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MouseDoctor

11 comments

  • In your efforts to slow down MS progression, you’re trailing Ocrelizumab, right?

    But Ocrelizumab is basically an immunosuppressive drug that caused due to excess deaths due to opportunistic infections in clinical trials in rheumatoid arthritis and lupus erythematosus. Why are you more willing to test the drug in MS patients when the dangers are very apparent?

    Furthermore, Ocrelizumab is a anti-CD20 monoclonal antibody that targets mature B lymphocytes. In what way does Ocrelizumab have nerve protective properties?

  • We were not ignoring your post on this in the January post

    January is an exceeding busy time with teaching commitments, the research day, grant applications to do and clinics. So excuse our tardiness.

    "Why are you willing to test a drug when the risks are very apparent".

    Prof G may be able answer better, because I am not giving the drugs.

    However for any drug that is being or going to be used in MS there are side effect risks. Some of these are mild and some of these are life threatening. Therefore, you have to be aware of these risks when you take any drug. As you say some risks are known and there have been cases of PML with the B cell depletion approach.

    Now you need to weigh up the risks of trying a risky drug and it not working, it working and taking a drug and it causing side effects. This is a choose only if you are given an oppertunity to take such a risk.

    Many PPMSers say that nothing is being done for them, this one instance when a company is trying to do something.

    You may have heard that there is a trial to treat PPMSers with Tysabri called ASCEND. Will this
    be a "blessing from Heaven" or "Up in smoke" I could make an argument for both possibilities. The answer is you don't know for certain unless you do the study and people are given an option to partipate.

  • "Ocrelizumab is a anti-CD20 monoclonal antibody that targets mature B lymphocytes. In what way does Ocrelizumab have nerve protective properties?"

    The question is what causes progression in the first place.
    Does it have something to do inflammation and the B cell follicles present in the brains of progressive MSers? Could it be the influence of EBV triggering growth of B cells and they release damaging antibodies. Could it be that B cells are acting as antigen presenting cells to activate T cells that activate marophages to do damage to nerves. Alternatively is it something else that has nothing to do with B cells?

    If you look through the blog there are posts on this as well as posts why this may not be the case. I have views on how it will turn out but proof is in the pudding.

    However, it is known that some PPMSers do indeed respond to anti-CD20 therapy. We know this because of studies done with rituximab.

    Rituximab is not going to get commercially developed and so the alternative is Ocreluzimab. This is the same target as rituximab but is a humanised verses chimeric antibody and so one would expect that some PPMSers would get benefit from this treatment.

    Is it better to have option of something rather than nothing or wait for something else to come on the horizon.

    I

    However

  • Videos from Research Day

    Yes that is the plan. I think they will first need to be edited and
    any with me will need to be airbrushed.

    I do not know what the time-plan is in this regard I'll ask the guys from Shift.ms who were co-ordinating this

    I like you, can not wait to see them, I was in another room all day,

    So I am looking forward to seeing the dragon talk…what you'll have to wait and see.

  • Re: "In your efforts to slow down MS progression, you’re trailing Ocrelizumab, right?

    But Ocrelizumab is basically an immunosuppressive drug that caused due to excess deaths due to opportunistic infections in clinical trials in rheumatoid arthritis and lupus erythematosus. Why are you more willing to test the drug in MS patients when the dangers are very apparent?

    Furthermore, Ocrelizumab is a anti-CD20 monoclonal antibody that targets mature B lymphocytes. In what way does Ocrelizumab have nerve protective properties?"

    I agree; it is a drug with risks. Then MS can be a bad disease and may be the risk:benefit ration is okay.

    People with RA and SLE are systemically less well than people with and most would have had other immunosuppressive therapies, which may explain the infections.

    You must remember that the phase 2 results of ocrelizumab are very good; it is clearly a drug that is going to bat in the same arena with Natalizumab.

    I am very interested in ocrelizumab as it targets CD20+ cells and therefore works as an anti-EBV drug.

    The current dosing regime being tested is also favourable, i.e. an infusion every 6 months.

    In short we need to wait for the phase 3 results to see how safe the drug is in MS'ers. We mustn't throw they baby out with the bath water.

  • I was reading that the markets believe Fingolimod (Gilenya)made by Novartis and BG 12 made by Biogen will take a large chunk of the MS market over the next few years. They believe Sanofi who have teriflunomide (Aubagio)and alemtuzumab (Lemtrada)which they bought from Genzyme will not be as popular. However, a spokesman from Sanofi(ok I know he may be biased) has said about alemtuzumab-'Now that we have seen the clinical trial results- I have seen them but I cannot say morebecause we are going to publish them in April- we are very excited about this franchise.' Sounds interesting!
    Also in the US they are looking into starting trials for MN-166 Ibudilast for progressive forms of MS.

  • I have a question for both professors:

    What, in your opinions, are the Top 5 most exciting research projects happening in multiple sclerosis right now? This doesn’t have to be things you’re involved in, just stuff you’re aware of and psyched about.

  • Baltimore Pete

    It is very difficult to say for the "basic science" stuff because most of what is going on is below the radar. It is like a submarine and you only know about it when it surfaces. This occurs because of a chance meeting of people, you attend meetings or you see it published.

    So the top 5 is stuff we have yet to hear about. Could be tomorrow.

    Some of the Immunology is spectacular but it has got to the stage were the experimental designs are so complex that it will be difficult to replicate.

    The repair studies are potentially exciting.

    For the clinical stuff it is easier to know what is going on as the studies are often multi-group transparent and are registered

    Some of those I am really looking forward to the results or getting them off the ground

    The stuff we are involved with is the exciting stuff to us.

    Maybe with more thought I will give better answer but most of stuff is a secret.

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