Multiple sclerosis (MS) care is evolving as clinicians integrate research findings into everyday practice, a theme highlighted at the 2026 Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting in Charlotte, North Carolina.
Embedding Clinical Trials in the Clinic
Dr. Mark Freedman, director of the multiple sclerosis research unit at Ottawa Hospital, described how routine involvement in clinical trials positions physicians at the “forefront and the edge of the research,” according to an interview with reporters. He noted that trial participation gives patients access to investigational therapies that are otherwise unavailable.
Early exposure to new agents lets clinicians learn how to manage adverse events before the drugs reach the market, which can take five to eight years. “By the time these drugs hit market, you’ve become an expert in a possible treatment that’s going to evolve,” he said, emphasizing the practical benefits of research‑integrated care.
The session, chaired by Dawn Carle, RN, BScN, also addressed the limitations of traditional trial endpoints such as relapse rate and the Expanded Disability Status Scale (EDSS). Freedman argued that these measures often miss subtle disease progression that patients experience.
New Metrics and Future Directions
In discussing emerging endpoints, he highlighted the role of imaging and digital biomarkers. Gait‑tracking footpads and quicker cognitive tests could supplement the EDSS. “Clinical trials give you that testing ground where you’re collecting all this other data prospectively,” he explained.
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The concept of progression independent of relapse activity has emerged from recent studies and may soon become a primary outcome measure. While regulatory agencies typically allow only one primary endpoint, supplemental metrics can validate the main result and provide a fuller picture of treatment impact.
Historical examples reinforce this approach. In the 1980s, a British Columbia center led by the late Dr. Donald Paty used MRI scans to demonstrate lesion disappearance in patients receiving interferon beta‑1b, influencing FDA approval. The anecdote illustrates how ancillary data can sway regulatory decisions.
There is growing interest in personalized treatment selection. Freedman recalled early work linking interferon response to immunological markers, noting that modern trials could identify responders through genetic or blood‑based assays. Such insights might eventually guide clinicians in matching patients to the most effective therapy while minimizing risk.
Funding remains a challenge, but industry sponsors often support trials aimed at proving a specific benefit. He cautioned that “if we discover something else about the disease… they can go, ‘Okay, we’ll exclude those patients,’” highlighting the importance of balancing benefit and risk.
Integration of research into MS clinics could accelerate the adoption of more sensitive outcome measures and promote a deeper understanding of disease mechanisms. As trials become more complex, the data they generate may reshape how clinicians assess progression, predict treatment response, and ultimately improve patient outcomes.
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One possible scenario is that the next generation of MS trials will routinely incorporate wearable sensors and real‑time cognitive testing, generating a continuous stream of patient‑centered data.
If these tools prove reliable, they could replace the EDSS as the standard metric, allowing doctors to detect subtle changes earlier and adjust therapy before irreversible disability sets in. This shift would require collaboration among academic centers, industry, and regulators, but the precedent set by past trials suggests it is feasible.
Freedman’s experience shows that the most immediate benefit of research‑integrated care is expertise. Clinicians who routinely enroll patients in trials gain practical knowledge that translates into better risk management and more informed treatment choices once new drugs become commercially available.
Attendees were reminded that the ultimate goal of merging research with clinical practice is to enhance the benefit–risk profile for patients, a principle that has guided MS advances for decades.