Where multiple sclerosis treatment is heading

More than twenty drugs prevent relapses, and the strongest stop most attacks. The unmet need is slow worsening without relapses. A new class of pills has just produced its first wins there, and its first rejection.

• 817studies open or running
• 62of them in phase 3
• 5,550papers published this year
• 145NIH-funded projects

1. Now

   Nov 2026

   A new pill class works in two forms of MSHappened 51% fewer relapses

   Fenebrutinib beat an existing pill in relapsing MS and matched the only approved drug in primary progressive MS.

   51%: fewer relapses than teriflunomide.

   • Fenebrutinib, relapsing MS
   • Fenebrutinib, progressive MS

   FDA rejected a sister drug over liver riskHappened

   Tolebrutinib was turned down in the US for secondary progressive MS and recommended for approval in Europe.

   • Tolebrutinib decision

   Myelin repair drug did not workHappened

   PIPE-307 did not restore function. No repair treatment has succeeded in a large trial.

   • Myelin repair status

2. 6 months

   by May 2027

   Vidofludimus phase 3 resultsLikely

   Two trials with about 2,200 people reach their completion date in November 2026.

   • ENSURE-1
   • ENSURE-2
   • Vidofludimus calcium

   Remibrutinib phase 3 resultsPossible 51% fewer relapses with fenebrutinib

   Novartis's pill from the same class as fenebrutinib, against teriflunomide in two 1,000-person trials that finished in July 2026.

   51%: fewer relapses than teriflunomide with fenebrutinib, the same drug class.

   • REMODEL-2
   • Fenebrutinib, relapsing MS

   FDA decision on fenebrutinibPossible

   Reported to be under priority review for relapsing and primary progressive MS.

   • Fenebrutinib, relapsing MS
   • Fenebrutinib, progressive MS

3. 12 months

   by Nov 2027

   Frexalimab relapsing MS resultPossible 8% relapsed in 3 years, phase 2

   A 1,655-person trial against teriflunomide reaches its completion date in May 2027.

   8%: had any relapse over three years on the higher dose in phase 2.

   • FREXALT
   • Frexalimab phase 2

   First pill for primary progressive MSPossible

   If approved, fenebrutinib would be the first alternative to infusions for this form.

   • Fenebrutinib, progressive MS

4. 3 years

   by late 2029

   Frexalimab in progressive MSPossible

   A 943-person placebo-controlled trial in secondary progressive MS without relapses finishes in March 2028.

   • FREVIVA
   • Frexalimab phase 2

   CAR-T results from larger groupsPossible 57 people treated so far

   Longer follow-up shows whether one treatment keeps the disease quiet and how often serious reactions occur.

   57: people treated, with no new MRI lesions after the first month.

   • CAR-T early data

5. 5 years

   by late 2031

   More pills tested in progressive MSLikely

   Remibrutinib and orelabrutinib trials in progressive forms, with about 3,000 people between them, finish in 2030.

   • REMASTER
   • Orelabrutinib, secondary progressive
   • Orelabrutinib, primary progressive

   CAR-T as a one-time treatmentLong shot 57 people treated so far

   An approved cell therapy for MS that does not respond to standard drugs.

   57: people treated, with no new MRI lesions after the first month.

   • CAR-T early data

   A treatment that repairs myelinLong shot

   A drug shown to restore function, not only prevent new damage.

   • Myelin repair status

The research paths

Borrowed from other conditions

Open to join now

• Secondary progressive MS

  Remibrutinib pill (REMASTER)

  Phase 3 · 296 sites

  Locations and eligibility →

• Primary progressive MS

  Orelabrutinib pill

  Phase 3 · 86 sites

  Locations and eligibility →

• Secondary progressive MS

  Orelabrutinib pill

  Phase 3 · 96 sites

  Locations and eligibility →

• Relapsing MS

  Remibrutinib after switching from ocrelizumab

  Phase 3 · 131 sites

  Locations and eligibility →

• Progressive MS

  Frexalimab injection vs infusion

  Phase 3 · 68 sites

  Locations and eligibility →

• Relapsing MS

  Ublituximab, modified dosing (ENHANCE)

  Phase 3 · 51 sites

  Locations and eligibility →

See every recruiting MS trial →

When the large trials finish

Completion dates the trials registered. Results usually follow 3 to 12 months later.

Knowledge on the way

Not treatments yet: detection, causes and how care is delivered. Mostly NIH-funded.

• AreaQuestionFunded throughNews likely
• Detection Advanced MRI to see smoldering damage in MSNIH neurology institute staff scientists Funded through Ongoing News likely Continuous
• Care Exercise training tailored for Hispanic adults with MSUniversity of Texas Health Science Center · NIH Funded through Jun 2029 News likely 2028–2029

What just happened

Standard treatment today

• Relapsing MSA high-efficacy antibody (ocrelizumab, ofatumumab, ublituximab or natalizumab) or a pill, started early.
• Primary progressive MSOcrelizumab, the only approved treatment.
• Secondary progressive, no relapsesNo approved treatment in the US.
• SymptomsRehabilitation and treatment of fatigue, spasticity, bladder problems and walking.

See MS trials recruiting now →