Heinz Wiendl just had the pleasure of presenting at the European Academy of Neurology (EAN) in Helsinki the five hottest developments in neuroimmunology: clinical sciences.

This format is a contribution of ISNI (International Society of Neuroimmunology) in teaming up with EAN (session was done together with Roberta Maggliozi presenting the Basic Science part)

What did he present and consider top on his personal list?

1) Development of New Diagnostic Criteria for MS

• Elimination of the need for dissemination in time (DIT) for diagnosis.
• Introduction of paraclinical evidence and optic nerve as a diagnostic tool.
• Updates to criteria for Radiologically Isolated Syndrome and Progressive MS. 

2) Bruton Tyrosine Kinase Inhibitors (BTKi) for MS Treatment

• Despite high hopes, recent studies showed no superiority of evobrutinib over teriflunomide (EVOLUTION 1 and 2 trials)
• First results really give major headaches, also because of very principle issues regarding the necessity to adopt trial designs in MS for the future
• Next trial results to be expected in autumn (tolebrutinib)

 3) Early MS consists of 3 Immunological Endophenotypes with different disease trajectories and responses to immune therapies

• Identification of three distinct immunological subtypes in early MS
• Potential for personalized treatment approaches based on endophenotype.

 4) Myasthenia Gravis is the New MS! (with regard to its dynamic, success in identifying novel treatment targets)

Massive evolution of treatment options, particularly 
I) the class of FcRn modulators 
II) the class of complement inhibitors 

but also novel treatment goals (complete remission of the disease!)

5) NMOSD and MOGAD: Precision Medicine Breakthroughs

• Advancements in understanding pathophysiology have led to better treatment strategies
• Learning pathogenesis via therapeutic intervention as a parallel principle!