Current Challenges and Future Directions
“At the moment, we are faced with different treatment options that will probably be in daily practice within the next two to four years,” Prof. Kappos stated. “Much of the evidence is not yet published or peer reviewed, but still there are some indications that may help us to define a profile of these compounds…. [Through clinical trials] we learned about the importance of early intervention and—mainly through negative studies—that later MS stages and progressive disease courses respond in a different way to treatments and need different study designs and more advanced outcome measures.”
Many achievements have been made as a result of successful clinical trials in MS therapy, including new treatment algorithms and diagnostic MRI criteria, but several challenges remain, according to Prof. Kappos. “We have to adapt and further develop our concepts, we have to develop criteria for phase- and cause-adaptive differential indications, and we have to further explore benefits and risks of new compounds … with additional phase III-B and IV studies…. Future research will focus on the interactions of microglia and their role in the development of disability and deficits in MS.
“Investigator-initiated and publicly funded prospective and comprehensive observational and cohort studies must increasingly complement the current paradigm of mostly corporate-sponsored clinical trials,” Prof. Kappos concluded.
—Ariel Jones