#ThinkHand & #ChariotMS: making the case for treating more advanced MS

Finally a trial for people with more advanced MS including those in wheelchairs. #ThinkHand #ChariotMS

Klaus has done a amazing job at setting-up a meeting to get the #ChariotMS trial concept off the ground. You have heard a lot about the concepts underpinning this trial over the last few years and why we want to test cladribine in more advanced MS including people in wheelchairs. The following is the agenda for the day. We will provide an update on the day’s outcome in the next few days. 

CoI: multiple and this meeting was kindly supported by Lipomed who make one of the parenteral forms of cladribine

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.


  • So, from this I'm assuming they use off label rituxan in progressive MS in Sweden? Is there an data we could see about it's clinical effectiveness on the blog? Also, thank you all so much for the hard work. This is really amazing

  • What's the point of this study, from the patients perspective, when you have this:

    Rituximab in patients with primary progressive multiple sclerosis: results of a randomized double-blind placebo-controlled multicenter trial.

    "Although time to CDP between groups was not significant, overall subgroup analyses suggest selective B-cell depletion may affect disease progression in younger patients, particularly those with inflammatory lesions."

    • That is why we going with a CNS penetrant drug. We think you need to target inflammation, in particular B and plasma cells, within the CNS.

    • You know rituxan dont penetrate cns
      And plasma cells dont express cd20 cluster
      "Rituximab may not traverse the normal blood–brain barrier (BBB) and this could limit the effectiveness of this agent in PCNSL. Rituximab concentrations in CSF are 0.1% of plasma levels when it is administered at a standard IV dose of 375 mg/m2, suggesting poor BBB penetration"

    • Was the talk filmed for posterity?

      You don't sound very optimistic. Can you tell us about the alternatives?

    • Yes all talks were filmed but I guess you will have to wait for research day for a repeat showing

      Optimistic…If it doesn't happen it will say something…The alternatives are nothing happens or we need to find a philantropist

By Prof G



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