Environmental modifiable risk factors for multiple sclerosis: Report from the 2016 ECTRIMS focused workshop.

Multiple sclerosis (MS) is an inflammatory and neurodegenerative demyelinating disease of the central nervous system (CNS), most likely autoimmune in origin, usually beginning in early adulthood. The aetiology of the disease is not well understood; it is viewed currently as a multifactorial disease which results from complex interactions between genetic predisposition and environmental factors, of which a few are potentially modifiable. Improving our understanding of these factors can lead to new and more effective approaches to patient counselling and, possibly, prevention and management of the disease.

Population structure and HLA DRB1 1501 in the response of subjects with multiple sclerosis to first-line treatments.

Using retrospectively collected outcome data for treatment naïve subjects treated with either glatiramer acetate (GA) (n=332) or interferon beta (IFN β) (n=424), we replicated the lack of a significant difference in efficacy between these treatments. Further, for both treatments, we observed a decline in the hazard of a relapse over time, which may suggest the existence of subsets of subjects with differential responses to each treatment. The HLA DRB1 1501 allele explained some of this variation in event-free survival while on GA, and we found suggestive evidence that an IRF8 polymorphism influences event-free survival in IFN β treated subjects.