ECTRIMS 2025: focus on precision medicine and cognition

The world's largest MS congress summarized the trends: moving beyond “relapse prevention” strategies, smarter trial design, and a focus on cognitive outcomes and treatment accessibility.

For patients, this means a shift toward personalized therapy and measurable outcomes that are important in everyday life.

Precision medicine and real-world data

A study was presented in which Nira Medical, together with the Rocky Mountain MS Clinic, used artificial intelligence models (LLM) to create an “MS registry” of >4,200 patients, allowing analysis of who responds to therapies and how, what the indicators are, and how the disease changes.

Results: EDSS (>97% of visits) was successfully extracted from EHR data, providing a tool for large-scale research.

Significance: it allows each patient to be approached based on their “profile” (biomarkers, history, MRI, therapy) — that is, with precision.

Diagnosis: new criteria and biomarkers

The analysis showed that the new 2024 McDonald Criteria yield more diagnoses and earlier than the 2017 version: in a cohort of 326 patients, 74% met the new criteria vs. 59% under the old criteria; for the group with suspected progression — 83% vs. 57%.

New areas of damage (optic nerve) and new biomarkers (e.g., central vein, kappa FLC) have been included, which improves accuracy.

For patients, this means: earlier diagnosis → earlier treatment → potentially better outcome.

Cognition, side effects, quality of life One of the open lectures was an analysis of cognitive function in MS: how damage to gray matter, atrophy, and a decline in brain reserve affect daily life.

Much attention was paid to indicators that are important not only for MRI or relapses, but also for quality of life: we see a trend of “not only stopping relapses, but also preserving function, cognition, and the ability to work and live fully.”

Rehabilitation and cognitive support have become part of the “therapeutic package” rather than an add-on.

Disease progression and therapy

The congress discussed new therapeutic approaches not only to relapsing MS, but also to progressive forms, with a focus on slowing down disability rather than just reducing relapses.

The topic of personalised therapy: the choice of treatment takes into account genetics, biomarkers, MRI data, cognitive status, lifestyle and patient preferences.

What this means for patients and practice

If you have MS, ask your doctor if biomarkers/MRI pathways are available to you, which provide a “personalized” approach to treatment selection.

Treatment approaches are changing: it is no longer “one drug for all,” but rather taking into account your indicators, lifestyle, and goals.

Cognition and quality of life are not secondary. If you experience fatigue, memory/concentration problems, this should be included in your treatment and support plan.

If you live/work in the US or in a complementary system, it is worth checking whether your center uses new approaches (registries, artificial intelligence, personalization). The diagnosis can be made earlier if you have suspicions — use the new criteria; earlier treatment = better preservation of functions.