Reflections from ECTRIMS 2025: collaboration, innovation and the power of connection

Event reports
28 Nov 2025

Attending the recent 41st meeting of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in Barcelona, on 24-26th September 2025, was an inspiring opportunity to learn, share ideas and reconnect with colleagues internationally. The event brought together professionals from a wide range of disciplines, all united by a commitment to improve the lives of people living with multiple sclerosis (MS).

The 2024 revisions to the McDonald diagnostic criteria for MS were discussed, which now include the optic nerve as a fifth anatomical region for demonstrating dissemination in space, enhancing the sensitivity and accuracy of early diagnosis. This is an important development that will lead to earlier or increased diagnoses of MS. This has major implications for MS services, including a likely rise in diagnostic rates, greater demand on multidisciplinary care, and the need for increased funding to support timely treatment and proactive management (Brownlee 2024).

The conference brought forward a number of late-breaking research findings that hold significance for clinicians and researchers working in MS. This summary article offers a concise overview of selected key studies, with commentary on implications for clinical practice and service design. In addition, it highlights a newly-launched CAR T cell trial at University College London Hospitals NHS Foundation Trust (UCLH) that points to the next frontier in MS therapy.

Late-breaking research highlights from ECTRIMS 2025

1. Biomarkers of progression independent of relapse activity (PIRA)

A major press release from ECTRIMS reported that researchers analysed cerebrospinal fluid (CSF) from 122 patients with relapsing MS and identified a panel of 13 proteins that distinguished those with progression independent of relapse activity (“PIRA”) from those with stable disease (≈ 86 % accuracy). This work emphasises that disability accrual outside of overt relapse remains biologically distinct and may be amenable to earlier detection.

Clinical implications:

  • MS services should continue to emphasise objective monitoring of change (EDSS, timed walk, cognition) even in the absence of relapse.

  • Centres may wish to explore collaboration with specialist biomarker programmes (e.g. at UCLH) to integrate CSF/imaging workstreams into longitudinal care pathways.

Nurses and AHPs should consider how monitoring of non-relapse progression can be built into routine review and relayed in service performance metrics.

2. Real-world effectiveness of high-efficacy therapies

An observational, multi-registry cohort presented at ECTRIMS showed that the anti-CD20 therapy ocrelizumab demonstrated superior relapse control compared with other active treatments in routine practice. This adds to the evidence base for comparative effectiveness outside of randomised trials. (Note: the specific registry data were summarised in secondary media rather than full peer-reviewed publication at time of writing.)

Clinical implications:

  • In shared-decision discussions with patients, services can reference real-world data alongside RCTs when discussing expected benefits, monitoring and the logistics of high-efficacy infusion therapies

  • Service planners should ensure infusion/monitoring capacity and follow-up pathways for high-efficacy agents remain robust in light of evolving uptake.

3. Repair and remyelination: early signals from Cambridge

A late-breaking presentation from the NIHR Cambridge Biomedical Research Centre (BRC) reported on the CCMR-Two trial (metformin + clemastine) in relapsing MS. While preliminary, the data suggest enhanced remyelination may be feasible using repurposed medications. (Referenced via Cambridge summary.)

Clinical implications:

  • Teams should counsel patients that such remyelination strategies remain investigational and should not be self-administered outside trial settings.

  • Consider referral pathways for eligible patients into repair/remyelination trials and ensure that research teams and nurse-led services are aware of them.

  • Education materials for MS nurses and AHPs should include evolving repair-focused therapeutics to underpin holistic care conversations.

4. Life-stage and lifestyle factors in MS: menopause, diet and comorbidity

Several presentations addressed the impact of life-stage (e.g. menopausal transition in women with MS) and lifestyle/dietary influences (such as ultra-processed food intake) on MS presentation and activity. These data serve to emphasise that MS care is not solely about immunotherapy but also about broader health-modifying factors.

Clinical implications:

  • In women with MS, integrate menopause history and symptom screening (vasomotor, bone health, sleep, mood) into routine review visits, and ensure coordination between primary care/neurology/MS services and women’s health/menopause services.

  • Educate patients about diet, lifestyle, mobility and comorbidity mitigation (e.g. cardiovascular risk), and work with dietitians and AHPs to embed this into holistic MS practice.

  • Service-level planning should ensure that holistic support (dietetics, physiotherapy, menopause guidance) is embedded in MS pathways.

5. Emerging benchmark data: durable outcomes with cladribine

Another key dataset at ECTRIMS reported 4-year outcomes for cladribine tablets (Mavenclad) showing low rates of PIRA and sustained brain-volume preservation in early relapsing MS.

Clinical implications:

  • When reviewing high-efficacy or short-course DMTs with patients, these durability data may contribute to discussions around treatment initiation timing and long-term planning.

MS teams should monitor brain-volume change (where available) and incorporate this into discussions of long-term risk/benefit of DMTs.

CAR T cell therapy at UCLH: a new horizon

Separately to the above ECTRIMS studies, the UK has launched an important early-phase trial of CAR T cell therapy for MS. At UCLH, a phase 1 study (AUTO1-MS1) is investigating Obecabtagene Autoleucel (obe-cel) in people with progressive MS. The principal investigator is Dr Wallace Brownlee, consultant neurologist and clinical lead for MS at UCLH and honorary academic director, MS Academy.

The trial aims to enrol up to 18 adults globally by early 2027 and is designed to assess safety, tolerability and early biological effect of CAR T cell therapy in MS.

Clinical service implications:

  • MS services should identify and inform eligible patients (e.g. refractory progressive MS, sub-optimal response to existing DMTs) about the existence of the trial, in collaboration with neurology research teams.

  • MS nurses and research-nurses should liaise with the UCLH/Cancer Clinical Trials Unit to understand referral and screening criteria, capacity and expected monitoring requirements.

  • From a longer-term perspective, the advent of CAR T in MS reinforces the need for MS nursing and specialist services to stay agile – in terms of infusion/transplant service frameworks, safety-monitoring pathways, and cross-discipline collaboration (neurology + haematology + research).

  • Educational programmes for MS nursing/MDT teams should begin to include CAR T concepts (immune-reset, B-cell depletion, safety management) as this modality moves from hematology into neuro-immunology.

One of the exciting sessions offered in addition to the formal programme was Women working in Multiple Sclerosis (WiMS), led by Dr Tarunya Arun which gathered around 40 women working in MS care across the UK and Republic of Ireland. The atmosphere was collaborative and energising, with a strong sense of shared purpose. Dr Blanca De Dios Pérez gave a fascinating presentation on her work in vocational rehabilitation, highlighting the importance of supporting individuals with MS to maintain employment and independence. Nicola Daykin followed with an excellent overview of her innovative buddy scheme for MS nurses – a model designed to foster peer support, professional development and retention within the specialist nursing workforce.

If you would like to become a member, please join here via LinkedIn.

Another highlight was the Rehabilitation in MS(RiMS) session, which focused on psychological health, particularly for people with progressive MS. Several projects were showcased, demonstrating how holistic and person-centred approaches can make a significant difference to emotional wellbeing and quality of life.

It was encouraging to see psychological support being recognised as a core component of rehabilitation, not an optional extra. Living well with progressive multiple sclerosis: rehabilitation to improve functioning and wellbeing - SINTEF

Dr Rebecca Maguire highlighted how many people with MS engage in active concealment of their diagnosis, driven by anticipated stigma and fear of social exclusion, which can significantly delay access to support and undermine psychological wellbeing. The Experience of Stigma and Concealment in Multiple Sclerosis

Sessions on brain health and artificial intelligence (AI) provided a glimpse into the future of MS care – exploring how digital tools and predictive models could support earlier intervention, more personalised treatment, and improved long-term outcomes.


Summary and service planning considerations

The research presented at ECTRIMS 2025 and the new CAR T initiative together signal a number of strategic shifts for MS services:

  • Increasing emphasis on silent progression (PIRA) rather than relapse events alone – requiring more sophisticated monitoring, biomarker integration and team education.

  • Continued strong emphasis on high-efficacy DMTs, but an evolving horizon of remyelination strategies and immune-reset therapies (e.g. CAR T) that will eventually demand new service infrastructure and nurse/AHP roles.

  • A broadening of the MS nurse/AHP role into holistic life-stage care (especially for women around menopause), lifestyle and comorbidity management, and patient-education around emerging therapies.

  • Research-service integration will become ever more central: local MS teams will need strong links with academic centres (e.g. UCLH, Cambridge BRC), trial units and industry-academic collaborations.

  • Education and training must ensure the interdisciplinary MS team (nurses, AHPs, neurologists, research staff) stay abreast of biomarker science, repair-therapeutics, immune-reset technologies, and holistic patient care frameworks.


Final thoughts

For healthcare professionals working in MS, the message from ECTRIMS 2025 is clear: we are entering a new phase of MS care – one in which relapse-control remains crucial but is no longer sufficient alone. Progression independent of relapse (PIRA) is receiving deeper investigation, and service models must evolve accordingly. At the same time, repair and immune-reset strategies (including the CAR T trial at UCLH) are transitioning from concept to early-phase reality. Multi-disciplinary leadership will be vital in delivering the holistic, patient-centred, future-aware MS service.

References

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