Real-world study of MS treatments for ongoing inflammation

Multiple sclerosis (MS) is a disease that affects the brain and spinal cord. It often starts in young adults and can cause problems with movement, thinking, and independence. While there are effective treatments that reduce sudden flare-ups (relapses), these medicines don’t always stop the slow, ongoing inflammation in the brain that continues to cause damage over time. This type of inflammation, called “smouldering inflammation,” is harder to see but plays a major role in long-term disability.

This study will look at how well three commonly used MS treatments – ocrelizumab, fingolimod, and natalizumab – work to reduce smouldering inflammation in real-life clinical settings. To do this, Professor Alexander Klistorner and his team will use a new MRI-based measure called Chronic Lesion Tissue Expansion (CLTE), which tracks how slowly damaged areas in the brain grow over time. CLTE is a sensitive way to measure the hidden damage that continues even when people are not having relapses.

The team will use data from the MSBase Registry and Imaging Repository, which includes brain scans and medical information from thousands of people with MS. By comparing MRI scans before and after someone changes treatment, it will be possible to see whether these therapies slow down the hidden damage in the brain. This method helps us compare treatments more accurately, because each person serves as their own comparison.

The study was designed together with people living with MS, many who have expressed that stopping this hidden, slow progression is their top priority. Results from the study will help shape future research and treatment strategies to better protect people from long-term disability.