This has been another exciting year for MS research. Thanks to funds provided by its chapters and private donors, the National Multiple Sclerosis Society was able to spend a record $27 million to support research programs in 2000. Since its founding 54 years ago, the Society has invested over $290 million to find the cause, treatments and cure for MS.

During the year, our volunteer scientific advisors reviewed 275 MS research proposals and approved 117 as being of high scientific merit and relevance and thus warranting the Society's support. New funding commitments totaling $3.4 million were made in the targeted research areas of gender differences, genetics, and The MS Lesion Project. The Society now has over $40 million in current and future commitments to over 300 MS research projects, for which money must be raised.

Significant advances have been made in both laboratory and clinical studies in MS. As the world's largest private supporter of MS research, the Society has been at the core of many of these advances during 2000.

Key highlights include:
 

• The U.S. FDA approved Novantrone® (mitoxantrone for injection concentrate) "for reducing neurologic disability and/or the frequency of clinical relapses" in people with secondary-progressive MS, progressive-relapsing MS, or worsening relapsing-remitting MS. This is the first drug approved in the U.S. for treating secondary-progressive MS. The Society funded some of the first studies of Novantrone in laboratory rodents with the MS-like disease EAE, which helped move this agent into clinical studies.

• National MS Society-supported investigators at Mayo Clinic reported success in promoting the regrowth of myelin in mice with MS-like disease by injecting them with immune-system proteins called "monoclonal antibodies." Additional research is ongoing in advance of possible clinical trials in humans with MS.

• The Society convened an international task force to refine and improve diagnostic procedures to reflect our better understanding of MS and advances in technology, especially MRI. A consensus publication laying out new guidelines for diagnosing MS is in preparation, which is anticipated to be widely adopted by the medical community.

• The first large clinical trial of an experimental oral therapy for MS began in the spring. The "CORAL" trial, conducted by Teva Pharmaceutical Industries, is testing an oral form of Copaxone® in 1300 people with relapsing-remitting MS over 56 weeks to determine whether it can reduce the rate of MS relapses. Another study involving Copaxone, led by University of Maryland researchers, suggested that over six years of therapy, Copaxone continues to have positive effects against relapsing-remitting MS.

• Two separate clinical trials testing two forms of interferon beta-1a (Avonex® and Rebif®) suggested that both drugs delayed development of clinically definite MS, when compared with placebo, in individuals with first signs of demyelinating disease who are at risk for developing clinically definite MS.

• An international team reported results of a study of nerve tissue samples taken from people with MS, identifying four distinct categories of MS based on the appearance of brain lesions, or areas of myelin destruction. To follow up, the Society launched "The MS Lesion Project," a five-year, $1.8 million international research project to correlate clinical manifestations of MS and findings from MRI and brain tissue samples. This targeted research initiative, centered at Mayo Clinic, is the largest grant awarded in the history of the Society.

• Researchers at Cleveland Clinic and elsewhere showed that treatment with Avonex had beneficial effects on a number of cognitive functions among people with relapsing MS.

• Berlex Laboratories announced mixed results from its North American clinical trial of Betaseron® for secondary-progressive MS. In the study, the drug failed to slow progression of disability but did reduce annual relapse rates and accumulation of brain lesions detected by MRI. The company submitted results from these and from a more successful European trial to the FDA for consideration for approval to expand Betaseron's use to people with secondary-progressive MS.

• A small study testing the ability of oral modafinil (Provigil) to fight fatigue, a common and potentially disabling symptom of MS, showed promising results in MS. Modafinil is currently FDA-approved for the treatment of narcolepsy.

• Investigators in the U.S. and the United Kingdom reported that several derivatives of marijuana, called cannabinoids, could temporarily relieve spasticity and tremor in mice with MS-like disease. A large-scale trial of capsules containing extracts of marijuana and its component THC is now underway in Britain to determine whether is can help control spasiticity in people with different forms of MS.

• The Society convened an international task force of clinicians, statisticians, ethicists and regulators to generate ethical guidelines for the use of placebos in MS clinical trials. They concluded that placebo-controlled clinical trials in forms of MS for which partially effective therapies exist are ethical, so long as study subjects are fully apprised of the availability of such therapies and are encouraged to take them.