Two months ago we floated the concept of doing a UK-wide seroprevalence study in UK residents with MS to see how many had seroconverted to become anti-SARS-CoV-2 antibody positive and to see if there are differences in seroconversion rates between people on different DMTs. The motivation was based on a prediction that people with MS on ocrelizumab would have lower titres of anti-SARS-CoV-2...
Recently there has been a debate on whether humans myelinate like animals and the suggestion was that in MS they may not. Yet we are ploughing huge resource into animal experiments to find repair agents for humans To work on animals, you typically have to have ethical approval and in Europe you need to consider reduction, refinement and replacement of animals in research. Each year we have to...
Antibodies againts the CD19 marker on B cells can clear out B cells from the blood and to some extent the lymph glands, but antibody doesn’t get into the brain very well and so will not clear out the brain very well. Even if it did get in the brain, as the antibodies often need natural killer cells/neutrohils to mediate the destuction and these cells are not attracted into the brain. T...
Barts-MS rose-tinted-odometer: ★★★★★ Good news for people with MS living in the US. The National Multiple Sclerosis Society is acknowledging that autologous hematopoietic stem cell transplant (AHSCT) is an effective treatment for MS as is recommending AHSCT a useful treatment option for pwMS who have substantial breakthrough disease activity despite treatment with high-efficacy DMTs or have...
The original phenytoin study, published by the team at University College London, demonstrated that the use of phenytoin (- sodium channel blocker) for three months after the onset of acute optic neuritis was neuroprotective. Slide from Medscape education We have now analysed the blood samples taken for neurofilament analysis and found that neurofilament heavy chain levels (as opposed to light...
Barts-MS rose-tinted-odometer: ★ In the last 2 days, you will have seen from my posts and the discussion that it has generated that there is a problem with the current MS lexicon. We need to get some form of nomenclature that addresses the confusion about what MS is as a disease and at what is the state and/or stage of MS for individuals with the disease. Knowing how to refer to people with MS is...
Otilimab and mavrilimumab are human antibodies that block Granulocyte-macrophage colony stimulating factor (GM-CSF) of the GM-CSF receptor respectively. The may block macrophage function but could also block a new T cell type implicated in MS, which secretes GM-CSF J. Rasouli et al. A distinct GM-CSF+ T helper cell subset requires T-bet to adopt a TH1 phenotype and promote neuroinflammation...
Barts-MS rose-tinted-odometer: ★ In my opinion, the term ‘progressive multiple sclerosis’ is a misnomer. In general, progression means improvement, which is one of the reasons I prefer the term ‘late-stage MS’, which not only differentiates the terminologies but captures the associated disability that comes with this phase of the disease. It is important to stress that the pathologies that drive...
Barts-MS rose-tinted-odometer: ★ I have just been chastised by someone from a Swiss Pharma company for suggesting that siponimod is a cul-de-sac DMT. Why can’t someone who is diagnosed and labelled as having SPMS who is started on siponimod be switched to any other DMT? I agree, but the absurdity of the situation arises because of the rigidity of the Lublin classification of MS (see below) and...
Barts-MS rose-tinted-odometer: ★★★★★ Did you watch the anti-CD20 debate on the triMS-online platform yesterday? The question that was asked was ‘Can we use anti-CD20 therapies as immune reconstitution therapies rather than maintenance therapies?’. I am not sure the debaters answered the question. When I asked Anders Svenningsson, who is probably the world’s biggest adopter of anti-CD20 therapy...
Yesterday there was a debate on whether we should use anti-CD20 antibodies as immune reconsititution therapies. Of course the answer needs a trial, but what do peole think was the outcome. Sadly, it seems that a substantial number of the clinical fraternity don’t get or buy it. My head is so bruised and the wall has a dint it in. The only way to covince them is data, but in the absence of a...