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Pandemic

Yesterday I had the experience of a patient with highly active MS pull out of being treated with ocrelizumab because of concerns around being infected with the coronavirus COVID19. I suspect this will be the first of many patients with multiple sclerosis to do so.  It is clear that COVID19 epidemic is now a pandemic, i.e. it has involved enough continents and countries to be considered a major...

Anti-Drug Antibodies. Don’t SH1 on yourself when you have a problem…hatchet the others!

Rule #1 of “Pharma club” is Don’t admit you have a problem! Rule #2 of “Pharma Club” is “Don’t admit you have a problem”, Rule#3….Don’t admit… As you know. We have been looking at anti-drug antibody responses because they are important to the individuals who fail treatments as their drugs stop working. You can now get our latest...

CD20 wars under starters orders

How do you like your DMT served, long and slow or quick and easy? The regulators have the trial data for ofatumumab and it will now be up to the regulators to see how quick they approve the drug. It looks like the Americans will win with a Summer 2020 showing and the EMA will lag behind for 2021. In future what will the MHRA (UK regulators) do…follow the EMA or the FDA. Recently the FDA has...

Cannabis use in MS is here to stay

Muscle spasms, stiffness (also known in medical speak as spasticity) and pain are major problem areas in MS. Most are on tablets for this, commonly baclofen, with fewer individuals receiving botox for focal areas of stffness or intrathecal (via lumbar puncture directly into the CSF) baclofen for severe lower limb stiffness. Many also use cannabis for this indication, but the exact usage is...

DMT churn

Please note that I am so conflicted when it comes to giving advice about DMTs that you need to take what I say and think with a ‘pinch of salt’; including the contents of this post.  Meaning: To take something with a “grain of salt” or “pinch of salt” is an English language idiom that means to view something with scepticism or not to interpret something literally. The...

Anti-Clotting agent for alemtuzumab

Alemtuzumab is a very good drug, but the problem is the side-effects issues that develop of which their are many and ever increasing it seems. However with the warnings about cardic risk, a change in label and alternatives, I suspect it would be putting a plaster on a sinking ship. However, it can tell us some interesting biology as can the PD-1 inhibitors, which also have side-effect problems. I...

When doing research, doesn’t help your cause

As part of our remit of working with beasties, it is important for us to discuss animal work. Working on EAE is becoming a dying art….I have recently met a few colleagues who have said their ethical boards have stopped them working on EAE. The Home Orifice in the UK, who control animal experiments in the UK has EAE within its sights and so we are living on borrowed time. Indeed in Europe...

The Battle of the Bottom Feeders

Matching-adjusted comparisons demonstrate better clinical outcomes in patients with relapsing multiple sclerosis treated with peginterferon beta-1a than with teriflunomide. Newsome SD, Mokliatchouk O, Castrillo-Viguera C, Naylor ML. Mult Scler Relat Disord. 2020 Jan 17;40:101954 In a fish tank you have the bottom feeders that clear up the scraps left by others, in this report we have a battle of...

Will we be joining the Glee Club?

You asked what do I think about the news of the mastitinib trial? I guess we have to wait and see what happens when it is presented at AAN at ECTRIMS but they are reporting activity on one dose (4.5mg/kg) in PPMS and non-relapsing SPMS. This could be good news if true, but it could also be part of a buy-me report for the company. Importantly for me the higher dose was not reported to work, so...

Tea Time, HSCT inhibits brain infiltrating T cells

Extensive intrathecal T cell renewal following hematopoietic transplantation for multiple sclerosis. Harris KM, Lim N, Lindau P, Robins H, Griffith LM, Nash RA, Turka LA, Muraro PA. JCI Insight. 2020;5(2). pii: 127655. A recent study of autologous hematopoietic stem cell transplantation (AHSCT) for active relapsing-remitting multiple sclerosis (RRMS) showed efficacy in preventing disease...

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