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The European Committee for Treatment and Research in MS (ECTRIMS)

Nicola Russell
Director of Services, MS Trust

Way Ahead 2007;11(1):7

The annual meeting of ECTRIMS took place in the last week of September 2006 and saw many of the leading MS experts from across the world meet to discuss the current state of research and treatment. This meeting does not cover rehabilitation. It is difficult to summarise a three-day meeting in a few words but the following topics were certainly under discussion:

  • It seems as though the incidence of MS is increasing in women but not men. Further research is underway to support this hypothesis. [Orton SM, Herrera BM, Yee IM, et al. Sex ratio of multiple sclerosis in Canada: a longitudinal study. Lancet Neurol 2006; 5(11): 932-6.]

  • The increasing incidence of MS in children, with possibly 3 - 5 % of the total population of people with MS now under the age of 16.

  • Steroid therapy for relapse management should ideally be started within seven days.

  • The role of inflammation and chronic demyelination is still confused, but it is now definite that damage to nerves can start early in the disease process even if clinically the person appears well. Decisions around drug therapy therefore need to be considered sooner rather than later.

  • Damage within a lesion seems to be ongoing, not a one off event.

  • Natalizumab usage has now started in Europe and the USA, and the consensus is that providing patients are selected carefully and monitored closely the clinical benefits of this drug outweigh the risks.

  • Fingolimod (FTY720) data was presented. This is a new oral drug, which has just completed its early phase II studies. Larger phase III studies are starting and hope to replicate the promising early results. Even if all goes well it would seem unlikely that this product would be licensed before 2010.

  • Other new drugs under investigation include: Cladribine, Laquinimod, Teriflunomide, and two as yet unnamed compounds CDP323 and SB683699.

  • Cannabis remains under investigation for both symptomatic relief and neuroprotection.

The good news from ECTRIMS is that lots of research is ongoing with a variety of different agents. The risk is that in the UK we are getting a second-class service compared with other parts of the world due to our low number of neurologists and completely inadequate budgets.

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