Multiple sclerosis is a chronic disease

characterized by demyelination – damage caused by the immune system to myelin – the protective covering around nerve fibers. When myelin sheaths are damaged, the conduction of electrical impulses along the nerve cells is impaired, which negatively affects the functions of the nervous system. This disease is characterized by lesions in the brain and spinal cord. Symptoms include fatigue, vision problems, muscle weakness, stiffness, and spasms, as well as mobility impairments and pain. Relapsing-remitting multiple sclerosis is the most common course of the disease and is characterized by periods of new or worsening symptoms – relapses followed by periods of remission. The severity and frequency of relapses vary significantly between patients. Multiple sclerosis is the leading cause of non-traumatic disability. Extreme cases of the disease lead to significant mobility impairments and blindness.

Current therapy for multiple sclerosis focuses on preventing relapses and slowing disease progression. The treatment requires a long-lasting application and high expenditure on public resources.

Moreover, it leads to patients’ dependence on healthcare. The disease-modifying therapies will contribute to slowing down the disease progression and prevent relapses, but they cannot ensure restoration of neuronal damage and symptom management. Furthermore, the treatment requires a multidisciplinary approach and various social services, such as home help and transportation, which have a significant impact on maintaining an improved quality of life.

The innovative remyelinating therapy has the potential to repair the myelin sheath of neurons, which will contribute to improvement in visual impairments, cognitive function, and functional abilities. This therapeutic approach will ensure the restoration of myelin sheath by blocking inhibitors of remyelination. Moreover, it will increase the number of oligodendrocyte precursor cells that mature into oligodendrocytes which have the crucial function of producing myelin. The remyelinating therapy will provide clearing debris left over from myelin damage that inhibits myelin sheath repair. The purpose of this novel approach is to restore the functions of nerve cells and provide the formation of a new myelin sheath around axons. Furthermore, this therapy will reduce neurodegeneration in the central nervous system, preventing physical disability and cognitive impairment. Remyelinating therapies are being researched mainly as a part of combination and add-on therapies to reach an effective therapeutic response. The high therapeutic potential of this novel approach is being investigated by numerous clinical trials, of which 90% are currently in phases II and III.

Multiple sclerosis: What potential breakthrough are we awaiting?

Remyelinating therapy will restore physical capacity, vision, and cognitive functions. This approach will provide improvement in quality of life and reduction of emotional distress. The novel therapy will contribute to combat fatigue and improve physical capacity, which will offer numerous social as well as economic benefits. In this manner, remyelinating therapy will provide a therapeutic potential to reduce dependence on health care and enhance engagement in professional tasks.

How will this approach help the patients?

The innovative remyelinating therapy will decrease the burden on patients and their relatives, ensuring improved mobility, memory, concentration, vision, and fatigue alleviation. Depression, anxiety, and physical impairments are common complications of multiple sclerosis that lead to reduced capacity to engage in daily life and professional activities. Multiple sclerosis is a socially significant disease that requires long-lasting and lifelong multidisciplinary treatment, which leads to early physical disability and loss of autonomy. This novel therapy will contribute to improvement in quality of life and reduction of dependence on healthcare. The innovative approach will provide social and economic benefits by permitting active participation in professional activities and social interactions.

How many patients will be concerned?

The number of patients diagnosed with multiple sclerosis in the European Union is 750 thousand. In Bulgaria, the cases of multiple sclerosis are around 7 thousand. The disease is often diagnosed in patients in their 20s and 30s. Multiple sclerosis is an early-developing disease that impairs patients’ participation in daily life and professional activities. Remyelinating therapy will ensure the slowing down of the disease progression and restoration of functional capacity by repairing the integrity of the myelin sheath covering the neurons. There is a potential for restoring physical activity and providing numerous social and financial benefits, as more patients will be able to participate actively in daily life and professional activities.

What will be the potential impact on healthcare systems in Europe?

The application of remyelinating therapy could be realized in combination with current disease-modifying treatments. This approach will provide higher therapeutic efficacy and optimal symptom management. Thus, there will be more possibilities for better allocation of healthcare and public resources.

DISCLAIMER

The therapies described above are currently under development and are not available to patients neither in Europe, nor in Bulgaria.