“Understanding these additional mechanisms better and being able to target these processes within the central nervous system represent some of the major challenges that we have to meet this unmet need.”

Primary progressive multiple sclerosis (PPMS) is among one of the most debilitating forms of MS, causing patients to experience a decline in neurologic function earlier in their life span. While there are some approved medications that may help slow disease progression, there is still much to learn about the underlying mechanisms of the progressive phenotype in order to develop more targeted treatments.  

Amit Bar-Or, MD, FRCPC, FAAN, FANA, the Melissa and Paul Anderson President’s Distinguished Professor at the Perelman School of Medicine, and chief of the MS Division at the University of Pennsylvania, believes that, similarly to relapsing forms of the disease, treating PPMS with the most high-efficacy drugs at the earliest stage may help prevent or slow disease progression.

This treatment philosophy stems from the belief that the biology of PPMS exists much earlier than the clinical manifestation. Addressing central nervous system compartmentalized mechanisms of progression, including inflammatory and degenerative processes, are 2 therapeutic targets that Bar-Or feels are promising.   

In an interview with NeurologyLive, Bar-Or spoke about these different disease mechanisms and shed light on some of the early-stage research being done in this space.