Multiple Sclerosis, Complications and Therapeutics 2.0

Dear Colleagues,

The World Health Organization (WHO) estimates that over 2.5 million people globally suffer from MS. With the present global population growing to an unprecedented height of 6.5 billion in 2005 and anticipated to reach 7.6 billion by 2020, the prevalence and onset of MS in children and particularly adults is expected to rise exponentially. It is estimated that approximately 400,000 people suffer from MS in the US, with 500,000 Europeans and 18,000 Australians also suffering the disease. There are different subtypes of the disease characterized by increasing severity; benign MS, relapse/remitting MS (RRMS), secondary progressive MS (SPMS) and primary progressive MS (PPMS). According to the international Federation of MS Societies, the estimated breakdown of the four types of MS described above is as follows: benign MS (20%), RRMS (25%), SPMS (40%) and PPMS (15%).

The MS market is expected to more than double in value across the major markets from 2006 to reach $10.7 billion in 2019 and is one of the fastest growing CNS therapy areas. One of the drivers behind this growth is the uptake of specific drugs in interferon naïve patients. Despite the market’s growth the MS market is relatively immature with only 5 products specifically indicated for the disease.

The MS specific therapies that are currently on the market include

• Schering AG’s Betaferon/Betaseron (interferon beta-1b)
• Biogen’s Avonex (interferon beta-1a)
• Teva’s Copaxone (glatiramer acetate)
• Serono/Pfizer’s Rebif (interferon beta-1a)
• Amgen/Serono’s Novantrone (mitoxantrone)

The current drugs available are extremely expensive costing up to $17,000 depending on the country. Due to the limited affordable treatment options, there is no effective therapy able to stop progression of disease (beta interferon-1a approved for delaying progression of MS) there is a very high unmet need in the MS market particularly in the following areas:

• Altering / stopping disease progression
• Inducing and maintaining remission
• Improved drug delivery methods
• Cheaper drugs / therapies

For improved MS treatments it is relatively weak as compared to other CNS disorders, although there are a number of different drug classes in development including;

• Monoclonal Antibodies - to block destructive immune cells entering brain and spinal cord
• Immunosuppressant’s - suppress immune system and prevent myelin damage
• Potassium channel blockers - improve the conduction of demyelinated fibers
• Protein growth factors - to limit demyelination and oligodendrocyte injury
• Immunotherapy / Vaccines - to switch immune response to protect neurons and prevent demyelination

This special issue is now open and is seeking research papers and reviews on MS therapeutics from animal models to human clinical studies, and MS complications and side effects of certain therapeutics.

Prof. Dr. Vasso Apostolopoulos
Dr. Narges Dargahi
Dr. Jack Feehan
Guest Editors

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