Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Page 12 Page 13 Page 14 Page 15 Page 16 Page 17 Page 18 Page 19 Page 20 Page 21 Page 22 Page 23 Page 24 Page 25 Page 26 Page 27 Page 28 Page 29 Page 30 Page 31 Page 32 Page 33 Page 34 Page 35 Page 36 Page 37 Page 38 Page 39 Page 40 Page 41 Page 42 Page 43 Page 44 Page 45 Page 46 Page 47 Page 48 Page 49 Page 50 Page 51 Page 52 Page 53 Page 54 Page 55 Page 56 Page 57 Page 58 Page 59 Page 60 Page 61 Page 62 Page 63 Page 64 Page 65 Page 66 Page 67 Page 6852 msfocusmagazine.org Medicine & Research Updates on Progressive MS: Notes from ACTRIMS 2016 Daniel Kantor, MD, FAAN Although there is still no cure for MS, there have been amazing advances in the treatment of relapsing MS during the past two decades. This backdrop of successful research has paved the way for a better understanding and focus on another form of MS – progressive MS. Becauseofthehigh,unmetneedforprogressive MS therapies and the ever-increasing under- standing of the biological foundation of progressive MS, the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) held its first stand-alone scientific/ medical meeting, Forum 2016 – Progressive MS: Bench to Bedside and Back. Major themes from the meeting: • How progressive MS is similar to relapsing MS • How progressive MS is different • What we can learn from the successes in relapsing MS research to help find a true treatment for progressive MS. How is the immune system involved in progressive MS? In general, we think of MS as an auto- immune diagnosis, meaning that instead of the body's defense force – the immune system What are the types of MS? Most people with MS start out with a relapsing course of MS, RMS, in which they periodically experience relapses (also called exacerbations or flare-ups) and disability is developed over time. Many people who started out with RMS later reached a point where they would develop disability even between relapses. This has been known as secondary-progressive MS or SPMS. However, the likelihood of this happening seems to be diminishing with the use of disease-modifying therapies. While RMS is the most common initial diagnosis, nearly 15 percent of people with MS start out with an accumulation of disability from the onset. This is known as primary- progressive MS, or PPMS. It is worth noting that some neurologists don't like to separate MS into different subtypes because, to a certain extent, all patients may have a mix of relapses and progression of disability. However, for the purposes of this article, we will discuss PPMS as it relates to treatment.