
Future Directions and Trial Design Needs in MS
In this final episode, Riley Bove, MD, considers the next phase of MS research, emphasizing the need for innovative trial designs to address sequencing, discontinuation, and subgroup-specific treatment strategies.
At the 2025 European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Congress, held September 24-26, in Barcelona, Spain, new findings on ofatumumab (Kesimpta; Novartis) drew significant attention for their implications in relapsing multiple sclerosis (MS). Among them were results from the ARTIOS trial, which evaluated patients switching from fingolimod or fumarate-based therapies after breakthrough disease, showing striking reductions in both relapses and MRI activity. In addition, long-term extension data reinforced the durability of ofatumumab’s efficacy and safety profile, underscoring its role as a central B-cell–depleting therapy in the MS landscape.
In this NeurologyLive® Special Report mini-series, Riley Bove, MD, an associate professor of neurology at the University of California, San Francisco, breaks down the latest evidence and shares key takeaways for clinical practice. Across four short episodes, Bove explores how ofatumumab differs from other therapies, interprets the new ARTIOS results, reflects on its evolving use since approval, and looks ahead to the questions still shaping MS treatment research.
In this final episode, Bove reflects on how studies like ARTIOS inform broader questions in MS management. She emphasizes the need for rigorous data on sequencing, treatment spacing, discontinuation strategies, and subgroup safety. Overall, the conversation underscores how innovative trial design can address the evolving complexities of long-term MS care.
Transcript edited for clarity.
Riley Bove, MD: I think the initial treatment decision—starting patients early on a highly effective therapy—is becoming more straightforward, and that’s where we see the best long-term outcomes. The more complex questions involve what comes next: how to switch treatments, how to space them out, when to discontinue therapy, and how to sequence different options. These are the kinds of issues that require high-quality data, similar to what ARTIOS has provided.
It’s also important to study treatment effectiveness and safety in different subgroups of patients. For example, we need more data in pregnancy and lactation, but also in aging adults and other populations where the balance of risks and benefits may differ.
Innovative trials like ARTIOS are essential because they address real-world clinical questions and expand our understanding beyond initial treatment choices. Continuing to design studies that answer these practical and nuanced questions will be key to advancing MS care.
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