Jeffrey Cohen, MD, director of the experimental therapeutics program at the Mellen Center for Multiple Sclerosis Treatment and Research at the Cleveland Clinic, is the newly named president of ACTRIMS, the Americas Committee for Treatment and Research in Multiple Sclerosis.
Cohen’s appointment concluded the 2019 ACTRIMS Forum that ran in Dallas, Texas, Feb. 28–March 2. His term will last three years.
Cohen began studying multiple sclerosis (MS) in the 1980s when it was still considered an untreatable disease. Today, 15 disease-modifying treatments are approved for MS, and Cohen said he has “been involved in some way or another” with the development of each of them.
Cohen has worked with ACTRIMS since its founding in 1995. The group is made up of clinicians and researchers across North America who focus on sharing knowledge in hopes of improving MS treatment options, and providing training to early career physicians and scientists. It has counterparts in other areas of the world, including the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS).
During his residency, which began in 1981, Cohen was drawn to neuroscience and immunology, both fields then in their infancies and both notoriously complex. “MS is a field where those two topics intersect,” he told Multiple Sclerosis News Today.
Back then, scientists knew that MS was a “demyelinating disease,” one that leads to the protective myelin sheath surrounding neurons. — like rubber around a wire — to degrade and hamper communication between nerve cells. More recent advances in magnetic resonance imaging (MRI) have demonstrated that the disease not only scars and damages myelin, but also nerve cells themselves.
“When I first started training, MRI had not yet emerged as a test,” Cohen said. “Now that’s one of our most important tests for diagnosing MS and monitoring it.”
He came to the Mellen Center in 1994, just one year after the first disease-modifying treatment, Betaseron (interferon beta 1b, marketed by Bayer HealthCare), was approved for MS. He treats a large population of MS patients there, and was named director of its Experimental Therapeutics Program in 2014. He designs and runs clinical trials for MS and related diseases, while training other specialists in the skills necessary to run MS trials.
Recently, he helped with an update to the McDonald Criteria, a set of MS guidelines considered “the most important diagnostic criteria for the last 15 years.”
As revised in 2017, the guidelines emphasize the utility of MRI and cerebrospinal fluid tests in diagnosing the disease that, until recently, was determined based on clinical symptoms.
Despite the field “dramatically changing,” work remains to be done, Cohen said. He particularly noted the lack of disease-modifying therapies for people with progressive MS forms, unlike the existing options for those with the relapsing-remitting form of the disease. Progressive MS and potential treatments that might better address the damage already found in these patients will be a focus of his ACTRIMS presidency, Cohen said.
Doctors still don’t know exactly what might trigger MS, and can’t predict who might develop it. “The two ends of the spectrum is where the big unmet need is right now,” he said.
Other goals will be fostering greater collaboration among researchers, physicians, and “like-minded organizations,” along with new educational and training opportunities for early-career investigators specializing in MS. Cohen says the organization is “in a position to really take off.”
For each annual meeting, ACTRIMS chooses a theme to guide its presentations and discussions. This year’s theme was “personalized medicine.” Researchers discussed ways to tailor therapies based on patient characteristics, the likelihood of treatment response, and risks for future disability.
“We’re just learning how to do that in MS,” Cohen said. “As in most fields.”