RealTalk MS Episode 439: Preventing MS with Dr. Bruce Bebo

Host: Jon Strum
Guest: Dr. Bruce Bebo, Executive Vice President and Chief Research and Medical Affairs Officer, National MS Society
Date: January 26, 2026

Episode Overview

This episode explores one of the most ambitious frontiers in multiple sclerosis (MS) research: the prevention of MS. Host Jon Strum welcomes Dr. Bruce Bebo to discuss global efforts to identify risk factors, develop prevention strategies (primary and secondary), and coordinate international research. The discussion focuses on the transition from treatment and cure toward outright prevention, summarizing key advances, research initiatives, and the collaborative movement shaping the future of MS.

Key Discussion Points & Insights

1. Recent Advances in MS Research (00:01 – 14:58)

• Recognition of Innovation:

  • Dr. Manuel Friese awarded the 2025 Barancik Prize for studying inflammation-nerve interactions and neurodegeneration in MS.
  • Quote (Jon):
    “Dr. Friese... discovered that nerve cells aren't just passive victims of attack... [they] actively respond to inflammation by triggering internal pathways that disrupt several processes.” (04:23)

• New Therapeutic Avenues:

  • GDF15 protein, which rises during pregnancy and is associated with reduced MS relapses, is under investigation for immune system reprogramming.
  • BRAVE in MS network identified Bavasant (originally for sleep disorders) as a potential remyelination and neuroprotection drug.
  • AI used in Italy to predict MS progression shortly after diagnosis, showing promise to reduce uncertainty for patients.

2. What Does Preventing MS Mean? (15:00 – 21:11)

• Prevention in Research:

  • Prevention is one of three pillars on the Pathways to Cures Roadmap: Stop, Restore, and End—with "End" defined as prevention.

  • Primary Prevention: Preventing MS in the general population by addressing critical, identifiable risk factors (genetic and environmental).

    • Example: A future EBV vaccine could test whether EBV is “necessary and sufficient” for MS development.
    • Genetics account for ~30% of MS risk; environment/pathogens for ~70%.

  • Secondary Prevention: Identifying and intervening in high-risk individuals before clinical or neurologic symptoms arise.

    • Risk factors include family history, childhood obesity, smoking, and living in northern latitudes.
    • AI could analyze health records to find at-risk patterns and optimize preventive intervention.

  • Quote (Dr. Bebo):
    “So, I think we're closer to secondary prevention than we are to primary prevention. And the tools that we need to identify people who are at high risk... are starting to come together right now.” (20:51)

3. The Global Prevention Workshop: Vision & Collaboration (21:11 – 24:35)

• About the Lisbon Workshop:

  • 50+ MS leaders met to define a global MS prevention research agenda.
  • Inspired by the collaborative success of the International Progressive MS Alliance.
  • Early stage of resource pooling, with emphasis on developing funding and aligning international efforts.

• Leadership Roles:

  • MS Canada and Australia are spearheading the prevention initiative, with the US MS Society providing strong support—intellectual, financial, and collaborative.
  • Quote (Dr. Bebo):
    “...let it be officially declared that, yes, we will have a role in this... both financially and intellectually.” (23:42)

4. Next Steps for the International Research Agenda (24:35 – 26:22)

• Immediate Plans:

  • Another global meeting planned for summer to define strategic investments and begin funding key prevention research.
  • Progress happening both as part of the global collaboration and through separate national projects.

• Collaboration Blueprint:

  • The approach models after the successful International Progressive MS Alliance, with necessary adaptation for prevention-focused work.
  • Quote (Jon):
    “...the alliance, frankly, is the ideal blueprint for how international collaboration, how working with global partners accelerates everything and brings those topics to the top of everyone’s radar in the research community.” (25:41)

5. How Close Are We to Preventing MS? Tools, Concepts, and Examples (26:22 – 30:51)

• Proximity to Prevention:

  • Dr. Bebo suggests MS prevention (the “end cure”) is the closest of the three cure goals under the Pathways to Cures roadmap.
  • Envisions development of an “MS risk tool”—similar to risk calculators for heart disease or diabetes—that integrates genetics, environment, and healthcare data.
  • Example: In type 1 diabetes, secondary prevention has delayed disease onset for high-risk individuals; MS could follow a similar pathway.

• Radiologically Isolated Syndrome (RIS):

  • People with RIS (MRI signs of MS but no clinical symptoms) benefit from early MS therapies—delaying or possibly preventing progression.
  • Quote (Dr. Bebo):
    “...we may have already prevented MS in some people from those trials of radiologically isolated syndrome... minimally, we're going to delay the onset of MS by years... and perhaps we might even prevent MS from occurring in some people.” (28:42)

6. The Value of Prevention & Research Society’s Role (30:51 – end)

• Energizing the Community:
  • Host expresses optimism and renewed enthusiasm for the direction of prevention in MS research.
  • Dr. Bebo thanks the MS Society and the community for their critical support, especially with uncertain federal research funding.
  • Quote (Jon):
    “I always learn something new when I talk with you, but the other thing that happens is I come away from these conversations really energized…” (30:30)

Notable Quotes & Memorable Moments

• “Of the three cures in Pathways to Cures—stop, restore, and end—I think it’s this end cure, the prevention cure, that we’re the closest to.”
  —Dr. Bruce Bebo (26:51)

• “Our vision is to develop a multimodal risk tool... that would churn out... a 10-year MS risk score.”
  —Dr. Bruce Bebo (27:56)

• “Perhaps we might even prevent MS from occurring in some people. And that’s kind of the first step towards this secondary prevention.”
  —Dr. Bruce Bebo (29:38)

• “Stay tuned. It’s going to move fast, I think. Yeah. Going to move fast.”
  —Dr. Bruce Bebo (30:51)

Timestamps for Important Segments

• [00:01 – 14:58] — News on breakthroughs (Barancik Prize, GDF15, Bavasant, AI predictions)
• [15:00 – 21:11] — Dr. Bebo explains prevention in MS: primary vs. secondary
• [21:11 – 24:35] — Details on the international prevention workshop & leadership roles
• [24:35 – 26:22] — Next steps for global collaboration, funding, and research
• [26:22 – 30:51] — Dr. Bebo’s vision: risk tools, diseases to emulate, and RIS
• [30:51 – End] — Host reflections, importance of research society funding, closing remarks

Conclusion

This episode underscores a paradigm shift: from treating and curing MS, to preventing it altogether. With primary and secondary prevention strategies under serious investigation and international organizations aligning resources, the future of MS research looks promising—and perhaps, for the first time, the door is open to stopping MS before it starts.

Stay tuned. As Dr. Bebo says, “It’s going to move fast.”