The ECTRIMS Podcast

Can clinicians identify MS progression as it happens, or does confirming meaningful disability worsening require months of observation?
Early recognition of multiple sclerosis (MS) progression is critical to informing clinical decisions. Yet distinguishing genuine disease progression from temporary fluctuations remains one of the challenges in routine MS care.
In this episode of the ECTRIMS Podcast, produced in collaboration with the Multiple Sclerosis Journal, host Associate Professor Anneke van der Walt is joined by Professor Helmut Butzkueven (Monash University, Australia) and Professor Tjalf Ziemssen (University Hospital Dresden, Germany) to explore both sides of a timely clinical controversy: Can we detect a progression event in an MS clinic in real time?
Drawing on opposing perspectives published in the Multiple Sclerosis Journal, the discussion examines the value and limitations of disability assessments, longitudinal patient registries, digital monitoring tools and patient-reported changes.
Can routinely collected clinical data help clinicians recognise progression earlier? How reliable are current measures such as the Expanded Disability Status Scale (EDSS)? And what can clinicians do to identify meaningful change when consultation time and resources are limited?
The conversation highlights the importance of balancing early recognition with diagnostic certainty, while keeping the patient's lived experience central to clinical assessment.
Read the accompanying publications in the Multiple Sclerosis Journal:
YES – Can we detect a progression event in an MS clinic in real time? https://journals.sagepub.com/doi/full/10.1177/13524585251409568
NO – Can we detect a progression event in an MS clinic in real time?https://journals.sagepub.com/doi/full/10.1177/13524585251409547
Accompanying commentary https://journals.sagepub.com/doi/full/10.1177/13524585251409579
This ECTRIMS podcast episode is supported by an educational grant from Alexion, AstraZeneca Rare Diseases. Bristol Myers Squibb, Novartis, Roche, Sanofi, and UCB. Educational grant providers have no input into the podcast series content.

Prof. Sandra Vukusic has been named the 2026 recipient of the Rachel Horne Prize for Women's Research in MS.
In this special episode of the ECTRIMS Podcast, Sandra joins prize founder Rachel Horne and host Brett Drummond to mark the announcement and explore the research behind the recognition.
Sandra reflects on a career dedicated to improving the health and care of women living with multiple sclerosis, beginning with early research into pregnancy and postpartum relapse and evolving to encompass family planning, disease-modifying treatment, breastfeeding, menopause and wider aspects of women's health.
The conversation explores important evidence that women living with MS may be undertreated compared with men, including the potential influence of anticipated pregnancy on treatment decisions. Sandra also discusses how advances in research are helping women living with MS make choices about treatment and family life that were once considered impossible.
Rachel shares why she established the Rachel Horne Prize, the persistent gaps she saw in research addressing women's health in MS, and her hope that one day women's health will simply be an integral part of MS research and care.
A special conversation celebrating scientific achievement, progress — and the work still to come.

What if clinical trials could evaluate multiple treatment approaches at the same time and adapt as evidence emerges?
In this episode of the ECTRIMS Podcast, host Brett Drummond speaks with Prof. Jeremy Chataway of University College London and Prof. Daniel Ontaneda of Cleveland Clinic about multi-arm, multi-stage clinical trials and their potential to make MS research more efficient and responsive.
The episode comes at an especially timely moment. This week, interim results from the OCTOPUS trial showed that alpha-lipoic acid will progress to the next stage of the trial, while the metformin arm will be stopped. These results provide an early demonstration of the adaptive approach discussed in this episode — although the conversation itself was recorded before the interim results were available.
Together, they discuss:
How multi-arm, multi-stage trials differ from traditional clinical trial designs
Why these approaches could be particularly valuable in progressive multiple sclerosis
How a single trial framework can allow promising treatments to advance while less promising approaches are stopped
The potential benefits for recruitment, participant experience and reducing the time between trial phases
The statistical and practical challenges involved in designing and running these complex studies
How interim outcomes, imaging and biomarkers could help identify promising treatments earlier
What the OCTOPUS trial is investigating — and how its design is being used to evaluate potential treatments for progressive MS
Whether the same approach could be used to accelerate the development of remyelination and repair therapies
As the first OCTOPUS interim results now show, the adaptive design discussed in this episode is not simply theoretical. This episode offers a particularly relevant look at the thinking behind the trial and the methodology being used to determine which treatments should move forward and which should not.
This podcast episode is supported by an educational grant from Alexion, AstraZeneca Rare Diseases, Bristol Myers Squibb, Roche, Sanofi, and UCB. Educational grant providers have no input into the podcast series content.

The blood–brain barrier is a highly specialised interface that regulates the movement of cells, molecules and nutrients between the circulation and the central nervous system.
But what happens when this critical barrier becomes dysfunctional in multiple sclerosis?
In this episode of the ECTRIMS Podcast, host Brett Drummond speaks with Prof. Elga de Vries of Amsterdam UMC and MS Center Amsterdam about the evolving science of blood–brain barrier dysfunction in MS.
They explore how the blood–brain barrier functions in health, how its disruption relates to immune cell infiltration and inflammatory disease activity, and why research increasingly suggests these changes may remain relevant across different stages of MS.
The conversation also looks at innovative blood–brain barrier-on-a-chip models, how existing MS treatments interact with the barrier, and emerging approaches designed to transport therapies more effectively into the CNS.
Finally, they consider an intriguing future direction: could strengthening the blood–brain barrier itself become part of the therapeutic strategy for MS?
This podcast episode is supported by an educational grant from Alexion, AstraZeneca Rare Diseases, Bristol Myers Squibb, Roche, Sanofi, and UCB.

Can growing amounts of real-world MS data help clinicians predict disease progression and make more personalised treatment decisions?
In this episode of the ECTRIMS Podcast, host Brett Drummond speaks with Dr. Will Brown from Cambridge University and Dr. Carmen Tur from CEMCAT about the rapidly evolving field of predictive modelling in multiple sclerosis.
They explore why MS is particularly difficult to predict, from its biological and clinical heterogeneity to the lack of sufficiently sensitive, specific and widely available biomarkers. They also discuss how increasingly rich, long-term datasets are allowing researchers to study disease outcomes, treatment journeys and populations traditionally underrepresented in clinical trials.
The conversation examines the methodological challenges that come with real-world data, including missing data, non-random treatment allocation, clinical outcome selection and bias, as well as the opportunities and limitations of AI and machine learning.
Finally, they ask what must happen before predictive models can enter routine clinical care — including robust external validation, calibration, interpretability, equitable representation and evidence that using these tools actually improves clinical decisions and long-term patient outcomes.
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This podcast episode is supported by an educational grant from Alexion, AstraZeneca Rare Diseases, Bristol Myers Squibb, Novartis, Roche, Sanofi, and UCB. Educational grant providers have no input into the podcast series content.