ArchiveMay 2011

Pregnancy and natalizumab: results of an observational study in 35 accidental pregnancies during natalizumab treatment.

Hellwig et al. Mult Scler. 2011 May 25. [Epub ahead of print] Of the women exposed to natalizumab during pregnancy, 29 women gave birth to 28 healthy children; one child was born with hexadactyly (an extra finger), 5 pregnancies ended in an early miscarriage and one woman decided to undergo an elective termination of pregnancy. Importantly MS activity did not rebound during pregnancy or post...

Clinical consequences of MRI activity in treated multiple sclerosis

Cadavid et al. Mult Scler. 2011 May 25. [Epub ahead of print] Inflammation detected using brain MRI is the most sensitive marker of disease activity in MS. This study investigated the clinical consequences of MRI activity in 75 PwMS treated with two different first line DMTs. Transient remission of disease occurred in 46% of subjects (partial responders) and only 23% of subjects had complete...

MS and survival – long-term betaferon treatment improves survival

I had to give a talk yesterday, at the European Neurological Society (ENS) Meeting in Lisbon, on how to handle the complexity that the emergence of new DMTs are creating. I was trying to make the argument for early aggressive treatment and the expert patient, i.e. to involve the patient as much as possible in the decsion making process so as to ensure long-term adherence to therapy and to manage...

How long does it take to develop a DMT?

The following is fingolimod’s time-line. This is typical example how long it takes to develop a DMT for MS. If the PPMS trial is positive fingolimod will only be available for people with PPMS in late 2014 or early 2015. “Is it fair to make people with PPMS wait this long?” 1992: Fingolimod (FTY720) first synthesized by Japanese scientists 1997: Fingolimod in-licensed by...

Apologies, more politics; we need the brightest and best

We are desperately trying to employ a very bright young doctor and MS researcher from Iran. This is the response from our HR department:  “Bottom line: there are not many options available, unless the person is an renowned expert in their field and can apply for tier 1. If you want to employ them as a post-doctoral scientist – then QMUL will have to apply via tier 2...

FTY720 in Patients With Primary Progressive Multiple Sclerosis (INFORMS)

As a follow-up to our previous posting on the impact of FTY720 or Fingolimod on brain atrophy. Good news! After several months of logistical issues we finally randomised and dosed our first patients in the FTY720 PPMS trial. Click here for details “It is good to be able to finally offer our patients with primary progressive MS the possibility of being enrolled in a clinical trial. For once...

Why repeated lumbar punctures to assess neuroprotective trials?

In response to one of the comments from my posting in relation to disease outcomes. In MS damage to nerve processes called axons releases proteins into the spinal fluid. One class of these proteins are neurofilaments, which  supports the structure of the axon. I think of neurofilaments as the scaffolding or supporting structures of axons. What is important is that if...

Sildenafil (Viagra) ameliorates clinical symptoms and neuropathology in a mouse model of multiple sclerosis.

Pifarre et al. Acta Neuropathol. 2011 Apr;121(4):499-508. Sildenafil (aka Viagra), commonly used to treat sexual dysfunction in men with MS, has been reported to be neuroprotective. In this study, the investigators showed that sildenafil reduces the clinical signs of disease in a mouse model of MS. “I wonder if Pfizer would be interested in taking this forward in humans? I suspect not with...

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