ArchiveFebruary 2010

Multiple sclerosis ‘blood blockage theory’

We remain sceptical about this theory; venous outflow obstruction does not explain the epidemiology of MS and falls down short on many other observations.
The interventions required to relieve venous obstruction are not without risks. The ‘blood blockage theory’ remains a theory and any involvement with the theory should be via ethically approved research studies.

Ethical or unethical advertising?

Is direct-to-patient on-line advertising ethical or not? Please see following news piece for a debate on the issue:
Meredith Wadman. Drug ads move online, creating a web of regulatory challenges. Nat Med 2010;16:22. or

The earlier use of natalizumab!

Biogen-Idec and Elan have announced the eminent start of a clinical trial, called Surpass, to assess the effectiveness of switching to natalizumab (Tysabri) in patients that have experienced disease breakthrough with either glatiramer acetate or interferon beta. I interpret this as a show of confidence by the companies that we can overcome the PML problem; there are now 31 confirmed cases of post...

End of Life Issues

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Please send this link to as many people with multiple sclerosis that you know.
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What dose of vitamin D?

After our MS Research Day on the 30th January we have been asked by several people about the correct dose of vitamin D to take to try and prevent MS and related disorders. Unfortunately we don’t know. Until we do the appropriate clinical trials any recommendations will not be evidence-based. At present we defer to the Vitamin D Council’s recommendations (

Do you think placebo-controlled trials are ethical?

I received a strongly worded email criticising our site for participating in placebo-controlled MS clinical trials; in the opinion of the critic as there are licensed disease-modifying therapies for people with MS, placebo-controlled trials are unethical. What do you think? I responded as follows: “Yes, there are several ethical considerations that need to be taken into account in relation to...

FDA approves dalfampridine

On the 22nd January the FDA approved dalfampridine (Ampyra, Elan/Acorda Therapeutics) extended-release tablets to improve walking in people with MS. Dalfampridine is a potassium channel blocker, that has been shown to improve walking speeds vs placebo. The drug was previously known as fampridine sustained release. Given at doses greater than the recommended 10 mg twice a day, dalfampridine can...



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