ArchiveNovember 2016

WINNERS: Innovation of the year!

Last night the cardboard 9 Hole Peg Test won “Innovation of the year” at the Barts Health Innovation Awards!  “This award is for an innovative idea that can be developed into a product (e.g. app, device, diagnostic test).” We’re obviously not working in this area to win awards, but a little recognition now and again is no bad thing. The judges agreed that this is innovative as it is not only...

Interferons verses Glatiramer Acetate

La Mantia L, Di Pietrantonj C, Rovaris M, Rigon G, Frau S, Berardo F, Gandini A, Longobardi A, Weinstock-Guttman B, Vaona A.Interferons-beta versus glatiramer acetate for relapsing-remitting multiple sclerosis. Cochrane Database Syst Rev. 2016 Nov 24;11:CD009333. [Epub ahead of print] BACKGROUND: Interferons-beta (IFNs-beta) and glatiramer acetate (GA) were the first two disease-modifying...

#ClinicSpeak & #ResearchSpeak: CCSVI a post-truism

Should we reframe the CCSVI meme as a post-truth phenomenon? #ClinicSpeak #MSBlog #ResearchSpeak After much discussion, debate, and research, the Oxford Dictionaries Word of the Year 2016 is post-truth – an adjective defined as ‘relating to or denoting circumstances in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief’...

#ResearchSpeak: rise of the PIRTs

Are you pro-PIRTs or would you prefer to be maintained? #ResearchSpeak #MSBlog #MSResearch You may agree, or disagree, that one of the major advantages of the PIRTs (pulsed immune reconstitution therapies) is that they front-load risk with the potential to induce long-term remission and hopefully in some pwMS a potential cure. At present we only have one licensed PIRT, alemtuzumab. The study...

Is there life still left in 1st line injectables? An assessment of cognition

Neurol Sci. 2016 Nov 24. [Epub ahead of print] Cognitive dysfunction in patients with multiple sclerosis treated with first-line disease-modifying therapy: a multi-center, controlled study using the BICAMS battery. Cinar BP, Kösehasanoğulları G, Yigit P, Ozakbas S. Abstract Multiple sclerosis (MS) can impair cognitive functions even in the early stages. The Brief International Cognitive...

#ClinicSpeak: Is progressive MS modifiable?

Please hand me my rose-tinted glasses; I need to lend them to my colleagues. #ClinicSpeak #MSBlog #ECF2016 I had a bit of a disagreement with several of my colleagues in Baveno.  One didn’t like the conclusion I drew about therapeutic lag and the effect of highly-active DMTs in so called ‘non-relapsing progressive MS’. He was of the opinion that if we allowed people with...

NEDA

Rotstein DL, Healy BC, Malik MT, Chitnis T, Weiner HL. Evaluation of no evidence of disease activity in a 7-year longitudinal multiple sclerosis cohort. JAMA Neurol. 2015 Feb;72(2):152-8 IMPORTANCE: With multiple and increasingly effective therapies for relapsing forms of multiple sclerosis (MS), disease-free status or no evidence of disease activity (NEDA) has become a...

Sodium Channel blockers as a target for progressive MS

Schattling B, Fazeli W, Engeland B, Liu Y, Lerche H, Isbrandt D, Friese MA.Activity of NaV1.2 promotes neurodegeneration in an animal model of multiple sclerosis. JCI Insight. 2016 Nov 17;1(19):e89810. Counteracting the progressive neurological disability caused by neuronal and axonal loss is the major unmet clinical need in multiple sclerosis therapy. However, the mechanisms underlying...

#ClinicSpeak & #NeuroSpeak: NEDA defines a pecking order

At last we begin to see treat-2-target of NEDA entering clinical practice. #NeuroSpeak #ClinicSpeak #MSBlog The study below shows treating-2-target finaling getting traction in the real-world. Interestingly when you treat to target NEDA rates increase substantially. Why? One of the criticisms is that NEDA is very difficult to attain and several data sets have shown that NEDA rates are low. The...

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