Merck: a relentless pursuit of the best outcomes for the entire MS community

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Germany's Merck (MRK: DE) has spent more than 25 years researching and developing solutions for advancing multiple sclerosis (MS) care.

The Pharma Letter held a Q&A with Dimitrios Georgiopoulos, Senior Vice President, Global Franchise Head, N&I, Merck, about the company's commitment to pushing the boundaries of knowledge in MS.

In what ways does Merck's 'As One for Patients' ethos manifest in the company's commitment to individuals with MS, particularly in its efforts to support older adults living with the disease?

Merck has more than 25 years of experience in MS care and is dedicated to addressing the significant unmet needs of patients. Our goal is to support People with MS (PwMS) at every stage of their journey, from diagnosis through to long-term living with MS. This commitment extends to those aging with MS, reflecting our ethos of working “As One for Patients” and also our strong belief in Diversity and Inclusion both in the workplace and in our society at large.

We recognize that while MS often begins in young adulthood, its prevalence among older individuals is increasing. Projections indicate that by 2031, 65% of PwMS in the EU5 will be aged 50 or older. This of course is a positive outcome of the fact that we have many more treatments able to slow down effectively the progress of the disease. But as this population now gets bigger, we also acknowledge that older adults with MS (OAMS) face unique challenges, particularly due to immunosenescence—the gradual decline of the immune system associated with aging—along with higher rates of comorbidities, polipharmacy and increased susceptibility to infections. For us at Merck, this is a call to action.

Unfortunately, there is a lack of data on the effectiveness and safety of MS treatments for OAMS, as most studies include patients only up to 55 years old. This presents an unmet need for the entire MS community. We are committed to providing data for this population, as demonstrated at ECTRIMS 2024, where we shared Real World Data to aid decision-making and raise awareness about the necessary adjustments in caring for aging PwMS, since currently, only 33% of OAMS  engage in discussions about aging with MS (based on data presented at ECTRIMS by Real World MS).

Our “As One for Patients” purpose drives us to continuously strive for the best outcomes for the entire MS community, beyond just medication.

How has the treatment landscape evolved over the past 25 years, especially for older adults and with the introduction of disease-modifying therapies? Are these changes resulting in improved outcomes for patients?

While still insufficient, recent studies are beginning to show positive outcomes for older people with MS, encouraging PwMS to engage in discussions with their healthcare providers about the right treatment choice also in the context of age. Twenty-five years ago, treatment options were limited, and individuals with MS often experienced rapid progression to severe disease stages. However,various factors like advancements in MS research or the early use of highly effective treatments showed that disease progression can be slowed down, aiming at enabling patients to live longer with a better quality of life and reduced risk of severe disability.

Historically, older adults with MS have been overlooked in studies, and their unique needs, along with aging-related challenges, are rarely addressed. As this population increases globally, it is essential to raise awareness of these specific needs and provide clear, evidence-based answers to support the MS community in decision-making.

What makes MS especially challenging for older adults, and how is Merck addressing these challenges? Is there any information being presented at ECTRIMS that highlights the company's efforts in this area?

As patients with MS age, they often experience a decline in acute disease activity, reduced repair capacity, increased brain atrophy, and diminished brain reserve. Additionally, an aging immune system, characterized by immunosenescence, can elevate the risk of infections, which is a concern for 85% of older adults with MS (based on data presented at ECTRIMS 2024 by Real World MS) when initially considering a disease-modifying therapy (DMT). These complexities, along with the presence of comorbidities and polypharmacy, make managing MS in older adults particularly challenging.

We are committed to supporting both older and younger patients by providing valuable data to the MS community. Numerous presentations of Real World Evidence on older adults with MS have been shared at ECTRIMS, highlighting our dedication to assisting older PwMS, their caregivers, and the scientific community.

Our commitment to "As One for Patients" inspires us to relentlessly pursue the best outcomes for the entire MS community, going also beyond medication to encompass comprehensive care and support.