Commentary
Video
A Medical Preview of 2024 for Multiple Sclerosis and Related Disorders: Jiwon Oh, MD, PhD
Author(s):
The staff neurologist and medical director of the Barlo Multiple Sclerosis Program at St Michaels Hospital shared thoughts on the promising advancements in the multiple sclerosis field for 2024. [WATCH TIME: 5 minutes]
WATCH TIME: 5 minutes
“I'm really excited about the upcoming revisions to the MS diagnostic criteria. There was a large group of clinicians and scientists that met a few months ago to discuss proposed revisions. It seems like there will be some dramatic changes coming up in the next year. Overall, I think this is positive because I think the diagnostic criteria considers all the emerging science on what we're thinking about MS.”
In 2024, medical professionals anticipate the latest updates in research and continue to advance the therapeutic options for patients with multiple sclerosis (MS) including relapsing MS and progressive MS, as well as related and demyelinating disorders such as neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein antibody-associated disease. The field has experience significant positive gains over the past couple of decades with understanding the fundamental drivers of the disease, identification of risk genes, having a more precise account of epidemiology, and the development of effective treatments.1 Currently, relapses in MS can be safely eliminated in most patients with the latest therapies, and treatment-resistant progressive symptoms have partially slowed.2
Among the recent advancements for therapeutics, Bruton tyrosine kinase (BTK) inhibitors, a cytoplasmic tyrosine kinase expressed by B cells and myeloid cells, show promise in curtailing disease progression by targeting immune cells on both sides of the blood–brain barrier. According to a recent review published in Nature Reviews Neurology, there are several BTK inhibitors currently under investigation for MS that differ in selectivity, strength of inhibition, binding mechanisms and ability to modulate immune cells.3 These BTK inhibitors include evobrutinib (Merck KGaA/EMD Serono), tolebrutinib (Sanofi), and orelabrutinib (Biogen/InnoCare Pharma), and the reversible inhibitors fenebrutinib (Roche) and BIIB091 (Biogen).4
Recently, Jiwon Oh, MD, PhD, staff neurologist and medical director, Barlo Multiple Sclerosis Program, St Michaels Hospital, University of Toronto, sat down in an interview with NeurologyLive® sat to share her medical perspective of potential advancements and therapies in the field of MS for 2024. She talked about the anticipated changes in the upcoming revisions to the MS diagnostic criteria. Oh also spoke about how the use of BTK inhibitors, especially tolebrutinib, might potentially address unmet clinical needs in nonactive secondary progressive MS. Additionally, she discussed new MRI measures that are likely to be included in the updated diagnostic criteria, and how they could enhance the clinical practice in MS.
REFERENCE
1. Cree BAC, Oksenberg JR, Hauser SL. Multiple sclerosis: two decades of progress. Lancet Neurol. 2022;21(3):211-214. doi:10.1016/S1474-4422(22)00040-0
2. Hauser SL. Progress in Multiple Sclerosis Research: An Example of Bedside to Bench. JAMA. 2020;324(9):841-842. doi:10.1001/jama.2020.1522
3. Krämer J, Bar-Or A, Turner TJ, Wiendl H. Bruton tyrosine kinase inhibitors for multiple sclerosis. Nat Rev Neurol. 2023;19(5):289-304. doi:10.1038/s41582-023-00800-7
4. Correale J. BTK inhibitors as potential therapies for multiple sclerosis. Lancet Neurol. 2021;20(9):689-691. doi:10.1016/S1474-4422(21)00250-7
