RealTalk MS – Episode 435
Title: Revisiting ECTRIMS 2025 with Dr. Bruce Bebo and Kristine Werner Ozug
Date: December 29, 2025
Host: Jon Strum
Guests: Dr. Bruce Bebo (Executive VP of Research, National MS Society), Kristine Werner Ozug (MS Advocate & RealTalk MS Team Member)
Episode Overview
This episode revisits the most popular RealTalk MS installment of 2025: a rapid-fire breakdown of the major news and highlights from ECTRIMS 2025, the world’s largest multiple sclerosis research conference. Host Jon Strum talks with Dr. Bruce Bebo, a leading research authority, right after the conference’s close, and later brings in MS patient advocate Kristine Werner Ozug to reflect on what mattered most to patients. Topics include the promise of precision medicine, diagnostic breakthroughs, cutting-edge trials, cognitive symptoms, the neuroprotective value of exercise, and the call for new clinical trial paradigms.
Key Discussion Points & Insights
1. ECTRIMS 2025 – Setting the Scene
- Massive International Gathering:
- Over 10,000 scientists and clinicians from 100+ countries after three packed days in Barcelona (01:51).
- 1,800 research posters, 100+ lectures.
- Precision Medicine as Central Theme:
- Dr. Bebo: “The theme of this year’s meeting was essentially precision medicine… finding the right treatment for the right person at the right time.” (03:10)
- Contrast to 20 years ago, when the concept was barely discussed.
2. Diagnostic Breakthroughs
- Updated McDonald Criteria:
- “The now published McDonald diagnostic criteria… allow us to better measure MS, both through blood tests and through imaging tests.” (04:35)
- Highlights:
- Earlier Diagnosis: MS can now sometimes be diagnosed using imaging plus blood biomarkers—before physical symptoms appear (04:47).
- Potential for Preventive Treatment: Dr. Bebo foresees diagnosis “just based on some blood or based pattern of signals… before it even affects the nervous system.” (06:18)
- Significance:
- This closes the gap between disease onset and intervention, improving outcomes.
“Under certain circumstances, we’ll be able to diagnose MS with just imaging and a blood biomarker without any clinical signs specific to MS being apparent.” — Dr. Bruce Bebo (04:47)
3. Real-World Therapy Insights & Precision Approaches
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Disease-Modifying Therapies (DMTs):
- There’s a gap between clinical trial conditions and real-world patient experiences.
- Ongoing studies at ECTRIMS examine how DMTs perform among diverse MS patients, including those with overlapping health conditions (06:20).
- Better understanding helps tailor treatments and supports the push toward precision medicine.
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BTK Inhibitors for Progressive MS:
- Multiple BTK (Bruton tyrosine kinase) therapies are in trials.
- Key Takeaway: “One BTK inhibitor is not like the other… some subtle differences… are resulting, I think, in significant differences in how they’re performing clinically.” — Dr. Bebo (08:54)
- This nuance underlines the complexity and potential of developing targeted treatments.
4. Patient Perspective: Kristine Werner Ozug’s Takeaways
(Segment starts 10:35)
- Thanking Trial Participants:
- Every researcher made a point to sincerely thank MS patients for their participation, recognizing research would be impossible without them (11:49).
“Without people like us participating, they don’t have research and they can’t create meaningful outcomes for people like me and our listeners.” — Kristine Werner Ozug (12:14)
Top Scientific Highlights
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Cognitive Symptoms Get the Spotlight:
- Prof. Maria Pia Amato (Italy) opened the conference by calling on clinicians to treat cognitive symptoms as seriously as physical ones (12:33).
- Need for standardized protocols and inclusion of cognitive metrics in trials.
- Kristine: “As somebody who has MS and has cognitive issues, I thought this was just wonderful to hear somebody call on this and say this out loud.” (12:50)
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Artificial Intelligence & Genetics:
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The Neuroprotective Power of Exercise:
- New studies confirm exercise—including accessible forms (chair yoga, hand cycling, etc.)—confers neuroprotective benefits (16:35).
- Inclusion: Adaptations for all mobility levels are vital.
“Any kind of movement is neuroprotective. So that was really exciting for me to share.” — Kristine Werner Ozug (17:53)
- Diet, Metabolites & MS:
- Studies linked high processed food intake to worse MS outcomes due to specific metabolites (18:35).
5. Major Awards & Thought Leadership
- Charcot Award: Dr. Ludwig Kappos
“Progression independent of relapse activity is definitely a hot button, if not the hot button research issue of the year.” — Jon Strum (20:38)
- Need for New Clinical Trial Design:
- Dr. Kappos and others advocate revising trial endpoints to reflect what is now known about MS progression (21:08).
- The process isn’t fast, but is underway.
Notable Quotes
- On the Evolution of MS Research:
- “This concept of precision medicine would not have been something we talked about 20 years ago. And it’s really inspiring and hopeful that we’re getting ever closer to that desired goal.” — Dr. Bruce Bebo (03:40)
- On the Importance of Research Volunteers:
- “They really care about the people with MS that participate in their studies… without people like us participating, they don’t have research.” — Kristine Werner Ozug (12:14)
- On Exercise as Neuroprotection:
- “Any kind of movement is neuroprotective.” — Kristine Werner Ozug (17:53)
Key Timestamps
- [01:51] – Dr. Bruce Bebo sets the stage for ECTRIMS 2025: scale, scope, and the shift toward precision medicine.
- [04:35] – Update on McDonald diagnostic criteria and earlier MS diagnosis using new biomarkers.
- [06:20] – Real-world evidence and nuanced understanding of disease-modifying therapies and BTK inhibitors.
- [10:35] – Kristine Werner Ozug provides reflections from a patient advocate viewpoint.
- [12:33] – Cognitive symptoms center stage: protocol shifts and clinical trial advances.
- [14:45] – The promise of AI in MS prognosis, and new findings in genetics/epigenetics.
- [16:35] – Exercise and neuroprotection for all levels.
- [18:35] – Diet, processed foods, and MS via gut health and metabolites.
- [19:37] – Charcot Award: Dr. Kappos calls for new standards in defining disease progression.
- [20:38] – PIRA defined and the challenge of silent MS progression.
- [21:08] – Call for clinical trial redesign.
Memorable Moments
- Bright optimism from both scientists and advocates about how rapidly the field is moving toward truly individualized therapy.
- The deeply personal thanks from scientists to patients, emphasizing MS research as a partnership.
- The shift in focus to cognitive symptoms—a frequently neglected but hugely impactful aspect of MS.
- Accessible science: Jon Strum and guests explain even complex advances (like blood biomarkers or genetic genealogy) in language grounded in daily MS experience.
- Real-world, practical advice: Highlighting resources for exercise at all ability levels (18:01).
Conclusion
This “year in review” for the global MS community captures the hope, complexity, and urgent pace of MS research today—from ever-earlier diagnosis and the promise of precision therapies to advancements in understanding cognitive impacts and the realities of living with and treating MS. Both expert and patient voices powerfully underscore that how we diagnose, treat, and study MS is evolving—driven by global collaboration, technological innovation, and a renewed commitment to putting patient lived experience at the center.