I saw someone with possible MS earlier this week and he had been told that he couldn’t have MS because he only had one detectable lesion on his MRI. Is this correct? The problem: ‘MS has become an MRIscopic disease’. The diagnosis of MS remains clinical and is underpinned by the need to show (1) dissemination in time (typically new activity 4 weeks apart or the presence of...
Prof G what happens to MS disease activity if you stimulate T-cells? About 2 years ago I attended a grand round during which a patient with a history of RRMS had had a catastrophic relapse after receiving ipilimumab for metastatic melanoma. The patient has a massive brain stem relapse and her MRI showed multiple Gd-enhancing lesions with several pseudotumoral lesions. She was in a bad way...
Association of Initial Disease-Modifying Therapy With Later Conversion to Secondary Progressive Multiple Sclerosis. Brown JWL, Coles A, Horakova D, Havrdova E, Izquierdo G, Prat A, Girard M, Duquette P, Trojano M, Lugaresi A, Bergamaschi R, Grammond P, Alroughani R, Hupperts R, McCombe P, Van Pesch V, Sola P, Ferraro D, Grand’Maison F, Terzi M, Lechner-Scott J, Flechter S, Slee M...
I have always wondered why the genomic experts in the field of MS haven’t been able to sort out why specific human leukocyte antigen (HLA) subtypes increase your risk of getting MS and others don’t. HLA or human leukocyte antigens are the so-called signposting proteins that antigen presenting cells (APCs) use to communicate with T-cells. The APCs continuously sample the environment...
Is targeting the B-cell sufficient to get on top of MS or do we need something extra? I spoke at the MS Nurses’ MS@TheLimits2019 meeting at the Royal College of Physicians yesterday. My brief was to cover the role of B-cells in the pathogenesis of MS and to review the converging evidence that supports B-cells being the central player in the pathogenesis of MS. It is clear that depleting B...
The following presentation was from Joela Matthews our neuroscience pharmacist to the neurology trainees on Wednesday.
Training the next generation of MSologists is one of my priorities. I helped arrange and teach on the Pan-London Calman Specialist Registrar (SpR) teaching day yesterday. It was great to see so many young trainee neurologists attending; thank you. And to the speakers for giving up their time to teach and inspire the next generation of neurologists to become MSologists; thank you. I hope you all...
The gender pay gap is alive and thriving in neurology. That’s not only bad for women MS experts, but for all of us with the disease. One of my best moments of 2018 came at the end of a Thursday afternoon at the ECTRIMS October conference when dozens of women MS clinicians and scientists crowded into a room – and launched the International Women in Multiple Sclerosis group. Their aim is to...
The following is an online presentation from Prof. Richard Burt on their latest HSCT results. His presentation was embargoed until today. Enjoy.
When I was asked whether or not these are the most important trial results I have seen in the MS space. What do you think I said?
In this study the results of a randomisation non-ablative HSCT stem cell therapy compared to current DMT and it does better. Much better This is not surprising we know that immune depleteion is effective. Effect of Nonmyeloablative Hematopoietic Stem Cell Transplantation vs Continued Disease-Modifying Therapy on Disease Progression in Patients With Relapsing-Remitting Multiple Sclerosis A...
I’ve been harping on about this strategy for the better half of the past two years, and lo and behold someone has actually done it, and it actually works. The drugs utilized in this study are in fact irrelevant, the importance is the strategy itself. What strategy you ask? Rodo’s Thinker! I’m glad you asked. The one where you go in with all guns blazing and then follow it up...