research has been an up-and-coming method to treat not only multiple sclerosis (MS), but a number of other neurological disorders, particularly those of neuromuscular origin. It has garnered so much attention that the 

National Institutes of Health (NIH) started their own trial

 in early January comparing the safety, efficacy, and cost-effectiveness of stem cell transplantation to the best available biologic drugs for severe forms of relapsing MS.

Mark Freedman, MD, MSc believes the days of uncertainty surrounding stem cells should be a thing of the past. He explained to 

 that a number of trials have proven they can be a safe and effective treatment option—when done correctly. On the other hand, though, he feels these procedures should only be done by the most experienced, high-level institutions to ensure that efficacy and safety.

Notably, Freedman, who is the director of the MS research unit at Ottawa Hospital, is gearing up for a presentation at the upcoming 

Consortium of Multiple Sclerosis Centers 2020 Virtual Annual Meeting

 to provide an update on the current research in stem cell use. In an interview with 

, Freedman provides an update on the current state of stem cell research in MS, as well as who should be the first to be treated with this therapy.

Freedman M. John F. Kurtzke Lecture: Stem Cell Research Update. CMSC 2020; May 29-29, 2020.

The director of the multiple sclerosis research unit at Ottawa Hospital discussed stem cell therapies being explored in multiple sclerosis, and which patients may be eligible for these treatments.

Mark Freedman, MD: An Update on Stem Cell Research in MS

"What was really eye-opening was to follow those patients over the ensuing 2 years, 5 years, 10 years, and 15 years plus, and that little head start continues to show itself as those patients are in the end still doing better than the ones that delayed therapy for a year."

At the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) 2019 Forum held in Dallas, Texas, Mark Freedman, MD, spoke about the first results from BENEFIT 15 and the long-term clinical outcomes in patients with clinically isolated syndrome (CIS) treated with interferon beta-1b.

BENEFIT 15 is a unique cohort with a 15-year follow-up from a clinical study of early or delayed treatment with interferon beta-1b in patients with CIS. Researchers randomly assigned patients with CIS and ≥2 MRI lesions suggestive of MS to receive interferon beta-1b or placebo. After 2 years or conversion to clinically definite MS, those on placebo were offered treatment with interferon beta-1b and 15 years after the initial randomization, all patients from participating study centers were approached to complete a comprehensive clinical and MRI reassessment. The results support a sustained benefit of early intervention with interferon beta-1b treating at or shortly after CIS in order to reduce the risk of conversion to CDMS.

The professor of neurology at the University of Ottawa, a senior scientist at the University of Ottawa, Ottawa Hospital Research Institute, and director of the multiple sclerosis research unit at the Ottawa Hospital general campus, explained that the lesson everybody appreciates today is that treating earlier is better when dealing with a disease that can lead to cumulative damage. To provide additional insight into the early results of BENEFIT 15, Freedman spoke with NeurologyLive in an interview at the meeting. 

The director of the multiple sclerosis research unit at Ottawa Hospital spoke about the results of BENEFIT 15 that support early intervention of interferon beta-1b treatment at or shortly after CIS.

Mark Freedman, MD: Early Intervention With Interferon Beta-1b for Patients Presenting With CIS

"We really are trying to focus on trying to be better for our patients and rather than roll the dice and pick a drug and see how it does, we are thinking we can do that in a more precise way."

At the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) 2019 Forum held in Dallas, Texas, Mark Freedman, MD, discussed precision medicine in the MS clinic and the importance of using the benefit:risk profile of a disease-modifying therapy and matching it to the benefit:risk tolerance of a patient.

The professor of neurology at the University of Ottawa, a senior scientist at the University of Ottawa, Ottawa Hospital Research Institute, and director of the multiple sclerosis research unit at the Ottawa Hospital general campus, explained that the community has learned to prognosticate and identify those who may have a poorer outcome based on how they present with their disease, the first 1—2 years, and the evolution of their disease, and that those patients will probably warrant a more aggressive approach with drugs that have a higher risk but carry a higher efficacy. However, for those patients have a less worrisome disease, Freedman suggests using one of the safer drugs like teriflunomide as an oral or one of the injectables which can control low-level disease, but over time are a much safer option.

To dive deeper into this presentation and learn more about how the clinician community is using precision medicine, Freedman sat down with 

The director of the multiple sclerosis research unit at Ottawa Hospital spoke about the need for clinicians to select the right patient for the right treatment in the MS clinic. 

Author | Mark Freedman, MD

Articles

Rapid Readout: Expert Perspectives on Multiple Sclerosis - Data from the 8th Joint ACTRIMS-ECTRIMS Meeting 2020

Mark Freedman, MD: An Update on Stem Cell Research in MS

Mark Freedman, MD: Early Intervention With Interferon Beta-1b for Patients Presenting With CIS

Mark Freedman, MD: Precision Medicine in Multiple Sclerosis