NeurologyLive® Year in Review 2023: Most Watched Interviews in Multiple Sclerosis

In 2023, the NeurologyLive^® team spoke with hundreds of people and posted hundreds of hours of interview clips. The staff spoke with neurologists, investigators, advanced practice providers, physical therapists, advocates, patients, pharmacists, and industry experts—anyone involved in the process of delivering clinical care.

These conversations were had with individuals from all over the world, both virtually and in person. The team attended more than 10 annual meetings of medical societies, each time sitting down with experts on-site to learn more about the conversations driving care and the challenges being overcome.

From those in the field of multiple sclerosis (MS) and related disorders this year, we learned about novel approaches to the management of MS, such as the development of Bruton tyosine kinase inhibitors; the importance of diet in MS; the rethinking of MS pathology in research; various new methods of measuring disease activity; and much more.

Here, we'll highlight the most-viewed expert interviews on NeurologyLive^® this year. Click the buttons to watch more of our conversations with these experts.

1. Challenges With Tailoring Diets in Multiple Sclerosis: Laura Piccio, MD, PhD

The neurologist and physician scientist at Washington University in St. Louis provided insight on the general dieting strategies patients with multiple sclerosis should take as more information becomes available.

WATCH TIME: 6 minutes

"You need a well-designed study to demonstrate that one diet is better, or more specific, for that particular disease. What we’re doing as a scientific community is increase the number of high-quality studies that could answer some of these questions."

2. Rethinking MS as a Smoldering Disease and the Role of the Epstein Barr Virus: Gavin Giovannoni, MBBCh, PhD, FCP, FRCP, FRCPath

At CMSC 2023, the professor of neurology at Barts and The London School of Medicine and Dentistry discussed the emerging paradigm shift in understanding multiple sclerosis (MS) as a smoldering disease and the potential role of Epstein Barr Virus in causing MS.

WATCH TIME: 6 minutes

"We have very effective therapies now that could stop all the focal inflammation, clinical relapses, and lesions, but the disease still continues. There's something happening in the brain and spinal cord causing people to worsen that we're not addressing."

3. Intrathecal Mesenchymal Stem Cells as a Potential Treatment for Progressive Multiple Sclerosis: Saud A. Sadiq, MD, FAAN

The director and chief research scientist at Tisch MS Research Center of New York talked about a phase 2 data study on stem cell treatment for multiple sclerosis that was presented at the 2023 AAN Annual Meeting.

WATCH TIME: 7 minutes

"It can take a lot of work before the actual work of the clinical trial can commence, and I think that's often off-putting to a lot of folks to as investigators because they don't necessarily know where to start. When you present it like that, clinicians are like, “I just want to know whether or not my treatment works.” Obviously yes [we want to know to], but this is the foundation for being able to appreciate if it [the thing you’re researching] does or does not work, and why and for whom and under what circumstances."

4. Gauging MS Disease Activity Through Octave’s MSDA Test: Taylor Gonyou, DO

The multiple sclerosis fellow at Michigan Institute for Neurologic Disorders provided perspective on the clinical utility and advantages of a multi-protein test that assesses multiple sclerosis disease activity.

WATCH TIME: 3 minutes

"This [MDSA test] can be helpful in many ways. We’re using precision medicine for the first time in MS, and it’s a good way to find a baseline for patients. Where does the patient stand from the first time they’re getting this test? Then you can follow them longitudinally over time."

5. Potential Role of Glial Fibrillary Acidic Protein in Progressive Multiple Sclerosis: Robert J. Fox, MD

The vice-chair for research at Cleveland Clinic’s Neurological Institute provided commentary on the expanded research of GFAP in multiple sclerosis and whether certain biomarkers may predict treatment response.

WATCH TIME: 8 minutes

"The CSF (cerebrospinal fluid) measures of those molecules [neurofilament light, GFAP] did not correlate with clinical or imaging measures of the tissue destruction. That was a little surprising because a lot of people think that CSF is a more direct and relevant compartment to measure these molecules."

6. The Road Ahead for BTK Inhibitors in Multiple Sclerosis: Amit Bar-Or, MD, FRCPC, FAAN, FANA

The Melissa and Paul Anderson President’s Distinguished Professor of Neurology, Perelman School of Medicine, University of Pennsylvania, talked about the promising potential of BTK inhibitors in treating both relapsing and progressive forms of multiple sclerosis.

WATCH TIME: 4 minutes

"If these therapies prove to strike a good balance between efficacy, including the relapsing and progressive biology, with being sufficiently safe and well tolerated, they will likely be relevant for patients across the spectrum. This spectrum would include patients from very early MS, potentially first line, all the way through to those with progressive forms of the disease."

7. The Debate About Hormone Replacement Therapy During Menopause in MS: Rhonda R. Voskuhl, MD

The director of the Multiple Sclerosis Program at UCLA discussed the need to consider HRT among women with MS going through menopause, and how HRT can improve its negative effects.

WATCH TIME: 4 minutes

“Of course, since MS affects women [in a ratio of] 3:1 over men, this is going to be on the minds of three-fourths of the MS population. So, a very interesting debate, and a very important one…. Menopause is bad for women with MS and is bad for even healthy women—by bad I mean they have cognitive symptoms, and in MS not just cognition, but also walking [issues] and other symptoms get worse. And it’s not just symptoms—I should make a caveat of that—it’s actually disability. So in addition to saying in questionnaires that their symptoms are getting worse, more than that, actually longitudinal exams have shown that their disability by objective test is getting worse at menopause."

8. Potential Avenues for Remyelination in Multiple Sclerosis: Bruce Bebo, PhD

The executive vice president of the National MS Society provided perspective on the challenges with remyelinating strategies for patients with MS, and the progress that’s been made thus far.

WATCH TIME: 4 minutes

"Early trials of promyelinating agents have shown that remyelination in humans is possible, I think the roadblock is demonstrating the clinical benefit of those approaches. There's a lot of work going on right now in determining what's the best timing for treatment, the best dose, best methodology for measuring myelin repair in humans."

9. Emerging Concepts in Multiple Sclerosis and Reversing Neurodegeneration: Daniel Ontaneda, MD

The program committee vice-chair of ACTRIMS discussed the continued efforts to understand inflammation and neurodegeneration of multiple sclerosis.

WATCH TIME: 3 minutes

"I’m not a basic scientist, but to me, it’s always exciting to see the very promising early investigations into MS. What’s beautiful about ACTRIMS is that it’s a single track, and the sessions are mixed between clinical and basic stuff. Many times you hear about scientists who are doing basic research, looking for new therapies, new pathways, that can target not only prevention of inflammation, but reversing injury that’s occurred."

10. The Phase 2 FUSION Trial of BTK Inhibitor BIIB091: Diana Gallagher, MD

The head of Biogen’s MS and Immunology Department Unit discussed FUSION, a new phase 2, 2-part study assessing the efficacy and safety of BIIB091, an investigational Bruton’s tyrosine kinase inhibitor

WATCH TIME: 3 minutes

"Based on our early SAD [single-ascending dose] and MAD [multiple-ascending dose] studies, we’re going to try to target a dose selection that will get us 90% [B cell] suppression on B cell activation."