New recommendations published this week in the MS Journal outline the first coordinated global research strategy to prevent multiple sclerosis (MS), a disease affecting more than three million people worldwide.
The report captures the outcomes of a landmark international workshop collaboratively led by MS Canada and MS Australia, which brought together more than 60 experts to define the next decade of MS prevention-focused research.
With treatments steadily improving and key risk factors now better understood, the path toward preventing MS is clearer than ever.
The new prevention initiative aligns with the existing Pathways to Cures Roadmap, which outlines research areas with the greatest potential to halt disease and prevent further damage, restore function and repair damage from the disease, and ultimately end MS by preventing disease from starting in the first place.
Historically, only six per cent of global MS research funding has been allocated to prevention efforts.
Dr. Pamela Valentine, President and CEO of MS Canada notes that there is strong evidence that many risk factors are modifiable and early intervention could significantly reduce future disease burden.
“Our goal is ambitious but key discoveries, new technology and momentum in the field give us an unprecedented opportunity. This initiative will advance our understanding of risk, help diagnose MS earlier and intervene sooner. The time to take on MS prevention is now,” Dr. Valentine said.
The report’s Lead Author and workshop Co-Chair, Professor Ruth Ann Marrie from Dalhousie University in Canada agrees.
“Recent scientific breakthroughs in understanding the disease and successes in preventing other autoimmune conditions now offer new hope that this is no longer an aspirational goal, but a realistic one,” Professor Marrie said.
The Global Prevention Workshop held earlier this year in Lisbon, Portugal, examined the biological processes that precede MS and identified potential opportunities for intervention well before symptoms appear.
Their recommendations call for a multi-pronged prevention strategy informed by an understanding of how MS evolves.
Professor Bruce Taylor, Menzies Institute for Medical Research, University of Tasmania and workshop Co-Chair, says the biological processes leading to MS begin many years before physical symptoms appear.
“There are genetic risk factors; environmental triggers that interact with these genes; and ultimately, the clinical onset of MS when symptoms appear.
“If we can understand these processes better, there is potential for earlier detection, and finding new ways to prevent, slow or stop MS,” Professor Taylor said.
Potential interventions to prevent MS can be grouped according to timing.
- Primordial Prevention: Preventing risk factors, such as childhood obesity or infectious mononucleosis, from occurring in the first place.
- Primary Prevention: Targeting existing, modifiable risk factors like low vitamin D or cigarette smoking to prevent disease onset.
- Secondary Prevention: Utilising new detection markers to identify MS in its earliest biological stages and stop its progression before clinical symptoms arise.
Experts have identified several environmental and lifestyle risk factors that can be modified, offering substantial potential for risk reduction.
Landmark research suggesting that Epstein-Barr virus (EBV) infection is necessary for MS development highlights a key area for intervention, potentially through new vaccines or antiviral drugs.
There is a major need to boost work to find and validate markers for early detection of MS, especially tests for changes in the immune system.
Achieving MS prevention will require global collaboration, investment in early detection technologies, and thoughtful engagement with the significant ethical considerations surrounding the identification of high-risk individuals.
MS Australia CEO, Rohan Greenland underlined the importance of cooperation and collaboration in ensuring the success of this global initiative.
“The workshop and the report emphasize the critical need to ensure this is a truly global effort.
“MS Australia looks forward, together with our partner, MS Canada, to lead efforts to build broad coalitions across public health agencies, research institutions, and patient advocacy groups to implement effective, affordable, and accessible interventions worldwide,” Mr. Greenland said.
