Multiple sclerosis (MS)

New solutions are needed in the MS market

Understanding of the biology and importance of disability accumulation has evolved

*A B-cell–depleting anti-CD20; relapse-independent worsening, 88% (147/167); relapse-associated worsening, 14.4% (24/167).

A text callout highlighting “A large proportion of people with multiple sclerosis (MS) continue to experience clinical deterioration despite a lack of overt ongoing inflammatory disease activity.... This is often referred to as progression independent of relapse activity...”

†The concepts and contents of the article by Giovannoni, et al, emerged from several meetings hosted by Sanofi Genzyme during the 2 years before its publication. Sanofi Genzyme provided financial support to help adapt and design the figures and for a third party to help coordinate the submission of the manuscript to the journal. At no stage did any staff at Sanofi Genzyme have input into the writing or editing of the article.

Each type of MS has a unique path toward irreversible disability accumulation^4,5

A Flowchart illustration highlighting the disease progression of RMS, SPMS, and PPMS.

Disability accumulation originates from 2 different processes³

Across the MS spectrum, unmet needs remain for your members

A funnel graphic showing the prevalence of MS in the United States.

Current treatments may not completely impact drivers of disability accumulation^15-20

Illustration highlighting that the current treatments may not completely impact drivers of disability accumulation.

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References: 1. Lublin FD, Häring DA, Ganjgahi H, et al. How patients with multiple sclerosis acquire disability. Brain. 2022;145(9):3147–3161. doi:10.1093/brain/awac016 2. Kappos L, Wolinsky JS, Giovannoni G, et al. Contribution of independent progression vs relapse-associated worsening to overall confirmed disability accumulation in typical relapsing multiple sclerosis in a pooled analysis of 2 randomized clinical trials. JAMA Neurol. 2020;77(9):1132–1140. doi:10.1001/jamaneurol.2020.1568 3. Giovannoni G, Popescu V, Wuerfel J, et al. Smouldering multiple sclerosis: the ‘real MS’. Ther Adv Neurol Disord. 2022;15:17562864211066751. doi:10.1177/17562864211066751 4. Tur C, Carbonell-Mirabent P, Cobo-Calvo Á, et al. Association of early progression independent of relapse activity with long-term disability after a first demyelinating event in multiple sclerosis. JAMA Neurol. 2023;80(2):151–160. doi:10.1001/jamaneurol.2022.4655 5. Secondary progressive multiple sclerosis (SPMS). National Multiple Sclerosis Society. Accessed June 13, 2025. https://www.nationalmssociety.org/understanding-ms/what-is-ms/types-of-ms/progressive-ms 6. Coret F, Pérez-Miralles FC, Gascón F, et al. Onset of secondary progressive multiple sclerosis is not influenced by current relapsing multiple sclerosis therapies. Mult Scler J Exp Transl Clin. 2018;4(2):2055217318783347. doi:10.1177/2055217318783347 7. Manjunatha RT, Habib S, Sangaraju SL, Yepez D, Grandes XA. Multiple sclerosis: therapeutic strategies on the horizon. Cureus. 2022;14(5):e24895. doi:10.7759/cureus.24895 8. Disease modification. National Multiple Sclerosis Society. Accessed June 13, 2025. https://www.nationalmssociety.org/for-professionals/for-healthcare-professionals/managing-and-treating-ms/disease-modification 9. Scalfari A, Traboulsee A, Oh J, et al. Smouldering-associated worsening in multiple sclerosis: an international consensus statement on definition, biology, clinical implications, and future directions. Ann Neurol. 2024;96(5):826–845. doi:10.1002/ana.27034 10. S0101: Age and sex 2023 American Community Survey 1-year estimates. US Census Bureau. Accessed June 13, 2025. https://data.census.gov/table/ACSST1Y2023.S0101?q=United States 11. Wallin MT, Culpepper WJ, Campbell JD, et al. The prevalence of MS in the United States: a population-based estimate using health claims data. Neurology. 2019;92(10):e1029–e1040. doi:10.1212/WNL.0000000000007035 12. Data on file. Sanofi US. 13. Zhang Y, Salter A, Jin S, et al. Disease-modifying therapy prescription patterns in people with multiple sclerosis by age. Ther Adv Neurol Disord. 2021;14:17562864211006499. doi:10.1177/17562864211006499 14. Fuchs TA, Schoonheim MM, Zivadinov R, et al. Cognitive progression independent of relapse in multiple sclerosis. Mult Scler. 2024;30(11–12):1468–1478. doi:10.1177/13524585241256508 15. Correale J, Halfon MJ, Jack D, Rubinstein A, Villa A. Acting centrally or peripherally: a renewed interest in the central nervous system penetration of disease-modifying drugs in multiple sclerosis. Mult Scler Relat Disord. 2021;56:103264. doi:10.1016/j.msard.2021.103264 16. Oh J, Bar-Or A. Emerging therapies to target CNS pathophysiology in multiple sclerosis. Nat Rev Neurol. 2022;18(8):466–475. doi:10.1038/s41582-022-00675-0 17. Turner TJ, Brun P, Gruber RC, Ofengeim D. Comparative CNS pharmacology of the Bruton’s tyrosine kinase (BTK) inhibitor tolebrutinib versus other BTK inhibitor candidates for treating multiple sclerosis. Drugs R D. 2024;24(2):263–274. doi:10.1007/s40268-024-00468-4 18. Galesaria A, Häusler D, Weber MS. Microglia: the missing link to decipher and therapeutically control MS progression? Int J Mol Sci. 2021;22(7):3461. doi:10.3390/ijms22073461 19. Siden M, Rissanen E, Tuisku J, et al. Evaluation of the effect of fingolimod treatment on microglial activation using serial PET imaging in multiple sclerosis. J Nucl Med. 2017;58(10):1646–1651. doi:10.2967/jnumed.116.183020 20. Yang JH, Rempe T, Whitmire N, Dunn-Pirio A, Graves JS. Therapeutic advances in multiple sclerosis. Front Neurol. 2022;13:824926. doi:10.3389/fneur.2022.824926