Research that falls under this program is Dose timing. Based on the concentration of medication in the blood, it is determined whether the patient should stay on the standard infusion schedule of MS medication or whether they can wait a few more weeks. A major study is currently ongoing for the administration of the drug Natalizumab, while another study for the drug dosing of Ocrelizumab will hopefully start in the coming year. A project entitled Treatment discontinuation is aimed to discover if treatment with first-line treatments can be safely stopped if people are free from relapses for a longer period of time.
Cohorts
In order to apply personalized treatment, patients need to be monitored over a period of time to know how their MS develops. An important project to study this is ‘Project Y’. This cohort consists of MS patients born in 1966 in the Netherlands from which we collected blood, stool, imaging, eye and bone scan and questionnaires. We now have a valuable database with which we will be able to answer numerous scientific questions about MS. Another important cohort is ‘APPS MS’. This involves people with MS being tracked for a year as they use two apps on their smartphone. For example, we are investigating whether keystroke dynamics can be used as biomarkers to monitor MS disease activity. In the past 20 years, numerous people with MS have visited the MS Center Amsterdam for MS care and / or MS research. All the data gathered from their visits has recently been stored in one database: MS Database Amsterdam.
Biomarkers
The ability to measure substances in the blood – blood biomarkers – plays an important role in personalized care. For example we look at lipids and profiles of white blood cells. Another important biomarker is neurofilament light chain (NfL), which is a protein that is found in axons. A low level of NfL in the blood indicates that there is little brain damage at that time. In the future, having an NfL test will help determine more quickly whether a drug has an effect. This would be a big step forward in the application of personalized MS care.
