Toward a global research agenda for preventing multiple sclerosis

Background: Considerable progress has been made in understanding genetic and environmental risk factors for multiple sclerosis (MS), yet we still cannot prevent MS. Objectives: To drive progress in primary and secondary prevention of MS by developing a comprehensive research agenda based on current knowledge. Methods: A global workshop convened people with lived experience, clinicians, researchers, and policymakers with expertise in MS, other chronic diseases, epidemiology, clinical trials, genomics, immunology, virology, behavioral science, and public health to develop pathways to advance the MS prevention agenda. Results: Regarding primary prevention, workshop participants recommended acting on known modifiable risk factors; identifying novel etiological factors and determining how they lead to disease; and building coalitions including organizations with shared interests. Regarding secondary prevention, workshop participants recommended identifying biomarkers relevant from initial immune dysregulation through to initial clinical presentation, linking biomarkers to long-term MS outcomes, developing cost-effective screening tools for MS and point-of-care testing, and developing prodromal criteria for MS that could be implemented clinically. Communication and evaluation frameworks, adoption of an implementation mind-set, and engagement of public health were highlighted as key supporting elements. Conclusion: This workshop sets the stage for developing a global prevention agenda for MS.