The New Year has started with high-profile announcements regarding the new drugs in the pipeline for MS. Several such developments were announced at the recent ECTRIMS and ACTRIMS (respectively: European and Americas Committee for Treatment and Research in MS) meetings.
In 2018 we look forward to following their progression through the various stages needed to show the efficacy and safety of new medicines. Many MS Drug watchers will know that such announcements do not always lead to a new drug being effective, safe or marketed in Europe, but it is good to know that the whole field of drug development for MS is alive and very active!
In MS, most of the new disease modifying drugs are focused on the early relapse – remitting stages of MS and their effectiveness is generally measured as the number of relapses experienced in a group of patients treated with the active drug compared with those experienced in a control placebo treated group. This research structure is called a randomised controlled trial. Success or failure of a drug treatment is expressed by determining whether there are more frequent positive results in the active drug treated group than in the placebo treated group.
Once these trials have been completed, and the effectiveness and safety of a drug is established, regional regulatory agencies working in different healthcare systems will determine how useful a given drug might be compared with other drugs currently in use to treat the same condition. Such agencies will also compare the cost of treating patients with one drug compared with another and will evaluate the safety of one drug compared with another to make sure that any treatment that is approved by an agency is as cost effective and safe as possible. Obviously, all these stages take time and effort and often involve considerable discussion between doctors who treat specific conditions, pharmaceutical industries that develop the drugs and the region’s regulatory agencies. In the UK, drugs are currently evaluated by a Europe-wide regulatory agency. However, because a variety of healthcare structures exist across Europe each country in the EU may adopt a different approach to the introduction and use of new drugs in their healthcare system. In the UK for example, NICE (National Institute for Clinical Excellence) is generally the final decision point for the use of specific drugs in the UK. It is important therefore that when reading press reports about a “new wonder drug” for any condition we bear in mind that access to all the possible treatments for a given condition may not be available locally.
Organizations like MS Research Treatment and Education have the opportunity, some might say the obligation to campaign for the widest possible use of all proven and safe treatments in the UK. However, decisions regarding the use of the newer drugs constantly emerging in MS are complex and should ideally be made by highly experienced medical specialists who are up to date with the huge volume of information available to them. It all takes time, effort and careful thought. If you have the impression that we hear a lot about wonderful new drugs but never seem to be able to be able to access them, bear in mind that “it’s just not that simple”!
Over the year we will try and bring you news regarding new and established treatments for MS, and where they stand in the “bigger picture”.