Multiple sclerosis (MS) is a posited autoimmune disorder of the central nervous system with both inflammatory and degenerative features. Despite the rapidly expanding therapeutic repertoire for relapsing MS, we remain limited in our ability to alter the progressive course of MS. Indeed, results of therapeutic trials in progressive MS disease have, to date, been disappointingly negative. On December 1, 2014, a negative study of fingolimod in primary progressive MS again reinforced our inability to alter the course of progressive disease.1 The next anticipated results are from a study of natalizumab in secondary progressive MS, due in fall 2015.