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New heights for progressive MS research

The Serial Unified Multicenter MS InvesTigation (SUMMIT) study is generating excitement in its quest to unravel the mystery of MS progression.

by Donna Shryer

Why do some people experience aggressive worsening of their multiple sclerosis and others experience a mild course? Right now, no one knows the answer to this critical question. In its quest to unravel the mystery of MS progression, the Serial Unified Multicenter MS InvesTigation (SUMMIT) is generating much excitement. This international consortium, a special initiative launched by the National MS Society, began in 2010 and, as its moniker suggests, aims to propel MS research to new heights.

The SUMMIT involves a tightly coordinated international team of researchers working at four leading MS centers located in Boston; San Francisco; Basel, Switzerland; and Amsterdam. Collectively, the consortium is following 1,500 people with MS. The goal is to distinguish what causes the disease to progress more rapidly in some people versus others. To answer this question, the team is looking at potential risk factors or disease triggers as well as biological indicators (biomarkers) that can help predict progression or point to a biological pathway that’s driving it.

Scientists need to understand these still-unknown disease mechanisms in order to lay a foundation for discovery and development of new therapies that can slow, halt, reverse and perhaps someday even prevent degenerating progressive attacks on the central nervous system.

This work addresses an urgent need in the field of MS research. Virtually every disease-modifying therapy approved for relapsing-remitting MS—which is characterized by periodic exacerbations of symptoms, followed by partial or complete recovery—has been tried, or is currently undergoing clinical trials, for MS progression. Unfortunately the results so far indicate that they aren’t effective in people who do not experience relapses.

“The big unanswered question is why MS sometimes progresses and sometimes does not. We’re going to find those answers, and it will mark an important step toward understanding how to approach a cure,” says SUMMIT consortium leader Dr. Howard L. Weiner (Harvard Medical School), an expert on MS research and clinical care, and recipient of the 2007 National MS Society/American Academy of Neurology’s John Dystel Prize for MS Research.

Joining Dr. Weiner in the SUMMIT consortium are three global leaders in MS clinical research: Dr. Stephen Hauser (University of California, San Francisco), an MS genetics expert and also a Dystel prizewinner; and MS clinical trials experts Drs. Ludwig Kappos (University Hospital, Basel, Switzerland) and Chris Polman (VU University Medical Center, Amsterdam).

At all four centers, the researchers are collecting data from patient examinations, MRI scans, blood tests, genetic analyses and other epidemiological reviews from the participants, and compiling them into one standardized data set to identify factors that may affect disease progression. Suspected factors that may affect disease progression include family history, smoking, sun exposure, and gender hormones.

The SUMMIT consortium marks the first joint study between worldwide centers funded by the Society. The study targets MS progression and the factors associated with it. With all the data merged into one central location, great minds from these and other research centers can coordinate their efforts—and perhaps quicken the process—to isolate prognostic factors that define MS progression patterns.

Patterned for success
SUMMIT leaders expect that in time, patterns will emerge. Any one factor—or a combination of biological, environmental and lifestyle factors—may unite people whose MS progresses, and differentiate them from those whose MS does not progress. With that information, scientists might have new leads on developing more effective treatments for MS progression. And physicians might one day be able to proactively begin treatment of those predisposed to MS progression.