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Translational medicine is beginning to be successfully applied in multiple sclerosis (MS). This chapter reviews how advances in our understanding of MS and our ability to measure MS are contributing to the application of translational medicine in this disorder. It presents a historical perspective on the evolution of disease-modifying treatments, and then proceeds to provide a discussion on molecular pathophysiology. Next, the factors that contribute to the efficiency of translational medicine are explained. Lastly, the future of disease-modifying therapies is discussed. Interferon beta (IFNβ) was the first effective disease-modifying therapy to become available for MS. The factors that improve the efficiency of translational medicine in MS include: the identification of drug targets within well-validated biological pathways; and the use of pharmacodynamic markers, especially in early proof-of-concept and dose-ranging clinical trials. The continuing accumulation of knowledge and understanding of MS can help to accelerate the developing novel therapies for MS.