Stefan Bittner, MD, Johannes Gutenberg-University, Mainz, Germany, shares his thoughts on the major topics in clinical neuroimmunology that are driving progress in disease treatment and management. The role of smoldering inflammation is a key focus, suggested to be the primary driver of disease progression in multiple sclerosis (MS). Numerous studies have demonstrated the presence of progression independent of relapse activity, suggesting that aiming for relapse prevention and ‘no evidence of inflammatory disease activity’ is not sufficient to prevent disability accumulation in MS. Ongoing work is aiming to characterize the true significance of smoldering pathology and how it can be addressed therapeutically. Optimal management of MS in pregnancy and the ‘early and aggressive’ treatment approach are also major talking points. This interview took place at the European Academy of Neurology (EAN) 2022 Congress in Vienna, Austria.
Prof. Bittner received honoria and compensation for travel expenses from Biogen, Bristol Myers Squibb, Novartis, Merck Serono, Roche, Sanofi Genzyme and TEVA. His research is funded by Deutsche Forschungsgemeinschaft (DFG), Hertie Foundation and Hermann- and Lilly-Schilling Foundation.