Understanding the past so that we strive for an even better future in MS care

The impact on quality of life that multiple sclerosis (MS) has on the more than 2.8 million people affected by this progressive disease is often spoken about, but not truly understood by those who do not live with this condition.

For most, they are diagnosed as young adults, a critical time for building careers, starting families, and understanding what priorities in life are most important. Many lose their jobs as the disease progresses due to physical and neurological impairments.? It’s not uncommon for people with MS to need wheelchairs, mobility aids and caregivers just to meet their daily needs.

Thankfully, huge progress has been made across the care landscape in the last decades, from improved diagnosis to better management options, accessibility of care and increased awareness of patient needs. At this year’s ECTRIMS, we at Roche are particularly pleased to see how far we have come in our understanding of MS through the presentation of 10-year milestone data, new formulations and potential treatment targets. Looking back at the important steps taken forward is a useful tool in seeing where we still need to go in improving daily life for those with MS – a key focus area for us.?

Redefining our understanding of MS

A lack of understanding of the biology of this progressive disease and its devastating impact on the body, meant treatment options were limited for decades. In the 1990’s, as the scientific and medical communities’ understanding of this disease increased, so did treatment options. As the first treatments became available, they gave some hope to people with MS, particularly those with relapsing forms of MS (RMS). But for those living with primary progressive MS (PPMS), no disease-modifying medicines were available.

Yet, with an increasing knowledge of the disease came the opportunity to discover more. Historically, T cells were believed to be the underlying cause of MS. However, growing evidence suggested a role for B cells . Dr. Stephen Hauser, then Chair of the Department of Neurology at the University of California, San Francisco (UCSF) and current Director of the UCSF Weill Institute for Neurosciences, began discussions to test B-cell depletion in MS in the early 2000s.

With a culture of continuous innovation, Genentech, a member of the Roche group, answered the call and supported Dr. Hauser’s Phase 2 studies in RMS and PPMS to test this hypothesis thoroughly. Insights from these studies showed that Dr. Hauser was on to something, and we’ve been committed to tackling MS ever since. It’s exciting to have 10 years of long-term data from the pivotal studies that show the impact that this approach has on disability progression, enabling people with RMS and PPMS to live more independently, often without the need for a wheelchair or walking aid.

Leading the expansion of innovative therapies

We’ve experienced tremendous expansion in the use of innovative therapies in recent years. We have a clearer understanding of the needs of people living with MS, coupled with tailoring our approach to people’s personal needs. New routes of administration help people with MS adhere to their treatment plans to suit their lifestyle, rather than changing the way they live.This includes vital progress over the last decade in understanding the efficacy and safety of MS treatments across new and diverse populations. For example, MS is first likely to appear in women at an age when they may be thinking about starting a family. Understanding how both their MS and medication may impact pregnancy and being a parent are important considerations to make a decision that is right for them.

In addition, Black and Hispanic people with MS have a greater disease severity, faster disease progression and greater risk of disability. Research is needed to understand underlying biological explanations while efforts also need to focus on addressing health inequality amongst these groups, including being underdiagnosed and undertreated, as well as being vastly underrepresented in clinical trials.

In the last ten years alone, we’ve seen a tremendous transformation of the care landscape, helping people maintain their independence and continue to do the things that they love most, without fear that their treatment plan may get in the way.

Roche is committed to making a difference for all communities affected by MS and is actively advancing clinical trials in these patient populations.?

Striving for even more progress

When looking back to the ‘90s when MS treatment was so limited, it is remarkable to see how far treatment? has come for people living with this MS, slowing disease progression and minimising the impact of disability.

At Roche, we are incredibly proud to play a leading role in the journey, while recognising that it is one that is far from over.

There is still a need for innovation, notably in preventing disease progression with novel approaches, and this research needs to be supported by strong foundations of inclusivity and access to achieve better outcomes for all people with MS. We’re committed to further innovative research on new disease targets and collaborations to achieve this, and, on a personal note, I’m looking forward to looking back in another 20 years to see how much more we have achieved together with the MS community.