Latest News, What's New in MS Research May 21, 2026

 

Reviewed by MSAA Chief Medical Officer Barry A. Hendin, MD

Multiple sclerosis was front and center when neurologists from across the country and around the world convened in Chicago in April for the annual meeting of the American Academy of Neurology (AAN).

Researchers presented the results of more than 190 MS-focused studies during the meeting. They shared key data on investigational and approved disease-modifying therapies, factors that affect the course of MS, the impact of co-existing health conditions and the medications used to treat them, and approaches to symptom management. And, of course, no medical meeting these days is complete without reports on how artificial intelligence, or AI, is reshaping care in MS.,

 

FDA approves Ocrevus^® for pediatric relapsing-remitting MS

The Food and Drug Administration (FDA) this month (May 2026) approved Ocrevus^® (ocrelizumab) for the treatment of relapsing-remitting MS in children and adolescents age 10 and older who weigh 55 pounds or more.¹ The approval makes the intravenously infused medication only the second disease-modifying therapy (DMT) with an FDA-sanctioned indication for use in pediatric patients. In 2018, the regulatory agency approved Gilenya^® (fingolimod) for use in children and adolescents ages 10 to 17 years who have relapsing forms of MS.

In a May 8, 2026 press release announcing the FDA decision, Ocrevus manufacturer Genentech noted that in the OPERATTA II study, Ocrevus demonstrated noninferiority to fingolimod in reducing the annualized relapse rate and “superiority in reducing new or enlarging T2 lesions (48% reduction vs fingolimod) and gadolinium-enhancing T1 lesions (87% reduction vs fingolimod).”

Genentech added that the safety profile seen in pediatric patients was consistent with that observed in adult patients. “Serious adverse events and serious infections were infrequently observed and well balanced; no adverse events led to treatment withdrawal in the Ocrevus group, and three patients withdrew in the fingolimod group,” the Company press release noted.

Genentech noted that an estimated 5,000 to 10,000 children and adolescents in the United States have pediatric onset of MS.

 

 

Two studies show that popular weight-loss drugs provide additional benefits in MS

The glucagon-like peptide-1 receptor agonist (GLP-1 RA) drugs used by millions of Americans for weight loss demonstrated benefits in multiple sclerosis in two studies reported during the American Academy of Neurology meeting.

In the first study, researchers used data from the TriNetX research network to compare outcomes in 14,300 people with MS who had received GLP-1 therapy and in other people with MS who had not been exposed to the medication. To make a meaningful comparison, people in the two groups were matched 1:1 based on age and sex. Both groups included people who were taking disease-modifying therapies (DMTs) for MS and others who were not taking those medications.²

Taking a GLP-1 receptor agonist was associated with lower rates of:

• Acute steroid-treated relapses: 2.33% for people taking the weight-loss medications vs. 5.0% for people not using the medication
• Optic neuritis: 1.53% vs. 4.02%
• Demyelinating events: 3.58% vs. 6.5%
• Gait or mobility abnormalities: 7.56% vs. 12.76%
• Fatigue: 8.3% vs. 14.2%
• Depression: 18.1% vs. 25.2%

“These findings suggest that GLP-1 RAs may be associated with neuroprotective and anti-inflammatory effects relevant to MS pathophysiology,” the study’s authors wrote.

In the second study, investigators from the University of Washington found that GLP-1 RA use was associated with increased physical activity and improved patient-reported outcomes among 70 people with MS treated at their center.³

The study participants had an average age of 51.3 years and a median Expanded Disability Status Scale score of 2.5, indicating relatively modest disability. After an average of 7.2 months on a GLP1-RA medication, their average amount of time devoted to physical activity each week more than doubled, from 52.3 minutes to 115.7 minutes.

These individuals also reported statistically significant improvements in anxiety, bowel function, bladder function, and sensory symptoms. Less-pronounced improvements were noted in body pain, vision, spasticity, and dizziness. However, there were no significant changes in walking, hand function, fatigue, cognition, or depression.

The results of the two studies – one quite large and the other relatively small – are encouraging. Both studies were retrospective, however, meaning that they drew on existing data to look back at what already had occurred. While such research is valuable, the gold standard for investigating the efficacy of a medication is a prospective study – a trial designed to answer a carefully defined question that tracks people going forward over a set period of time. Additionally, it will be important to conduct research on how GLP1-RA medications affect MS outcomes specifically in people already taking DMTs to see if the weight-loss drugs provide an additive effect.

 

 

 

ChatGPT outperforms neurologists in Spanish study of MS decision-making

ChatGPT-4o (Generative Pre-trained Transformer 4-omni) was more likely than a group of neurologists to make treatment decisions aligned with guideline recommendations when presented with 20 hypothetical cases of multiple sclerosis (MS) or a related condition, neuromyelitis optica spectrum disorder (NMOSD).

Spanish researchers compared the artificial intelligence (AI) platform’s decision-making with that of 290 neurologists.⁴ The neurologists participating in the study had been in practice for an average of 14 years. Sixty percent had a practice emphasis in MS. In fact, participants saw an average of 15 people with MS per week.

The study’s primary endpoint was the extent to which treatment decisions reflected the latest guidelines. Each case vignette was presented to ChatGPT two ways – with and without an explicit prompt to make a guidelines-based treatment recommendation.

When ChatGPT received this explicit prompt, it had 80.5% accuracy in terms of making decisions that were in accordance with the guidelines. Even without such direction, however, ChatGPT had 72.9% accuracy, as compared to 66.5% accuracy among the neurologists, a statistically significant difference.

In particular, researchers noted that ChatGPT was more likely than the neurologists to initiate treatment and to switch or intensify an existing treatment in step with approaches recommended by guidelines.

The study’s authors wrote that their findings demonstrated “AI’s potential to support timely treatment decisions. Incorporating such tools into practice and training may accelerate best-practice adoption and improve patient outcomes.”

While these results are fascinating, it’s worth remembering that neurologists don’t treat vignettes. They treat human beings whose lives have a richness and complexity that can’t possibly be captured in a two-paragraph vignette, but that the neurologist must consider when making decisions. As the authors note, AI has great potential as a tool that supports decision-making, but when it comes to actual people, it still takes one to treat one.

 

 

 

 

 

Examining the impact of disease-modifying therapy on gynecologic conditions

Women with MS who took disease-modifying therapies (DMTs) were roughly 1.3 to 1.6 times more likely than women with MS not taking DMTs to have gynecologic conditions ranging from vulvovaginitis to cervical cancer, according to a recent study.⁵

Researchers drew on data from the TriNetX global collaborative network to assess the gynecologic health of 96,466 women with MS. They paired women who were and were not taking DMTs, matching them on the basis of characteristics including age, marital status, race, ethnicity, body mass index, tobacco use, and long-term use of hormonal contraceptives.

The women taking DMTs had a higher risk than their counterparts for all seven gynecologic conditions evaluated:

• Being positive for human papillomavirus, which is linked to the development of cervical cancer: 1.66 times greater risk
• Being positive for herpes simplex virus, which causes genital herpes: 1.36 times greater risk
• Cervical dysplasia, the abnormal growth of precancerous cervical cells: 1.6 times greater risk
• Cervical cancer: 1.27 times greater risk
• Cervicitis, inflammation of the cervix, often caused by sexually transmitted infections: 1.5 times greater risk
• Vulvovaginitis, 1.32 times greater risk
• Bartholin cysts/abscesses, a painful, infected, fluid-filled lump on the labia: 1.63 times greater risk.

The increased risk faced by women on DMTs was statistically significant for each of the seven conditions, meaning that it is very unlikely that the differences between them and women not taking DMTs occurred by chance.

The study’s authors said that clinicians should recognize these potential effects of DMT use and “integrate gynecological counseling and screening into routine MS care.”

These findings, while unwelcome, need to be considered in context. MS is an autoimmune disease, and DMTs are effective in treating the condition precisely because they modulate the immune system to stop or reduce attacks on the myelin sheath that protects nerves. Increased susceptibility to infection and to the consequences of infection long have been known to be potential adverse effects of the immunomodulating action of DMTs. This study quantifies that risk in terms of several gynecologic conditions, which is an important contribution, but it does not reveal a previously unrecognized risk.

What the study does underscore, however, is the importance of taking several proactive steps to protect gynecologic health while continuing to obtain the benefits that DMTs offer in controlling MS. Those steps include ensuring that your gynecologic care provider knows that you have multiple sclerosis and are taking a DMT, monitoring your health and promptly seeking care for any gynecologic issue, and obtaining screening for HPV infection and other cervical conditions on the schedule recommended by your gynecologist or other clinician.

 

 

 

MSAA initiative examines best messaging strategies for reaching diverse audiences

Each person’s experience with MS is unique, and is shaped by factors including access to care, socioeconomic status, race, cultural context, and other social determinants of health. At the same time, many of the challenges posed by MS are common to a high proportion of people living with the disease. Given that mix of the individual and the collective, how can advocacy groups best provide data-driven, community-informed education to people with MS?

The Multiple Sclerosis Association of America (MSAA) explored that question through a pilot MS Awareness Educational Campaign that entailed three weeks of testing video-based advertisements and calls to action delivered via Facebook, LinkedIn, and paid search ads in two regions: upstate New York and Atlanta.⁶

The campaign built on findings from MSAA’s MS Ecosystem Framework research, which identified key barriers through surveys, roundtables, and interviews. The ultimate aims of the campaign are to establish a data-informed framework for future national efforts, validate content that resonates with the MS community, and promote awareness of MS symptoms and treatment, MS-specific education, and available MSAA resources.

Facebook messaging targeted both general and look-alike audiences, while LinkedIn reached healthcare professionals, and search ads focused on regional MS-related keywords. Creatives included email and SMS signup promotions, “Back to Basics” informational ads, testimonials, and early diagnosis-focused videos.

Notable regional differences emerged in an analysis of the campaign’s results. Messaging efforts in Atlanta achieved higher visibility but lower engagement (average 35 seconds on site, 15% engagement rate) compared to upstate New York, where users showed deeper interaction (52 seconds, 19% engagement).

Content format significantly affected outcomes: informative, action-oriented videos – particularly testimonials – outperformed static posts, with an “Early Diagnosis – More Detail” ad achieving a 1.3% click-through rate. Facebook generated 155,000 impressions overall, with re-targeted “Email Signup Promo” ads driving 35% of total impressions.

In presenting the campaign’s results at the American Academy of Neurology meeting, MSAA noted that the “findings demonstrate that combining geographic targeting with emotionally engaging, story-driven video content enhances both reach and engagement. Localized, human-centered messaging and strategic retargeting are critical for fostering meaningful awareness and improving outcomes across diverse MS communities.”

 

 

 

 

Study demonstrates favorable impact of frexalimab on MS biomarkers over three years

The investigational disease-modifying therapy (DMT) frexalimab reduced blood levels of two markers of MS activity and limited brain volume loss (BVL) over three years in a Phase II study involving 129 people with relapsing forms of multiple sclerosis.⁷

The French biopharmaceutical company Sanofi is developing frexalimab, which is a monoclonal antibody – a laboratory-produced protein designed to imitate the immune system’s ability to combat harmful pathogens, such as bacteria or viruses. Frexalimab blocks the CD40/CD40L pathway to inhibit the activation and functioning of immune system cells that play a role in multiple sclerosis. Sanofi explains that by blocking this pathway, frexalimab exercises its effects without depleting key immune cells, such as T cells and B cells.⁸

A Phase II trial published in 2024 found that 12 weeks of treatment with the intravenously administered medication reduced active central nervous system lesions by 89% and reduced blood levels of two markers of MS activity – neurofilament light chain (NfL) and chemokine (C-X-C motif) ligand 13 (CXCL13) – by more than 20%.⁸

Following up on those short-term results, researchers examined the impact of frexalimab over 144 weeks, or roughly three years. Among study participants who received 1200 mg of frexalimab by intravenous infusion every four weeks, blood levels of NfL fell by 47% from baseline to week 144, while levels of CXCL13 decreased by 48%.

Other study participants, including those who received frexalimab by subcutaneous injection from the start of the trial and those assigned to the placebo arm who then switched to frexalimab after the 12-week initial study period, also saw reductions in NfL and CXCL13, with decreases ranging from 31% to 65%.

Meanwhile, the median brain volume loss from baseline in people receiving intravenous frexalimab over 144 weeks was -0.84% for the whole brain, -1.18% for the thalamus, and -0.85% for the cerebral cortex.^{9, 10}

Frexalimab is now being assessed in two Phase III trials, FREXALT, which is focused on relapsing MS, and FREVIVA, for people with non-relapsing secondary-progressive MS.

 

 

 

 

A wake-up call about the impact of sleep apnea in people with MS

People with MS who have obstructive sleep apnea (OSA) are more likely than others with MS to have emergency department visits, hospital admissions, steroid use, and new diagnoses of insomnia and cognitive impairment.

Researchers identified those apnea-related risks by drawing on data from the TriNetX Research Network to identify 15,896 people with MS and OSA. They then used factors including age, sex, race, body mass index, and use of disease-modifying therapies to match each person with MS and OSA with a similar person who had MS but not OSA.¹¹

The people with OSA were roughly 1.5 times more likely than their counterparts to require an emergency department visit, hospital stay, or steroid prescription. They were 2.7 times more likely than those without sleep apnea to be diagnosed with insomnia during the study period, and 2.1 times more likely to be diagnosed with cognitive impairment.

The researchers wrote that their findings “highlight the necessity of routine screening for OSA as part of the comprehensive management of multiple sclerosis,” noting that OSA is more common among people with MS than in the general population.

Beyond providing answers about the impact of sleep apnea in MS, this study gives rise to an important question: can managing OSA through use of continuous positive airway pressure (CPAP) machines, weight loss, or other means, reduce not only the apnea but also the related risks it poses for people with MS? Hopefully additional research will be conducted to provide more insight and answers to this important question.

 

 

 

 

Measuring the cost – personal and economic – of disease-modifying therapy not taken

Taking a medication entails cost and the possibility of adverse effects.

Not taking a medication can entail even greater cost and more unwelcome outcomes, as illustrated by a recent study involving 14,236 people with relapsing forms of multiple sclerosis.¹²

Researchers drew on records from a US-based insurance claims database to analyze those people’s health status and healthcare utilization from July 2020 through June 2023. Among the people studied, 8,763 had received a disease-modifying therapy (DMT) in the first year of the study period. Those people had an average age of 48.9 years, and 74% were female. The 5,473 untreated people in the study had an average age of 53.5 years; 78% were female.

Here’s how the two groups compared to one another:

Treated Group (n=8,763)

Untreated Group (n=5,473)

Infections

50.6%

54.3%

Malaise/fatigue

23.9%

28.2%

Depression

16.7%

19.9%

Burning/numbness/tingling

13.7%

20.5%

Hospitalizations

4.3%

9.7%

Physician visits, average number

10.9

12.7

Hospitalization cost, average in 2023 dollars

1,621

3,473

 

The study’s authors said their researcher highlighted “the potential clinical and economic benefits of treatment whilst underscoring the continued unmet need in the untreated.”

Other research has shown that roughly half of all people with relapsing forms of multiple sclerosis are not being treated with a DMT.¹³ However, that research found significant variations by age, with older people being less likely to be treated, suggesting that some of those people may have discontinued their DMT after several years of treatment.

Whether due to insurance-coverage issues, personal preference, or other reasons, many people with MS either cannot take DMTs or choose not to do so. The results of this study underscore the importance of efforts to remove barriers to access for those who would receive treatment if they could. These results also suggest the value of periodically reconsidering the decision to not receive treatment. Should the benefits outweigh the initial reasons for declining treatment, individuals may look into potential options for gaining access to DMTs.

 

 

 

 

Examining how treatment for cancer and autoimmune diseases affect MS

Immunotherapies that enhance the immune system’s ability to identify and attack cancer cells have transformed the treatment of many solid tumors and blood-based malignancies, but how do they affect cancer patients who also are living with MS, an autoimmune disease?

To answer that question, researchers recently examined neurological outcomes in 165 people with MS who received immune checkpoint inhibitors (ICIs), one of the most common forms of immunotherapy used to treat cancer.¹⁴ The researchers explained that they focused on ICIs because these immunotherapies are associated with both new demyelinating events and exacerbations of previously diagnosed autoimmune diseases.

Study participants were treated at 18 major medical centers across the United States. Seventy-two percent were female and their median age at start of ICI therapy was 63 years. Just over one quarter of the people remained on disease-modifying therapy (DMT) for their MS after starting treatment with an immune checkpoint inhibitor.

Over a median six months of treatment with an ICI, six people – or 3.6% of the total – had an MS clinical relapse. Two of these six individuals experienced their relapse more than six months following the last dose of immunotherapy. Three of these six people had a full clinical recovery, while the other three had a partial recovery.

Another seven people, 4.2% of the total, had new MS lesions on magnetic resonance imaging (MRI) after starting ICI therapy, but did not have an associated clinical relapse. The MRI findings of new lesions with two of these seven individuals occurred more than six months following the last dose of immunotherapy.

Eleven study participants had non-MS immune-related adverse events and 21% had non-neurologic immune-related side effects.

The study’s authors noted that MS disease activity following ICI treatment was uncommon generally, including in younger people and in those with more recent MS clinical activity.

A separate study presented at the American Academy of Neurology meeting looked at the safety of non-MS biologic therapies in people with MS also being treated for other autoimmune disorders.¹⁵

Drawing on data from 11 medical centers across the United States, researchers identified 190 people with both MS and another systemic autoimmune disorder. Study participants had an average age of 50.6 years and an average MS duration of 11.6 years. Seventy percent were female.

Inflammatory bowel disease was the most common non-MS autoimmune disorder, affecting 37% of the people studied. Meanwhile, 36% had psoriasis and 22% had been diagnosed with psoriatic arthritis. The average time on a biologic agent was three years, and 80% of the group had prescriptions for both an MS disease-modifying therapy and a biologic for another autoimmune disorder. (Those non-MS biologics did not include a type of therapy known as a tumor-necrosis factor alpha – or TNFα – inhibitor, because those medications are contraindicated in people with MS, meaning that they would be harmful for an individual with MS.)

There was a total of 20 serious infections (or 3.4 per 100 patient-years) during the study period. Additionally, 36 clinical MS relapses were recorded, for a rate of 6.1 per 100 patient-years. The study’s authors concluded, “Serious adverse events in patients with both MS and [another autoimmune disorder] on non-MS biologics were rare, including among patients treated concurrently with an MS DMT.”

Few, if any, people with MS only have MS. For those who must contend not only with multiple sclerosis but also with other serious illnesses, studies such as these can help inform shared decision-making with providers and shape treatment strategies designed to achieve the best possible outcomes while limiting risk.

 

 

 

 

 

Study supports consolidating initial doses of Briumvi^®

A study presented at the American Academy of Neurology meeting indicated that it may be feasible to consolidate the treatment-initiation regimen for the disease-modifying therapy Briumvi^® (ublituximab) from two doses to one.¹⁶

People with relapsing forms of MS who are prescribed Briumvi currently receive an initial four-hour infusion of 150 mg of the medication followed by a one-hour, 450-mg infusion 14 days later. They then receive 450 mg in one-hour infusions every 24 weeks.