The Multiple Sclerosis (MS) Node conducts cutting-edge translational and clinical research with the aim to improve early diagnosis, treatment, and quality of life of individuals with MS. The MS Node has a longstanding and internationally acknowledged research experience spanning from basic immunopathological characterisation of the disease and preclinical animal studies to studies on epidemiology, clinical course, imaging, treatment trials, health economy and patient reported outcome measures.
Node leader: Kjell-Morten Myhr
Myhr is a senior consultant and professor of neurology and has since 2001 chaired the Bergen Multiple Sclerosis (MS) Research Group at Haukeland University Hospital and the University of Bergen. He has previously chaired the Norwegian MS Competence Centre, the Norwegian MS registry and the first KG Jebsen Centre for Medical Research (in MS) and is currently the director of Neuro-SysMed.
MS therapy, aiming at optimising the treatment of relapsing-remitting MS, with early high efficacy therapies and stem cell therapy in patients with breakthrough disease activity. The node is also focusing on the treatment of progressive MS, as well as symptomatic therapy of pain and spasticity, and most recently searching for novel antiviral treatment targets for treatment and disease prevention.
Node activities
The MS Node has broad experience focusing on various topics related to diagnosis and treatment of the disease. Ongoing research projects are aiming at defining the importance of potential risk factors as well biomarkers for prognosis and treatment response to optimise treatment strategies at different disease stages. Overall, the aim is to develop tailored treatment strategies for patients with MS. Major challenges are thus how to improve the use of already available disease modifying therapies, and how to define new disease pathways that can be targeted by novel treatments. The latter is especially needed for the progressive disease courses in MS. Most recently, we are also developing novel treatment strategies for possible prevention of the disease. The MS Node is currently running twelve investigator and nine industry sponsored clinical trials.
Investigator sponsored clinical trials:
- he RAM-MS study evaluates the safety and efficacy of autologous hematopoietic stem cell transplantation compared to high-efficacy disease-modifying therapies in relapsing disease activity.
- The OVERLORD-MS study is a non-inferiority study evaluating and comparing the efficacy and safety of rituximab (500 mg) and ocrelizumab (600 mg) in newly diagnosed relapsing remitting MS patients.
- The ocrelizumab to rituximab switch study is an observational study evaluating the efficacy and safety of switching therapy from ocrelizumab (600 mg) to rituximab (500 mg) after 30 months of therapy. This is an extension of the OVERLORD-MS study.
- REDUCE-MS is an observational study investigating extended dosing interval of rituximab therapy. Patients that have been stable on standard 6-months dosing intervals of rituximab for 36 months (during the OVERLORD-MS study) will extend the dosing interval to 12 months for further 24 months.
- The COVID-19 vaccine response study evaluates the impact of various disease-modifying therapies on the vaccination response in MS patients, and in addition evaluate the clinical efficacy of vaccination.
- The SMART-MS study is a placebo-controlled, crossover pilot study evaluating regenerative effects from mesenchymal autologous stem cells in progressive MS.
- NORSEMAN-MS is a placebo-controlled add of nicotinamide riboside (NR) to standard care in progressive multiple sclerosis, evaluating effects on disability progression defined by the Expanded Disability Status Score (EDSS), the Nine-Hole-Peg test (9-HPT) or Timed 25 Foot Walking (T25FW).
- The rituximab versus cladribin study is a prospective registry-based observational study, comparing the efficacy of the therapies among previous untreated patients and those that switch from previous therapies due to treatment failure or side effects.
- TAF-MS 0 is a six-month observational study to evaluate Epstein-Barr virus (EBV) shedding in the saliva of patients receiving natalizumab, rituximab or
cladribine for relapsing-remitting MS. - TAF-MS 1 is a placebo-controlled add-on proof-of-concept study of tenofovir alafenamide fumarate (TAF) to standard natalizumab infusion therapy. Stable natalizumab treated RRMS patients will receive oral placebo or 25 mg of TAF for six months.
- A digital therapeutic to improve Insomnia in multiple sclerosis is a randomised controlled trial to evaluate the efficacy and safety of cognitive behavioural therapy for insomnia in multiple sclerosis.
- The 3TR – Taxonomi, Treatment, Target and Remisson – study is an international EU-funded observational study to define treatment response biomarkers for different immune mediated diseases.
The MS Node also serves as the national coordinator for five industry-sponsored multicentre randomised clinical trials in both relapsing-remitting and progressive disease. In addition, they are the national coordinator in one extension study and another five safety studies sponsored by the industry. In addition, the MS Node is currently immune phenotyping stem cells and immune cells from patients included in the ongoing clinical trials, aiming at identifying biomarkers for tailored dosing or patient selection for the different therapies. They also perform preclinical animal studies to evaluate possible disease pathways of progressive MS and regenerative potentials of stem cell therapy. They also evaluate treatment responses by neurofilament biomarkers in both spinal fluid and serum. In collaboration with the Mohn Medical Imaging and Visualization Centre at Haukeland University Hospital, they evaluate treatment responses by magnetic resonance imaging (MRI).
The MS Node is also running projects for optimising treatment switches if treatment fails, as well as safety studies of therapy during breastfeeding. Further, the node has ongoing studies aiming at identifying modifiable risk factors for the disease that may influence disease progression, or even risk of side effects from therapies. This includes studies of comorbidity, with special focus on cancer, as well as registry projects analysing real world data on treatment compliance and factors influencing discontinuation rates for ongoing therapies.