The European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) is the world’s largest conference dedicated to multiple sclerosis (MS). Every year, thousands of researchers, clinicians, and patient advocates gather to present and discuss the latest advances in MS research and treatment. In 2025, the event takes place in Barcelona, bringing together more than 9,000 participants from over 100 countries. For patients, ECTRIMS is a source of hope—it highlights where science is heading and what breakthroughs may shape future care.
As the press kit states: “ECTRIMS is the largest international meeting focused on MS research and clinical care, attracting neurologists, researchers, and healthcare professionals from all over the world.” This makes it an invaluable place to learn about new findings and what they might mean for everyday life with MS.
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1. PIRA biomarkers: Early signs of progression
One of the most important insights from ECTRIMS 2025 concerns progression independent of relapse activity (PIRA). This term describes the silent worsening of MS disability, even without relapses. Researchers presented the first evidence that certain proteins in the cerebrospinal fluid can signal early PIRA.
Why this matters: detecting progression earlier could help tailor treatment strategies and encourage the development of therapies targeting this hidden disease activity. While this is still early research, the signal is strong enough to raise optimism. However, more studies are needed to confirm these biomarkers before they can guide clinical practice.
Takeaway for patients: PIRA is real and important, and science is working on tools to recognize it earlier. This may eventually help you and your doctor adjust treatment before changes become visible.
Reference: Landwehr A., et al. Proteomic Signatures of PIRA: Distinct proteins in cerebrospinal fluid are associated with progression independent of relapse activity in multiple sclerosis. Presented at ECTRIMS 2025, Barcelona, Spain
2. Menopause and MS: Hormones and health risks
Another topic that speaks directly to many women with MS: menopause. The study presented at ECTRIMS found differences in MS symptoms and comorbidities between pre- and postmenopausal women. Hormonal changes appear to influence whether the optic nerve or spinal cord is affected first, and may also impact the risk of cardiovascular disease.
Researchers caution that this is an emerging field: much more research is needed to understand exactly how menopause interacts with MS. Still, this is an important step toward personalized care for women at different stages of life.
Takeaway for patients: Menopause may influence how MS shows itself, but the evidence is still early. It’s worth talking with your healthcare team about symptoms and overall health during this transition.
Reference: Şimşek SY. Impact of Menopause on Initial Clinical Presentation and Comorbidities in Women with Multiple Sclerosis: A Comparative Study with Age-Matched Men. Presented at ECTRIMS 2025, Barcelona, Spain
3. Ultra-processed foods: Links to disease activity
Diet is one of the areas where patients often ask: what can I do? A new study showed that higher intake of ultra-processed foods was linked to more relapses and more MRI lesions in people with early MS. Ultra-processed foods are industrial products high in sugar, fat, salt, and additives—think packaged snacks, soft drinks, and ready meals.
It’s important to note: this study shows an association, not proof of causation. People who eat more processed foods may also have other risk factors. Still, the data are consistent with what we know about inflammation and overall health.
Takeaway for patients: You cannot control every risk factor, but diet is one area where small changes may help. Choosing more fresh, whole foods is likely beneficial—not only for MS, but for general health.
Reference: Dalla Costa G. Association of Ultra-Processed Food Intake with Increased MS Disease Activity: Findings from the BENEFIT Trial. Presented at ECTRIMS 2025, Barcelona, Spain
4. Pediatric ozone exposure: Environmental risks
MS is not only about those already diagnosed—family members also think about risk. Children of people with MS have a slightly higher chance of developing the disease. New evidence shows that exposure to high levels of ozone pollution before disease onset further increases this risk. The study found about a 10% higher risk per exposure unit.
This is the first consistent evidence linking ozone exposure and pediatric MS. While families cannot control air pollution, awareness of environmental risks can support public health efforts and long-term prevention.
Takeaway for patients: The absolute risk for children remains low, but environmental factors like clean air may play a role. Advocacy for healthier environments benefits everyone.
Reference: Pugliatti M., Bergamaschi R., Pilotto A., Ghezzi A., et al. Exposure to ozone is associated with an increased risk of pediatric multiple sclerosis (pedMS): the PEDIGREE study. Abstract IMS25-LBA-176. Presented at ECTRIMS 2025, Barcelona, Spain
5. Ocrelizumab: Effective, but with limits
Ocrelizumab, a widely used therapy, was also in the spotlight. In real-world data, it showed stronger relapse control compared to fingolimod, natalizumab, and alemtuzumab. The differences were modest but meaningful. However, researchers emphasized that ocrelizumab did not prevent progression independent of relapse activity (PIRA).
This underlines a critical point: while current treatments are very effective against relapses, they do not stop the silent progression of MS. New therapies are needed to target this challenge.
Takeaway for patients: Ocrelizumab remains one of the most effective options for relapse prevention. But ongoing research is vital to address progression beyond relapses.
Reference: Roos I. Real-world effectiveness of ocrelizumab in multiple sclerosis: a multi-registry observational cohort study. Presented at ECTRIMS 2025, Barcelona, Spain
6. Understanding evidence: Statistical vs. clinical significance
When hearing about studies, it’s easy to get lost in the numbers. Two important distinctions help:
Statistical significance: whether a finding is unlikely to be due to chance.
Clinical significance: whether the finding is large enough to matter for daily life.
Also, beware of relative vs. absolute numbers. For example, a “50% risk reduction” may sound big—but if the baseline risk is 2 in 100, it means going down to 1 in 100. Both views are important, but absolute numbers often show the real impact more clearly.
Conclusion and outlook
ECTRIMS 2025 brings encouraging and thought-provoking findings—from early biomarkers of progression, to lifestyle factors like diet, to women’s health and environmental influences. For patients, the key message is: research is moving forward, and while not every discovery changes care today, each step builds the foundation for better, more personalized treatment tomorrow.
More insights from ECTRIMS 2025 will follow in the coming days on MS-Perspektive.
Disclaimer: This information is for educational purposes only and does not replace professional medical advice. Always discuss your individual treatment and lifestyle choices with your healthcare team.
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Nele
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