Research
Eight questions organise everything we know about treating and understanding MS. Each frontier gathers the trials, results and hypotheses that bear on it, and says plainly where it stands.
Frontier 1
What starts MS
Why does MS begin, and can it be prevented?
- What it is: Why MS starts: Epstein-Barr virus, genes, smoking, low vitamin D and adolescent obesity.
- What we know: Almost everyone with MS has had the virus, but most people who catch it never get MS.
- What results say: Treating people with scan changes before symptoms delayed a first attack in two trials.
- Still unknown: Whether vaccines against the virus, now in early trials, can prevent MS.
12 hypotheses · 1 trials recruiting
Frontier 2
Stopping inflammation
How well can relapses and new lesions be stopped?
- What it is: Stopping the immune cells that enter the brain and spinal cord and cause relapses and new lesions.
- What we know: This is where treatment has advanced most.
- What results say: Several medicines prevent most relapses in many people.
- Still unknown: Long-term safety, cost, how long to treat and whether early strong treatment changes the long-term course.
132 hypotheses · 32 trials recruiting
Frontier 3
Why MS progresses
What drives worsening without relapses, and what slows it?
- What it is: Disability that worsens even without relapses, the main cause of long-term disability.
- What we know: Most medicines that stop relapses do little against progression.
- What results say: Only a few medicines have slowed progression in trials.
- Still unknown: Which driver matters most: trapped inflammation, energy-starved nerve fibres or repair that fails with age.
198 hypotheses · 34 trials recruiting
Frontier 4
Repair and protection
Can lost myelin be rebuilt and nerve fibres protected?
- What it is: Rebuilding lost myelin and protecting nerve fibres from dying.
- What we know: The brain can repair myelin, but in MS the repair often stalls.
- What results say: Early trials show repair can be measured in people.
- Still unknown: No treatment has yet shown a lasting gain in everyday function.
109 hypotheses · 17 trials recruiting
Frontier 5
Symptoms and everyday function
Which treatments make daily life with MS better?
- What it is: Much of what people with MS live with each day is symptoms: fatigue, walking difficulty, stiffness, pain, bladder problems, and changes in thinking and mood.
- What is tested: Treating them improves daily life now, whatever the course of the disease. Trials test medicines, rehabilitation, exercise, devices and psychological therapies.
- What results say: Some treatments have clear evidence, such as fampridine for walking speed in some people and exercise for fatigue and fitness. For many symptoms the trials are small and the effects modest or uncertain.
82 hypotheses · 153 trials recruiting
Frontier 6
Resetting the immune system
Can the immune system be rebuilt so the disease stops?
- What it is: Removing much of the immune system once and letting it grow back, instead of lifelong suppression.
- What we know: A regrown immune system that no longer attacks could stop the disease without ongoing treatment.
- What results say: Stem-cell transplants can halt inflammatory MS for years in some people.
- Still unknown: Whether CAR-T cells and tolerance therapies, now in early trials, work and are safe.
13 hypotheses · 4 trials recruiting
Frontier 7
Measuring MS
Which measures show what matters, early enough to test treatments?
- What it is: The measures every trial depends on: relapses, MRI, disability scores and blood markers.
- What we know: Better measures make trials faster and fairer.
- What results say: Blood neurofilament light and new MRI signs of smouldering inflammation are being tested.
- Still unknown: Whether a change on a scan or blood test means anything to the person.
Biomarker and imaging measures · 115 trials recruiting
Frontier 8
Related diseases: NMOSD and MOGAD
What works in the related antibody diseases?
- What it is: NMOSD and MOGAD: separate diseases that can look like MS, usually driven by a known antibody.
- What we know: Some MS medicines can make NMOSD worse.
- What results say: Several medicines now prevent attacks in NMOSD.
- Still unknown: Which treatments work in MOGAD remains unknown. Trials are under way.
38 hypotheses · 13 trials recruiting
Across the questions
Running trials whose results could change what is known.
What has failed or given mixed results, and what that taught.
Hypotheses that have not reached trials in people yet.
What artificial intelligence is being used for in MS research, and what it has and has not shown.
Assembled by software from public sources and not checked by people. Each record links to its source. Report an error