– Bruce Bebo, National MS Society
The Pathways to Cures roadmap represents one of the most coordinated global efforts ever undertaken in multiple sclerosis (MS) research. Led by the National MS Society and shaped through input from scientific leaders, clinicians, funders and people living with MS, the framework sets out three essential pathways – stopping MS, restoring function and ending MS forever.1,2
In this Q&A, Bruce Bebo, EVP of Research at the National MS Society, discusses how the roadmap was built, the scientific breakthroughs driving each pathway, and the collaborative global initiatives accelerating progress toward meaningful cures for MS.
This Q&A article was prepared by touchNEUROLOGY in collaboration with the National MS Society and Bruce Bebo, EVP of Research at the National MS Society.
We have learned so much about MS and its treatment, but cures remain elusive. The roadmap is our effort to change that – for each and every person with MS.
We have aligned research and resources worldwide to accelerate research. It was an intentionally collaborative effort, we developed the roadmap in consensus with scientific thought leaders and people affected by MS, and it was endorsed by more than 30 global MS societies and professional organizations.
We refined the roadmap last year, working with nearly 200 scientists, healthcare providers, policy makers, funders and people with MS from 15 countries. Global consensus is critical to this roadmap, so that we all can focus on the most impactful research that will end MS.
Each pathway represents opportunities to cure MS. Together they span the course of the disease. Also, together, they address the great variability of this disease, and the many ways that MS disrupts the lives of the individuals who live with it.
Stopping MS means we are aiming for no new disease activity and no new injuries to the central nervous system. Researchers are exploring how we can detect MS as early as possible, and whether we can tailor treatments to individuals with the disease. Just last month, we saw a report that biological signs of MS can be detected in blood samples years before symptoms begin.3
Restoring function means repairing the damage MS has done to the central nervous system. This would allow people to recover function that has been lost, like mobility or cognitive function. On the one hand, this means undoing the damage done to the myelin sheath (remyelination). A small trial just reported at the world’s largest MS research meeting, showed evidence of myelin repair with a combination of the diabetes drug metformin and the antihistamine clemastine, so we are on the right track.4 On the other hand, we can restore function with rehabilitation. Another study showed evidence of myelin repair in a small trial of aerobic exercise.5 Truly exciting!
Ending MS means preventing MS altogether, that no one will ever again have to hear the words, “You have MS”.
Researchers focusing on this pathway are looking for ways to prevent MS. This involves looking at known risk factors such as obesity, vitamin D deficiency, Epstein Barr Virus, and also genetic factors. New research shows people who are at risk for getting MS may have specific strains of gut bacteria. This research opens the door to developing new strategies for preventing MS and for preventing damage after the first signs appear.6
Over 15 years ago, we noticed that many small companies were failing to complete the preclinical work necessary to move promising experimental compounds into clinical trials. We created a commercial development program called Fast Forward.7 The program is specifically designed to address the early funding gap in drug development. Fast Forward has invested more than $26 million in 56 proposals from small companies or academics to develop MS therapies or diagnostic tools in the earliest stages. Funding opportunities in recent years have targeted neuroprotection and repair. Fast Forward is helping us to make sure that the most promising candidates for filling this great unmet need in MS are not falling by the wayside during the drug development process.
As the largest and leading MS organization in the world, we have a responsibility to work beyond our borders. Right now, there is strong collaboration among the MS patient advocacy organizations and research groups around the world. These organizations are working together to share funding, expertise, resources and information so that we can make more progress toward solving MS. Two important initiatives bring this collaboration to light. First is the International Progressive MS Alliance, an unprecedented global collaboration of MS organizations, researchers, health professionals, the pharmaceutical industry, companies, trusts, foundations, donors and people affected by progressive MS, all working together to address the unmet needs of people with progressive MS and rallying the global community to find solutions.8
The Alliance identifies and invests in transformational multinational research that focuses on three scientific priorities: understanding, preventing and reversing progression; speeding up and improving clinical trials; and improving wellbeing for people with progressive MS.
The Alliance recently announced the upcoming availability of a Clinical and Imaging Data Resource, which provides the academic and research community with access to data from more than 13,500 clinical trial participants living with MS, including 72,000 MR scans and feedback from 200,000 clinical visits.9 This resource underscores the power of bringing the world together to solve progressive MS.
The second major initiative is the International Advisory Committee on Clinical Trials, which is a global body sponsored by the European Committee for Treatment and Research in MS (ECTRIMS) and the National MS Society in the US.10,11
This committee is made up of experts in clinical trials and clinical research in MS, who provide perspective and guidance toward developing landmark and significant recommendations and guidelines that impact diagnosis, treatment and care around the world. This committee has developed and refined the McDonald Diagnostic Criteria for diagnosing MS, and is currently working to review the clinical course descriptors for MS and how they can be more biologically based.12
In both initiatives, the voices and perspectives of people living with MS are at the forefront of the work. Within the Alliance, there is an Engagement Coordination Team made up of people living with progressive MS who help shape the strategic direction of the Alliance. They participate in the research review process, and their contributions ensure that our efforts are focused on the solutions that matter to them. Similarly, people living with MS play a key role as part of the Clinical Trials Committee, and they help guide the direction of this work.
Living with MS looks different for each person with the disease. Each of them has a different idea of what the cure looks like. Some people say it means no new damage on MRI scans, others say being able to walk without a cane. I believe MS ends with research, no matter what your cure looks like. Research is already showing us the earliest signals for this disease, the earliest opportunities for stopping it in its tracks. Newly revised diagnostic criteria based on this research already are helping people get diagnosed and treated months earlier! We are seeing promising signs for reversing damage, which has long been an unmet need. We also know more about risk factors that may confer susceptibility and those that may be protective, which is critical to prevention.
I believe this is the last chapter for MS.
Learning resources:
The refined Pathways to Cures Research Roadmap for multiple sclerosis cures – Multiple Sclerosis Journal
Endorsing organizations of Pathways to Cure
MS Global Strategy Group Impact Report 2025
Related content
Integrating imaging and biomarkers in the revised McDonald criteria
New McDonald criteria revisions: 6 key updates
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National MS Society. Pathways to Cures. Available at: https://www.nationalmssociety.org/understanding-ms/ms-research/pathways-to-cures (accessed 20 November 2025).
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National MS Society. Homepage. Available at: https://www.nationalmssociety.org/ (accessed 20 November 2025).
- Abdel H. et al,. Myelin injury precedes axonal injury and symptomatic onset in multiple sclerosis. Nat Med. 2025. doi.org/10.1038/s41591-025-04014-w.
- Yoon H. et al,. Multiple sclerosis and gut microbiota: Lachnospiraceae from the ileum of MS twins trigger MS-like disease in germfree transgenic mice—An unbiased functional study. Proc. Natl. 2025. Acad. Sci. U.S.A. 122 (18) e2419689122. doi.org/10.1073/pnas.2419689122.
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Cunniffe N et al. Evaluating the remyelinating efficacy and safety of the combination of metformin and clemastine in people with relapsing remitting multiple sclerosis (CCMR-Two): a randomised, placebo-controlled, double-blind, phase 2 clinical trial. Presented at: ECTRIMS 2025, Barcelona, Spain, 24–26 September 2025. Abstr # 152/O133.
- Wooliscroft L et al. Does Aerobic Exercise Promote Remyelination in Multiple Sclerosis? Pilot Data From a Single-blind, Parallel Group Randomized Controlled Clinical Trial. Presented at: ECTRIMS 2025, Barcelona, Spain, 24–26 September 2025. Abstr #1257/O073.
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National MS Society. Fast Forward: Commercial Development Program. Available at: https://www.nationalmssociety.org/about-the-society/who-we-are/research-we-fund/fast-forward-commercial (accessed 20 November 2025).
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International Progressive MS Alliance. Homepage. Available at: https://www.progressivemsalliance.org/
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International Progressive MS Alliance. MS Clinical and Imaging Data Resource. Available at: https://www.progressivemsalliance.org/ms-clinical-and-imaging-data-resource/(accessed 20 November 2025).
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ECTRIMS. MS Clinical Trials Committee. Available at: https://ectrims.eu/ms-clinical-trials-committee/(accessed 20 November 2025).
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ECTRIMS. Homepage. Available at: https://ectrims.eu/#:~:text=The%20world’s%20largest%20professional%20organisation,clinicians%20worldwide%20to%20transform%20lives (accessed 20 November 2025).
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National MS Society. 2024 McDonald Diagnostic Criteria. Available at: https://www.nationalmssociety.org/understanding-ms/what-is-ms/how-ms-is-diagnosed/2024-mcdonald-diagnostic-criteria (accessed 20 November 2025).
This content has been developed independently by Touch Medical Media for touchNEUROLOGY. Views expressed are the speaker’s own and do not necessarily reflect the views of Touch Medical Media.
Editor: Katey Gabrysch, Editorial Director.
Disclosures: This short article was prepared by touchNEUROLOGY in collaboration with the National MS Society and Bruce Bebo, EVP Research at the National MS Society.
The content was developed and edited by human editors. No fees or funding were associated with its publication. touchNEUROLOGY utilize AI as an editorial tool (ChatGPT (GPT-4o) [Large language model]. https://chat.openai.com/chat).
Bruce Bebo has nothing to disclose in relation to this interview.
Cite: Bruce Bebo. Pathways to Cures: Advancing global MS research through collaboration and innovation. touchNEUROLOGY. 25 November 2025.
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