That’s the storyline that’s unfolded in other diseases, such as when scientists discovered a mutated gene pattern among women who face a higher risk of developing breast and ovarian cancer. Testing for this gene now gives women and their physicians an opportunity to take proactive cancer prevention steps under certain circumstances.
“When we can predict why, when and how MS progresses over time, we’ll be in a strong position to develop highly targeted MS treatments, make better use of existing treatments and move closer to a cure that stops MS disease progression and restores function,” Dr. Weiner explains.
Breaking new ground
One point that sets the SUMMIT team apart is its long-term approach to the problem. This would be a significant step forward, says Dr. Hauser. “In the past, we’ve examined how MS progression behaves through clinical trials, and typically with only a two- or three-year window. But because meaningful changes in MS progression happen more slowly, we need a longer time frame to assess how our theories and therapies are working. We need studies like the SUMMIT to find those kinds of answers.”
A second distinguishing SUMMIT feature is its international perspective. “We’ve learned through other multinational trials that what happens in Eastern Europe may not necessarily happen in North America,” Dr. Hauser points out. “Genetic ancestry is different. People tend to take more medications in the Western world, so there could be interaction effects. People may have different levels of sun exposure, smoking histories and exposure to the Epstein-Barr virus. These are just some of the things that may influence the onset and behavior of progressive MS—and they’re all things we’re looking at. But before we can identify patterns, we have to know if our conclusions for patients in San Francisco are transportable to Amsterdam.”
Though SUMMIT is still in its infancy, Dr. Weiner believes that the study is on the right trajectory. During the initial two-year pilot study phase just completed, SUMMIT researchers established a seamless process to pool patient data across all four hospital centers. And with a trusted data sharing process in place, there may be opportunities to expand the SUMMIT, bringing other interested research groups into the study.
As for SUMMIT’s future, the team leaders are ready to move forward with a few clues they’ve already uncovered. So far, merged data indicates that certain changes in MRI scans, such as brain atrophy (shrinkage), may link to MS progression, although it’s too soon to say for certain. Specific MRI changes may also tie back to patterns of genetic inheritance.
“One thing people sometimes forget is that everyone who has MS, even at its earliest phases, faces the probability of disease progression, whether they have relapsing-remitting, primary-progressive, or other forms of MS,” notes National MS Society Chief Research Officer Dr. Timothy Coetzee. “Knowing what’s driving this is critical to stopping MS in its tracks,” he adds.
SUMMIT’s objectives address key aspects of the Society’s Strategic Response to MS, and also to priorities established by the International Progressive MS Collaborative. Now the SUMMIT team is working with Society leadership to develop a plan for the feasibility of sustaining this project on a long-term basis.
When asked to predict what the world will someday say about SUMMIT, Dr. Weiner is quick with a response: “I hope scientists say that the SUMMIT inspired them to develop better treatments that led us to a cure.”
Donna Shryer is a Chicago-based freelance writer with special interests in health, wellness and leading-edge medical developments.
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