Highlights of ECTRIMS 2013
Andrew N. Wilner, MD: Hello. I am Dr. Andrew Wilner, reporting from the 29th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in Copenhagen, Denmark. I am here today with Dr. Fred Lublin, Saunders Family Professor of Neurology at the Icahn School of Medicine of Mount Sinai in New York City and Director of the Corrine Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Medical Center, New York, New York. I am also here with Dr. Robert Fox, Associate Professor at the Cleveland Clinic Lerner College of Medicine and Staff Neurologist at the Mellen Center for Multiple Sclerosis, Cleveland Clinic, Cleveland, Ohio. Welcome, gentlemen. What presentations at this year's ECTRIMS meeting did you find most interesting?
Fred D. Lublin, MD: Walking over here, Bob and I were talking about the 2 themes that impressed us the most: progressive disease and the role of relapses.
Robert J. Fox, MD: There is an increasing focus on this unmet need. We approve therapies for MS, and they are all in the relapsing stage focus. We really don't have options for progressive MS. A lot of studies have looked at how to evaluate progressive MS and what biomarkers to use. Some potential therapies are still in trials and we are waiting for them to come out.
Radiologically Isolated Syndrome of MS
Dr. Fox: One area of progressive MS that we learned about was the radiologically isolated syndrome. These are patients who have an MRI of the brain done for other reasons, and they have lesions that look for all the world like MS, but they don't have symptoms of MS, and so we call that an "isolated syndrome of the MRI" or "radiologically isolated syndrome." We have known for quite a while that some of those patients go on to develop relapsing-remitting MS, and for the first time we heard about a small proportion of patients who go on to develop primary progressive MS.It is not a large proportion, but there are indeed some patients who have inflammation without any symptoms for years -- some up to 15 years -- and then they develop primary progressive MS. It really drives home that this disease probably starts long before patients first develop symptoms.
Dr. Lublin: One thing that came up from that study is the fact that patients with progressive MS can have a lot of disease in the brain.