Multiple Sclerosis – Unmet Need – Unmet Need – Multiple Sclerosis: Nonrelapsing Secondary-Progressive Multiple Sclerosis (US/EU)

No treatments are approved for nonrelapsing secondary-progressive multiple sclerosis (nrSP-MS), an MS disease course in which physical disability accumulates in the absence of superimposed relapses through mechanisms that could entail diffuse inflammatory processes in the CNS (i.e., smoldering MS). Although nrSP-MS patients may receive an approved MS disease modifying therapy (DMT) off-label, management of these patients remains an area of high unmet need. Recently, Sanofi’s oral Bruton’s tyrosine kinase inhibitor tolebrutinib achieved the primary endpoint in the Phase 3 HERCULES trial in nrSP-MS, significantly reducing confirmed disability progression compared with placebo, and other agents in late-phase development are being tested in this population. This report will examine neurologists’ satisfaction with DMTs used off-label today in nrSP-MS and gauge the opportunity and value-drivers for alternatives to treat this underserved MS subpopulation.

QUESTIONS ANSWERED

• Which clinical attributes are the key drivers of prescribing decisions in nrSP-MS and which DMTs used off-label are the best current performers?
• Which clinical attributes hold the highest level of need for improved treatment options in nrSP-MS?
• Based on conjoint analysis and TPP simulation, what trade-offs among efficacy, safety, and price are neurologists willing to make for a hypothetical new drug to treat nonrelapsing SP-MS?

PRODUCT DESCRIPTION

Unmet Need offers insight into key treatment drivers and goals, the performance of current therapies, and the remaining commercial opportunities, enabling you to:

• Evaluate clinical and nonclinical product attributes that influence treatment decisions through physicians’ weightings and analysis of stated vs. derived importance.
• Pinpoint areas of high unmet need by assessing current drug performance against key attributes and treatment drivers.
• Analyze market scenarios for different target product profiles using the TPP Simulator.

Markets covered: United States, United Kingdom, France, Germany

Primary research: Survey of 61 U.S. and 30 European neurologists fielded in July 2025

Key companies: TG Therapeutics / Neuraxpharm, Novartis, Merck KGaA / EMD Serono, Roche / Genentech, Biogen, Sanofi

Key drugs: Briumvi, Kesimpta, Mavenclad, Mayzent, Ocrevus, teriflunomide, Tysabri, tolebrutinib, frexalimab