The regulator's perspective: How should new therapies and follow-on products for MS be clinically evaluated in the future?

Daan Ja Crommelin, Karl Broich, Chris Holloway, Bianca Meesen, Jana Lizrova Preiningerova, Jean-Louis Prugnaud, Beatriz Silva-Lima

Research output: Contribution to journalArticleAcademicpeer-review


BACKGROUND: Although there is still no cure for multiple sclerosis (MS), the introduction of several innovative drugs with modes of action different from that of the existing drug arsenal and the progress in monitoring disease progression by imaging and using biomarkers are currently causing a knowledge surge. This provides opportunities for improving patient disease management. New therapies are also under development and pose challenges to the regulatory bodies regarding the optimal design of clinical trials with more patient-focused clinical endpoints. Moreover, with the upcoming patent expiry of some of the key first-line MS treatments in Europe, regulatory bodies will also face the challenge of recommending marketing authorisation for generic and abridged versions based on appropriate requirements for demonstrating equality/similarity to the innovator's product.

OBJECTIVE: The goal of this article is to improve the understanding of the relevant guidance documents of the European Medicines Agency (EMA) on clinical investigation of medicinal products and to highlight the issues that the agency will need to clarify regarding follow-on products of first-line MS treatments.

CONCLUSION: Today, it is clear that close collaboration between patients, healthcare professionals, regulatory bodies and industry is crucial for developing new safe and effective drugs, which satisfy the needs of MS patients.

Original languageEnglish
Pages (from-to)47-59
Number of pages13
JournalMultiple sclerosis (Houndmills, Basingstoke, England)
Issue number2 Suppl
Publication statusPublished - Aug 2016


  • Biosimilars
  • follow-on products
  • generics
  • multiple sclerosis
  • non-biological complex drugs (NBCDs), safety


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