multiple sclerosis secondary progressive

Multiple sclerosis trials now focus beyond relapsing-remitting disease to address the progressive forms (PPMS and SPMS) where anti-inflammatory approaches have shown limited efficacy. Remyelination — regenerating the myelin sheath stripped away by the autoimmune attack — is the most transformative target in current MS research, with several promising candidates entering Phase 2.

Active trials evaluate BTK inhibitors (tolebrutinib, fenebrutinib) for progressive forms, remyelinating agents (PIPE-307, CNM-Au8), high-efficacy induction therapies (cladribine, alemtuzumab) in early aggressive disease, and CAR-T cell approaches for treatment-resistant cases. Optical coherence tomography (OCT) and neurodegeneration biomarkers are advancing as trial endpoints.