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New study testing an upper limb rehab tool – get involved!

The Barts MS team are running a study, investigating whether a new hand and arm activity called “Under & Over” can improve upper limb function for people with MS. The study is titled: “Under & Over: A controlled study to develop an upper limb rehabilitation tool for people with Multiple Sclerosis.”  This study is now recruiting – find out more information on the...

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Prof G guilty as accused!

Barts-MS rose-tinted-odometer: ★★ Guilty as accused!  I did a very one-sided post this weekend on the pros of oral cladribine as a treatment for MS during the COVID-19 pandemic. One commentator asked ‘what about the cons?’. As with all immunosuppressive therapies, there is a risk of secondary malignancies. In fact, both the EMA and FDA labels mention secondary malignancies as a complication...

Ibudilast in Progressive MS: Hope with the size of a peanut

Neuroprotection has been a tough nut to crack in MS, and essentially we are still eagerly waiting for the first drug that improves neuronal survival without impacting on inflammation (such as our beloved CD20 antibodies or siponimod). Ibudilast is one of the latest molecules that has tried to influence progression in pwMS… In the 2018, Ibudilast (n=129) was compared with placebo (n=126) in...

A literal pain in the face

Trigeminal neuralgia (TN) is an excruciating shooting pain involving one or both sides of the face; occurring in isolation (also termed idiopathic) or as a symptom of MS or other neurological disorders. It is literally a pain for both the patient and the doctors who manage it. The only plus point is that it is episodic in nature. However, with any recurrence you are pretty much starting again at...

Clinical Trials in progressive MS. Is it time to bin Neurofilament Light?

Many year ago I was having a conversation with NDG and neurofilaments and she said neurofilament light was the wrong outcome. I didn’t really get it because, surely as a nerve dies it releases its contents (i.e. neurofilaments). However, I now think that neurofilament light is like a global MRI scan. If you can find neurofilaments then there is a lesion somewhere in the CNS. You may not...

Is it? isn’t it? The ocrelizumab Yo-Yo

In this paper the duration of use of ocrelizumab is a Coivd-19 risk factor in other papers, there is no risk. What is correct. I suspect abit of both and so if there is a risk I think we can say it is small, otherwise every study would be the same. Also we have to remember ocrelizumab is the agent approached for progressive MS and disabilty is a risk factor so this confounding variable needs to...

BartsMS off to the Excel for a Jab: Information confirmed

Heads up! To all with MS, on immunotherapies, heading to the Excel Centre in London for your 2nd jab… As soon as you arrive tell a staff member so you will get taken to the front of the line… and not have to wait for ages. I think where every you go, do the same. This advice from Rachel has been confirmed by Sarah (Both Blog Readers). Thanks to them for that. Spread the word by your...

MS and the Inverse Care Law at 50

Barts-MS rose-tinted-odometer: ★ Variation in access to good medical care and better outcomes has never been higher in high-income countries such as the UK. Variation is simply a euphemism for inequality. The MS community in the UK realised this a few years ago, which prompted us to launch our ‘Raising the Bar’ initiative to address inequality in access to healthcare for people with MS living in...

Asking to change the rules for cladribine? It’s already happened !

Fair enough, there has been a build up to this. After all, a couple of days ago MD ProfB explained – again – that whilst both cladribine and alemtuzumab are immune reconstitution treatments (IRTs) with significant long term effects on B cell subsets, particularly the memory B cell pool, this is where their similarity largely ends. Next came ProfG detailing 17 attributes of cladribine...

#MSCOVID19: specifically for NHS England

Barts-MS rose-tinted-odometer: ★★★★★ Early on in the pandemic, I did a blog post on why I thought oral cladribine was the ideal DMT for managing MS (26-April-2020) remotely. I summarised cladribine’s attributes in a simple 12-point list. This list can now be updated to include (1) data on good COVID-19 outcomes in pwMS who have been treated with cladribine, (2) about vaccine readiness, i.e...

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