Q&A August

This month it is the Summer Olympics so today we have Discus fish

Sculpture from the East End of London

Disclaimer: Please note that the opinions expressed here are those of the author and do not reflect the positions of the Barts and The London School of Medicine and Dentistry nor Barts Health NHS Trust or Queen Mary Univeristy of London.

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#MSCOVID19 Learning from 4 Jabs

Sophie Caillard, Olivier Thaunat, Ilies Benotmane, christophe masset, Gilles Blanchodoi:  Third courses and Bossters are going to appear soon. We know that people who take fingolimod and ocrelizumab make a relatively poor response, but I think people offered a boost will benefit protection wise. However we have concern about fingolimod and...

Derisking anti-CD20: the ADIOS-IM study

Barts-MS rose-tinted-odometer: ★★★★★ (a London Grey day #666677) Can we use an anti-CD20 therapy as an immune constitution therapy (IRT), i.e. 2 years of treatment followed by no treatment unless there is EIDA (evidence of inflammatory disease activity)? This strategy is not new to the field of MS; this is how we use alemtuzumab, cladribine and AHSCT. So why not with ocrelizumab, ofatumumab or...

Serum neurofilament light chain falls short of the bar

Is having a blood test version of this test simply a pipe dream I wonder? Will we have to do lumbar punctures to really find out what’s going on in the brain with MS? These are questions I grapple with on a regular basis in this field, and what complicates matters is that is positive data and negative data on blood NfL predicting disability progression in MS. This recent publication shows...

More evidence to support the smouldering MS hypothesis?

Barts-MS rose-tinted-odometer: ★★★★★ (neon tennis ball green #dfff4f) Yet another study showing that there are abnormalities in the so-called normal-appearing white matter (NAWM) that precede the development of new MS lesions.  This supports the hypothesis that there is something in the brain tissue that triggers the development of lesions and relapses. Could this be a virus, like an isolated...

Third Jab

This is the third Jab advice and this is not the same as booster advice. Updated JCVI guidance for vaccinating immunosuppressed individuals with a thirdprimary dose The Joint Committee on Vaccination and Immunisation (JCVI) has issued updatedguidance in relation to COVID-19 vaccinations for individuals aged 12 years and over withsevere immunosuppression. This letter sets out the actions we are...

At the Limits 2021

Today I have been let out to my first International Meeting in two years and yep it is in London

Here is a copy of my slides

Baker At the Limits online from BartsMSBlog

EyeMOD Vaccine Responses. Give Me Some News!

Last week we put out a call to see what is happening with fingolimod, siponimod, ozanimod and ponesimod vaccine wise. Sad to say my phone has not been ringing and so far…..Radio Silence. Is it rule number one from Pharma club? or just the studies are ongoing With regard fingolimod we (royal we) have done our own studies. Fingolimod has surprisingly made a mediocre vaccine antibody response...

Kind of Blue

Barts-MS rose-tinted-odometer: zero-★s (Feeling ‘Kind of Blue’ for a Saturday, midnight blue #191970) We have known for some time now that pwMS on DMTs who get COVID-19 seem to be at no greater risk of severe COVID-19 and death compared to the general population with the exception of pwMS on anti-CD20 therapies. This implies that anti-CD20 therapies either impact preexisting cross-reactive...

Booster.. Not good news for anti-CD20..Time to get thinking caps on quickly because the same old same old is probably not going to be good enough.

We can learn from other conditions and if they are seeing the same thing to MS they are more likely to be true. Here is a view on arthritis Fagni F, Simon D, Tascilar K, Schoenau V, Sticherling M, Neurath MF, Schett G. COVID-19 and immune-mediated inflammatory diseases: effect of disease and treatment on COVID-19 outcomes and vaccine responses. Lancet Rheumatol. 2021 Aug 27. doi: 10.1016/S2665...

Why I’m no longer talking to pwMS about wheelchairs

When newly diagnosed pwMS enter a clinic room, they have read up about MS and are often focused on the daunting idea of ending up in a wheelchair or having to use a zimmer frame. From natural history cohorts before disease-modifying treatments (DMTs) were introduced, we know that for an untreated pwMS it takes a median 11.4 years to reach EDSS 4/not being able to walk unrestricted anymore, 23...



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