Evolving Neurology And Neuroinflammation Therapies And Trials In 2025

By Daniel Vitt, Ph.D., CEO, Immunic

The pharmaceutical industry is entering a potentially transformative phase in addressing significant unmet medical needs in neurology and neuroinflammation. For decades, treatments for conditions like multiple sclerosis (MS), Parkinson’s disease, and Alzheimer’s disease have focused primarily on symptom management rather than modifying disease progression. In 2025, however, a shift is well underway toward more holistic and proactive approaches that emphasize neuroprotection, disease modification, and patient-centric solutions. This year could be defined by advancements in brain health and increased funding for innovative therapies but also an evolving regulatory landscape that demands greater justification for investment in high-impact breakthroughs.

Moving Beyond Relapse Treatment: The Neuroprotection Imperative

Historically, MS treatments have centered on systemic immune regulation, suppressing the immune system to counteract inflammatory relapses. While this approach has helped reduce the frequency and severity of relapses, alleviating acute inflammation and its associated symptoms, it does little to address smoldering neurodegeneration — a slow, ongoing process of nerve damage and silent disease progression that occurs independently of clinical relapses. This gradual deterioration is the underlying cause of worsening disability and long-term disease progression in MS, independent of relapse activity. Neuroprotection, which aims to safeguard neurons before they deteriorate, could represent a paradigm shift in treating progression in MS and other neurodegenerative disorders.

Research now recognizes that MS is not just an inflammatory disease; it is a complex interplay of immune dysfunction, neurodegeneration, and progressive disability. Effective treatments must balance immunomodulation with strategies that protect neuronal integrity and neuronal survival.

From my conversations with researchers, clinicians, and physicians, it’s clear that traditional relapse-focused approaches are no longer enough. Many experts are turning, for example, to biomarkers such as neurofilament light chain (NfL) and advanced imaging techniques. A key goal for clinical MS research today is to track disease progression that isn’t visible through conventional magnetic resonance imaging (MRI)-based assessments. The so-called ‘confirmed disability progression’ can be measured by the Expanded Disability Status Scale (EDSS). The ability to measure smoldering inflammation and early neuronal damage is reshaping how we think about intervention — bringing us closer to therapies that don’t just manage symptoms but slow or even prevent neurodegeneration and long-term disability progression.

The Rise Of Patient-Centric Therapies

A patient-first approach is set to dominate neurology and neuroinflammation drug development going forward. Traditionally, drug development prioritized clinical outcomes, focusing primarily on efficacy as measured in trials. While safety has always been a fundamental parameter, there is now a growing emphasis on patient experience — including ease of use, safety, and long-term adherence, as well as expanded efficacy parameters that better reflect real-world benefits.

Over the past few years, I’ve noticed a significant shift in the criteria that are important to patients when choosing their treatment plan, driven by the variety of available treatment options. Many now express a preference for oral therapies over injectable or intravenous agents, citing convenience and better adherence. Oral treatments tend to allow them to go about their lives with fewer disruptions, making it easier to stay consistent with their medication. Regulators are also responding to this reality — there is an increasing focus on patient-reported outcomes, and I expect to see this trend shape how future approvals unfold.

This shift in patient preference is influencing how treatments are developed and prescribed. As convenience and adherence take a higher priority, the focus is also turning to optimizing clinically relevant efficacy while minimizing side effects. As more patients demand treatments that integrate seamlessly into daily life, pharmaceutical companies must align their development strategies accordingly to ensure both clinical and real-world success.

Funding For Brain Health Research

In today’s evolving investment landscape, securing financial backing increasingly depends on differentiation. The push for high-impact breakthroughs — rather than incremental improvements — has led to greater entrepreneurial involvement in drug discovery and development. Companies focusing on areas such as neuroprotection and disease modification are well positioned, as investors increasingly prioritize therapies with the potential for long-term impact.

At the same time, regulatory bodies and investors alike are demanding clear evidence of an unmet medical need before committing resources to new therapies. This trend will shape how research and clinical trials are conducted, ensuring that funds are directed toward treatments with the potential for significant patient impact.

Thriving in biotech requires a mindset of constant evolution — expect the unexpected, adapt with agility, and never settle for solutions that don’t truly solve the problem. Progress comes not from predictability, but from resilience and critical thinking.

Harnessing Technology To Advance Drug Discovery And Clinical Trials

The role of education in medicine is evolving alongside technological advancements. Traditionally, healthcare professionals sought the “best treatment” based solely on clinical safety and efficacy, which is usually a one-dimensional view. However, the future of medicine is shifting toward an integrated, multidimensional, personalized approach — one that requires both robust education and access to cutting-edge tools. Therefore, educating healthcare professionals and patients on these advancements is crucial to optimizing outcomes.

One of the most exciting developments I have seen in recent years is the use of AI/ML and Big Data analytics in research and clinical development — not only transforming drug discovery but also enhancing how medical professionals and patients understand diseases and treatment options. AI-driven platforms can identify promising compounds, predict treatment outcomes with unprecedented precision, and facilitate tailored treatment plans based on real-time patient data.

On the clinical trial side, decentralized studies and remote monitoring are making research more accessible to a wider pool of patients, which is particularly important for patients whose symptoms can make travel to trial sites challenging. These advancements are making trials more efficient and more reflective of real-world patient experiences. These innovations empower both researchers and clinicians by providing deeper insights into disease variability, allowing for more precise and personalized treatment strategies.

Overcoming Challenges In Accessibility And Affordability

While scientific breakthroughs hold immense promise, their impact will be limited unless accessibility and affordability concerns are addressed. The high cost of novel therapies remains a significant barrier for many patients. As the industry moves forward, collaboration between pharmaceutical companies, regulatory agencies, and healthcare providers will be essential to ensure that life-changing treatments reach those who need them most.

In many conversations I have with physicians and industry colleagues, I encounter concerns regarding the affordability of medications. The pricing pressures on advanced therapies are real, and accessibility remains a major challenge. One of the biggest solutions I see on the horizon is a renewed focus on small molecule drugs, which are typically more cost-effective and scalable than biologics, making them a more accessible option for patients worldwide. At the same time, policy changes, such as those being debated in the U.S. and Europe, will likely play a role in determining how new therapies are priced and reimbursed in the future.

Manufacturing scalability is another hurdle, particularly for complex biologics and next-generation therapies. Advances in biomanufacturing and supply chain optimization will play a critical role in making such treatments more widely available. Small molecule therapies offer a significant advantage in this regard — they are generally easier and faster to manufacture.

Meanwhile, in an era of information overload, scientific advancements must contend with the challenge of misinformation and public skepticism. Social media has amplified visibility for neurological diseases, but it also has made it harder for legitimate scientific progress to stand out. Companies and researchers must proactively communicate their findings clearly and transparently, ensuring that accurate, evidence-based information reaches patients, healthcare providers, and policymakers.

The Path Forward

2025 is poised to be a breakthrough year for neurology and neuroinflammation, with advancements in neuroprotection, patient-centric treatments, and research funding, setting the stage for potentially transformative progress. With an estimated 2.9 million people worldwide living with MS, the urgency for innovative solutions has never been greater.

The industry must continue to push the boundaries of scientific discovery while maintaining a commitment to patient accessibility and affordability. Collaboration across the pharmaceutical ecosystem — researchers, clinicians, physicians, regulatory bodies, and advocacy groups — will be essential in driving these efforts forward. By embracing a holistic approach that prioritizes neuroprotection, technological integration, and strategic investment, the field of neurology can make significant strides toward improving patient outcomes in the years ahead.

About The Author:

Daniel Vitt, Ph.D., is the CEO of Immunic (Nasdaq: IMUX), a biotechnology company developing a clinical pipeline of orally administered, small molecule therapies for chronic inflammatory and autoimmune diseases. Vitt previously cofounded 4SC AG, advancing it from the research stage to a clinical-stage therapeutic development company. He studied chemistry at the University of Würzburg, where he also earned his Ph.D., focusing on the molecular design of small molecule therapeutics.