Future Implications of New Framework to Characterize Multiple Sclerosis: Ruth Ann Marrie, MD, PhD, FRCPC

WATCH TIME: 3 minutes

"If we talk about changing a classification that is familiar to people living with MS, clinicians, researchers, and regulators, we need to think about the consequences of that, how we can make those changes so that they achieve the goals we want without having unintended consequences. Think about how information can be communicated effectively, and how changes can be made effectively."

For years, multiple sclerosis (MS) has been defined by 3 clinical courses: relapsing-remitting, primary progressive, and secondary progressive. Although not necessarily a new concept, a recent paper published by the International Advisory Committee on Clinical Trials in Multiple Sclerosis suggested that the disease is driven by pathophysiological mechanisms, not clinical phenotypes. Authored by Ruth Ann Marrie, MD, PhD, FRCPC, and several others, the paper culminated years of previous research and highlighted several aspects of disease progression such as inflammation, neurodegeneration, aging, and many others, that support this theory.

The paper focused on clarifying the 1996 and 2013 clinical course descriptors, commonly referred to as the Lublin-Reingold classification, with the goal of determining an approach to developing a new framework for describing the disease. Marrie, a professor of medicine at the University of Manitoba, believes there is room for an emphasis on trials that are driven by looking at biologic mechanisms. In an interview with NeurologyLive^®, she discussed the major implications of the paper and whether it could have a serious impact on the indications of previously approved disease-modifying therapies. Additionally, she provided her thoughts on how the clinical community may react to the news, and if those who treat the disease may change their approach.

REFERENCES
1. Kuhlmann T, Moccia M, Coetzee T, et al. Multiple sclerosis progression: time for a new mechanism-driven framework. Lancet Neurol. Published online November 18, 2022. doi:10.1016/S1474-4422(22)00289-7.