Phase 4 trials ECTRIMS Summer School, Bari 2013

ECTRIMS Summer School presentation available for down load. #MSBlog #MSResearch

“As promised my presentation from yesterday for download. I hope it makes sense.”

About the author

Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.


  • Do you think it is a mistake to label PPMS as a branch of multiple sclerosis? Has that perhaps hindered research outcomes and elongated the search for effective treatments? Maybe by reclassifying it as its own disease we can bring better focus and adequate attention to it.

    • I think there is a lot of truth in what you say. To my mind classifying PPMS as a primary neurodegenerative disease could move things along significantly.

    • That is a heck of a paper anon 20:04, and one that paints the biological processes of MS in almost Shakespearean terms with the argument that we need to understand what the conniving T cells say to manipulated macrophages to get them to target myelin so selectively

      Dr. Stys argument that the MS research community is already "40 years behind" colleagues in the field of Alzheimer's and Parkinson's disease, is worrying, though Dr. Herdon does counterclaim: "It used to be, before we had treatments, that you could anticipate that after 20 years or so, close to 90% of relapsing-remitting patients would develop secondary progression, but long-term follow-up on patients taking Copaxone [glatiramer acetate; Teva Pharmaceuticals] showed that rate is now about 49%." .

      I would like more information on what cytodegeneration means.

    • Yeah, my progressive MS just started immediately and got worse from that point on. There was no time to effectively do anything about it, much like Alzheimer's I suppose. There are good types of MS to get and bad ones. There is the type where you stand a chance and the type where you don't really. MS comes in all shapes and sizes, all forms and forces.

    • mmm, so is there anything that can be done for SPMSers with seemingly no cognitive degeneration yet?

      In my comment on alzheimers it did not relate to cognitive decline it related when nerve damage is noticed. Therefore if you have a drug that slows nerve loss in progressive MS you have time to get it started and have some effect. I could have contrasts MS with stroke. In the stroke field there is a graveyard for useful drugs. They work if you load up with drugs before the stroke.But that is not how it happens you have the stroke and it takes hours to get to hospitaland get drugs by which time the damage is done.In MS the damage occurs in stops and starts over a long time so you have time to get drug sin before the next event.

  • PPMS is clearly is a branch of MS in my mind, grouping it differently may give it orphan disease status and lower the hurdles to get treatments.

    Has it hindered a search for effective treatments….probably…. for that the "EAE-ostriches" should hold their hands in the air. I can assure you the T cell brigade or out there in full force, ensuring that any thing non-T cell has plenty of hoops to jump through before (non) acceptance.

    What is the proof that T cells are important in MS?

    • Yes and no

      Having been on the end of a tongue lashing by someone who will not accept that progression is not due to anything but the action of T cells, I felt like asking them what is the evidence that T cells even drive relapsing MS?…not talking EAE.

      Name a drug that works in MS that does not affect B cells.

  • Your presentaiton doesn't really make any sense, withut the accompanying words you spoke. Are you able to provide a summary or a few pointers?

  • Does the chart posted on slide 37 refer to the results of JCV index blood tests six months prior to PML or at the time PML was diagnosed? Thank You.

    The deep appreciation I have for this blog is nearly unspeakable. I have learned a great deal from your archives which helps inform treatment considerations. Thank you for all the work you do to inform and educate. It is helping many lives immensely.

    • if you check the ANA meeting prog G commented on this previously it shows people with low titre JC virus response have less risk of PML

    • Thank you for taking the time to respond MouseDoctor. On review, "JCV Ab index data were available from 71 natalizumab-treated PML MSers at least 6 months prior to PML diagnosis", so question answered.

By Prof G



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