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EAN 2026 | Detecting and disrupting disability accumulation in MS: a session at EAN 2026

Celia Oreja-Guevara, MD, PhD, University Hospital San Carlos, Madrid, Spain, shares insights from a session at EAN 2026 on detecting and disrupting disability accumulation in multiple sclerosis (MS). Although advances in anti-inflammatory therapies have significantly improved disease management, Dr Oreja-Guevara explains that many patients continue to experience disability progression. She discusses the need for next-generation treatments that target microglial activation, with the aim of slowing or preventing progression. This interview took place at the 12th Congress of the European Academy of Neurology (EAN) in Geneva, Switzerland.

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Transcript

I was chairing a session about progression in multiple sclerosis and that is really very important because we have now a lot of anti-inflammatory drugs, around 20, and we can always control very well the relapse rate and we can control very good the activity in MRI. But the problem is still that the patients, despite that we have these good anti-inflammatory treatments, they are still progressing...

I was chairing a session about progression in multiple sclerosis and that is really very important because we have now a lot of anti-inflammatory drugs, around 20, and we can always control very well the relapse rate and we can control very good the activity in MRI. But the problem is still that the patients, despite that we have these good anti-inflammatory treatments, they are still progressing. And this is the progression that we know is completely independent of the relapses. So we have realized that now our goal for the treatment is to try to stop the progression or at least to try to reduce the progression in these patients because this progression is reducing the quality of life of our patients. So we have realized now, we have spoken in the symposia that the microglia is the most important player acting in the progression, so when there is activated microglia, the patients have a slow progression. That’s what we say, silent disease. And they are still having symptoms. And these symptoms are slow. And that is, for example, fatigue, cognitive alterations, so problems with walking. And all these symptoms, they are always slowly worsening and worsening without any reason, without any inflammation. So now our objective is to target the microglia, and now we will have new treatments, and these new treatments are the inhibitors of the BTK, and these inhibitors of the BTK, they will target the microglia, and we can try to stop or at least to reduce the progression of the disease and that will be an improvement, so that the objective will be to have an improvement of the quality of life of the patients.

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