I am by no means a baker, but I once participated in my department's bake-off and somehow came 3rd place with my blueberry yoghurt cake!

There have been significant findings and improvements in our understanding of multiple sclerosis (MS) and related inflammatory diseases of the brain and spinal cord over the past few years. However, there remain knowledge gaps such as around the optimal treatment approach in certain scenarios which we not uncommonly encounter in clinic. I am motivated to try and shed light on these knowledge gaps, so as to inform our clinical practice and our care of people with MS and related diseases.

It has been exciting to see the development of multiple therapies with different mechanisms of action, including highly effective treatments at controlling the inflammatory activity of MS. These therapies have also provided insights on MS disease mechanisms such as potential contributors to disability progression. Further, the advancements in defining CNS (central nervous system) autoimmune diseases of NMOSD (Neuromyelitis optica spectrum disorders) and MOGAD (Myelin oligodendrocyte glycoprotein antibody-associated disease) as distinct from MS have been important. MS-specific disease-modifying therapies do not appear to be effective in NMOSD and MOGAD, and additional research is required to determine the ideal treatment approach for these conditions.

Despite advances in MS treatment, there remain questions around the best way to treat people with MS in clinical scenarios for which randomised-controlled trial evidence is lacking. These include the settings of family planning, and what to do if a treatment such as ocrelizumab needs to be discontinued. In recent years, there have been advances in defining autoimmune diseases of the CNS distinct from MS such as MOGAD. The optimal treatment strategy for MOGAD is not yet well defined. We therefore plan to investigate these clinically pertinent questions through use of real-world data collected from neuroimmunology centres in the MSBase International Registry. We will also collaborate with the University of Oxford and other centres to study MOGAD. The insights we gain will be immediately applicable to the clinical care of people with MS and MOGAD.

Although randomised-controlled trials (RCT) have proven the effectiveness of disease-modifying therapies in controlling MS disease activity, there are clinical scenarios in which RCTs are not feasible to perform. In these instances, we require high-quality observational datasets to generate the evidence needed for optimal clinical management. Our research using real-world data will shed clinically relevant insights directly applicable to the treatment and care of people with MS and MOGAD.

I enjoy working together with and learning from my colleagues, in trying to fill knowledge gaps in MS and neuroimmunologic diseases. There can be challenges during each project, but it is most rewarding working with the team and coming out the other side with important findings that inform our clinical care.