Personalised Treatments in MS (Brown Group)
Led by a panel of expert patients, we use big data and cutting-edge artificial intelligence to identify the right drug, for the right person at the right time.
We enable everyone in the UK to participate in the most crucial research, and we reduce healthcare inequalities.
Learn more about our projects below.
Meet the Group
Learn a little more about each member of the Personalised Treatments group by clicking on their profile picture below.
Dr Will Brown
Group Lead
Prof Alasdair Coles
Professor of Neurology
Cyrus Daruwalla
Clinical Research Fellow
Courtney Kremler
Ph.D. Candidate
Daniela Soares Régua
Ph.D. Candidate
Gbenga Adesoye
Internal Medicine Trainee
Toni Bray
Clinical Research Manager
Jacky Porter
Clinical Research Manager
Sam Grant
Clinical Research Admin
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Maria Sanfilippo
Clinical Research Admin
Debbie Morrall
Clinical Research Admin
Nosson Almeida
Clinical Research Admin
Keith Logan
Clinical Research Admin
Magdalena Dragan
Clinical Research Admin
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Caitlin McArthur
Academic Resident Doctor
Dr Jada Coker
Visiting Research Fellow
Ryan Smith
Research Fellow
Lottie Gill
Research Fellow
Nadira Fernando
TBC
Publications
Brain 2026
Online Ahead of Print
Treatment escalation after clinically silent MRI lesions in relapsing-remitting multiple sclerosis
This article provides important evidence on how clinically silent MRI lesions can help guide treatment decisions in multiple sclerosis. Using real-world data from the international MSBase collaboration, the study shows that new on-treatment MRI lesions in the absence of clinical symptoms are a meaningful predictor of future outcomes. The findings indicate that people with single or multiple silent MRI lesions are at greater risk of subsequent relapse and disability progression, while treatment escalation following silent lesions substantially reduces the risk of future relapse. Together, these results suggest any seemingly "silent" disease activity warrants careful clinical consideration and may support earlier treatment escalation than is currently recommended in most guidelines.
Nature Reviews Neurology
Volume 22, Page 182-195, March 2026
Towards primary prevention of multiple sclerosis
Multiple sclerosis (MS) is a major cause of disability in young adults and remains incurable despite advances in treatment. This Perspective explores the challenges and opportunities of preventing MS before neurological damage occurs. It highlights difficulties including identifying people at sufficient risk, the low incidence of MS in the general population, limited opportunities for intervention and the potential risks of long-term treatment. Drawing on lessons from other diseases and recent advances in radiologically isolated syndrome, it proposes strategies for improving risk prediction, trial design, outcome selection and communication and concludes that developing and testing primary prevention strategies for MS should now become a priority.
Multiple Sclerosis Journal
Volume 29, Issue 7, June 2023
Early non-disabling relapses are important predictors of disability accumulation in people with relapsing-remitting multiple sclerosis
This study investigated whether non-disabling relapses early in relapsing-remitting multiple sclerosis (RRMS) are associated with future disability accumulation. Data from the MSBase registry was used to compare people with non-disabling relapses within two years of diagnosis with those who had no early relapses or experienced disabling relapses. Early non-disabling relapses were associated with a higher risk of disability accumulation in people who were untreated or receiving platform disease-modifying therapies. However, this increased risk was not observed among people receiving high-efficacy therapies. The findings suggest that non-disabling relapses may provide important prognostic information and should be considered when making treatment decisions in early RRMS.
The Lancet Neurology
Volume 20, Issue 9, September 2021
Safety and efficacy of bexarotene in patients with relapsing-remitting multiple sclerosis (CCMR One): a randomised, double-blind, placebo-controlled, parallel-group, phase 2a study
Preliminary research has suggested that agonists of the retinoic acid receptor RXR-gamma may promote remyelination, making them a potential therapeutic target for multiple sclerosis. Bexarotene, a non-selective RXR agonist that is approved for the treatment of cutaneous T-cell lymphoma (CTCL), was evaluated in a clinical trial involving 52 participants with relapsing-remitting multiple sclerosis (RRMS) to assess its safety and efficacy. The primary safety outcomes were the number of adverse events and withdrawals attributable to bexarotene, while the primary efficacy outcome was the patient-level change in mean lesional magnetisation transfer ratio (MTR). All participants receiving bexarotene developed central hyperthyroidism, and most also experienced hypertriglyceridaemia, indicating poor tolerability. Furthermore, there was no significant difference in MTR between the bexarotene and placebo groups, demonstrating a lack of efficacy. Based on these findings, bexarotene is not recommended for the treatment of multiple sclerosis due to its poor tolerability and failure to achieve its primary efficacy outcome.
The Lancet Neurology
Volume 19, Issue 4, Page 307-316, April 2020
Timing of high-efficacy therapy for multiple sclerosis: a retrospective observational cohort study
This international observational study examined whether starting high-efficacy therapy early in relapsing-remitting multiple sclerosis (RRMS) is associated with better long-term disability outcomes. Data from the MSBase and Swedish MS registries were analysed to compare patients who began high-efficacy treatment within two years of disease onset to those who started four to six years after onset. After matching patients with similar baseline characteristics, those treated early had significantly lower disability scores from six through ten years after disease onset. At ten years, the mean EDSS was 2.3 in the early-treatment group compared with 3.5 in the late-treatment group. The findings support earlier use of high-efficacy therapies to reduce long-term disability.
JAMA 2019
Volume 321, Issue 2, Page 175-187
Association of Initial Disease-Modifying Therapy With Later Conversion to Secondary Progressive Multiple Sclerosis
This international cohort study examined whether disease-modifying therapies (DMTs) reduce the risk of relapsing-remitting multiple sclerosis (RRMS) progressing to secondary progressive MS (SPMS). It analysed prospective data from 1,555 patients across 68 neurology centres in 21 countries, using a validated definition of SPMS. Compared with interferon beta or glatiramer acetate, initial treatment with fingolimod, natalizumab or alemtuzumab was associated with a lower risk of conversion to SPMS. Earlier treatment and earlier escalation to higher-efficacy therapies were also associated with reduced risk. These findings suggest that both the choice and timing of DMTs may influence long-term disease progression, although treatment risks must also be considered.
Brain
Volume 144, Part 6, Pages 1646-1654, June 2021
Surface-in pathology in multiple sclerosis: a new view on pathogenesis?
This review explores the uneven distribution of multiple sclerosis (MS) pathology throughout the central nervous system and its implications for understanding disease mechanisms and treatment. MS abnormalities are particularly concentrated near surfaces: white matter lesions tend to occur around the ventricles, while grey matter lesions and neuronal loss are greatest near the brain’s outer, subpial surface. MRI studies have also identified corresponding gradients of tissue damage extending inward from these surfaces, which are associated with clinical outcomes and may predict treatment response. This suggests that soluble factors from meningeal inflammation, released into the cerebrospinal fluid, may contribute to these patterns and highlight potential implications for therapies targeting disease processes within the brain.
The Lancet Neurology
Volume 16, Issue 4, Pages 271-281, April 2017
Treatment effectiveness of alemtuzumab compared with natalizumab, fingolimod, and interferon beta in relapsing-remitting multiple sclerosis: a cohort study
This international cohort study compared the effectiveness of alemtuzumab with natalizumab, fingolimod and interferon beta in people with relapsing-remitting multiple sclerosis (RRMS). The study analysed propensity-matched clinical data from MSBase and six other cohorts, including patients treated for up to five years. Alemtuzumab was associated with fewer relapses than interferon beta and fingolimod, while relapse rates were similar to those seen with natalizumab. Disability accumulation was also similar across treatments, although natalizumab was associated with greater disability improvement than alemtuzumab. The findings suggest that alemtuzumab and natalizumab are both highly effective treatments for RRMS, with treatment choice between them influenced primarily by their differing safety profiles.
Click on the paper titles below to view the key publications to which members of the Personalised Treatments in MS group have contributed.
Robust real-world evidence: optimising disease-modifying treatments for multiple sclerosis
A real-world clinical validation for AI-based MRI monitoring in multiple sclerosis
Remyelination varies between and within lesions in multiple sclerosis following bexarotene
Remyelination in humans due to a retinoid‐X receptor agonist is age‐dependent
Clinician and patient experience of neurology telephone consultations during the COVID-19 pandemic
Determinants of therapeutic lag in multiple sclerosis
Surface-in pathology in multiple sclerosis: a new view on pathogenesis?
Delay from treatment start to full effect of immunotherapies for multiple sclerosis
Magnetisation transfer ratio abnormalities in primary and secondary progressive multiple sclerosis
Timing of high-efficacy therapy for multiple sclerosis: a retrospective observational cohort study
Keratinocyte growth factor impairs human thymic recovery from lymphopenia
An abnormal periventricular magnetization transfer ratio gradient occurs early in multiple sclerosis
Alemtuzumab: evidence for its potential in relapsing-remitting multiple sclerosis
Funding
The current funding sources for the Personalised Treatments in MS group are shown below.
Delivering state-of-the-art MRI results automatically into healthcare records to improve care and transform research in multiple sclerosis: a pilot study
2024-07 to 2026-06 | Grant
MS Society (London, GB)
Epic neuroimmunology smartform and CONSENTOR
2024-01 to 2026-01 | Grant
Roche Pharmaceutical (Basel, CH), Sanofi (Paris, FR), Novartis Pharmaceuticals UK Limited (London, GB)
Installing and overseeing an open-source software platform (XNAT) to enable reliable and efficient imaging processing for Cambridge Neuroscience
2023-06 to 2025-05 | Grant
NIHR Cambridge Biomedical Research Centre (Cambridge, GB)
A 12-site retrospective observational study of real-world fumarate tolerability
2022-12 to present | Grant
Biogen IDEC (MA, MA, US)
Improving the long-term outcomes for people with multiple sclerosis by studying real-world data
2022-03-01 to 2027-02-28 | Grant
NIHR Academy (Leeds, GB)