October 25, 2024 | News | Living with MS MS Research MS Symptoms MS Treatments

New research presented at MS congress: ECTRIMS 2024

Part 1

Every year, about 10,000 multiple sclerosis researchers and doctors gather at the European Committee for Treatment and Research in MS (ECTRIMS) annual meeting. ECTRIMS 2024 was held in Copenhagen, Denmark. The following is a sampling of some of the key findings in this year’s wealth of MS research.

Changes in how MS is diagnosed: The MS diagnostic criteria (called the McDonald criteria) have been broadened to enable a more rapid diagnosis (Montalban and colleagues. ECTRIMS 2024;Scientific session 1). A key change affects radiologically isolated syndrome (RIS). RIS may be an early indicator of MS. It is identified when someone happens to get an MRI (e.g. for migraine or head trauma), and MS-like lesions are spotted on the scan (but the person has no MS symptoms). Now, RIS will be considered to be actual MS if the lesions are seen in different parts of the brain or spinal cord, the lesions have a certain appearance, and the lumbar puncture is positive. Whether RIS should be treated (and whether insurers will cover the cost of drugs for RIS/MS) is controversial.

Risk of MS in family members: The Risk Factors in Early MS (RISEMS) study obtained MRIs from younger people (average age 23 years) who had a close family member (parent or sibling) with MS (Alvarez and colleagues. ECTRIMS 2024;O003). About 15% had MRIs suggestive of MS. Over the next two years, one person was diagnosed with MS. (Curiously, most people in the study – 57% – had some kind of abnormality on their MRI.)

Mononucleosis as a risk factor for MS: ‘Mono’ is caused by the Epstein-Barr virus (EBV), although few people who contract EBV develop a full-blown infection. A Danish study reported that among people who were hospitalized for mononucleosis, the risk of subsequently developing MS was three times higher compared to people who didn’t get mono. The risk of developing MS was highest for people who developed mononucleosis during adolescence.

Treatment reduces MS fatigue: Two studies reported that MS fatigue improved for people during treatment with Ocrevus or Kesimpta (Penner and colleagues. ECTRIMS 2024;P042. Ramirez and colleagues. ECTRIMS 2024;P1774). The cause(s) of MS fatigue are not known. Fatigue may be reduced because of improved physical functioning or a reduction in inflammatory lesions in the brain/spinal cord with treatment.

Scaling down MS treatment: A database analysis looked at what happened when people switched from a more effective MS medication (e.g. Tysabri, Ocrevus, Kesimpta) to a less potent alternative (an oral or injectable) (Muller and colleagues. ECTRIMS 2024;O110). Overall, people who scaled down treatment were twice as likely to have relapses or worsening disability. However, the median age of people was only 40 years, which was young for this kind of study. In the subgroup aged 50 years or older, there was no additional risk when treatment was stepped down.

Migraine and MS: An estimated 12% of people with MS also suffer from migraines – with migraines occurring first in most cases (Skuljec and colleagues. ECTRIMS 2024;P614). Some MS medications (Tecfidera, Mavenclad, Tysabri, Ocrevus) may reduce the frequency and/or severity of migraine (Mandel and colleagues. ECTRIMS 2024;P1316). Some medications (e.g. Gilenya) may worsen migraine.

In part 2 of our ECTRIMS update we will look at new treatments in development for MS.

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