News Update: positive GNbAC1 phase 2 results

Has the black swan arrived? Could MS be due to a viral infection? Is the #CharcotProject alive and kicking?


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Prof G

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


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    • Yep, the apple cart is ready to upset. Wouldn't it be amazing if we started treating MS with antivirals rather than immunosuppressives?

    • Yep, that would be amazing. I am all for a paradigm change. I believe anti-virals are the future for MS.

    • "Wouldn't it be amazing if we started treating MS with antivirals rather than immunosuppressives?"

      Oh yes… Now this _is_ interesting stuff. Thanks for the post.

  • I asked about this trial back in October 2017 being. MD said it won't be very effective as it can't penetrated BBB. Is this now different?

    • Yes, the interim results presented at ECTRIMS were lukewarm. We need to see the full results before we can comment further. But the fact that the trial is positive is good news. Let's wait to see how positive and whether or not there will be a phase 3 programme.

    • Thanks Prof G. Lets wait and see. The puzzle of MS is unravelling fast. With successes in Ibudalist, Sipnimod, etc.

  • What does these results promise in comparison the established MS treatment options we use, are they more close to "the cure of MS"?

  • Could it eventually be a neuroprotective add-on therapy, or do you see it eventually as stand alone MS mono therapy?

  • These results are the first real indication that MS is caused or triggered by a retrovirus. Our study with raltegravir (INSPIRE) was negative, possibly because we used the wrong drug for this retrovirus(that's not unusual) or because we should have used a combination of anti-retrovirals. The reason may never be known. However, this trial indicates we are on the right track and that more research needs to be done to determine the cause or trigger for MS. The reason this is so important is that current therapies aim to suppress the immune system not to control the possible cause. This treatment aims at controlling the cause or trigger which is the way all disease should be treated.

    • There was a recent case report of a medical student with RRMS who showed remission and clinical improvement after treatment with Combivir. The report was implicating EBV and the target of the therapy but AZT has shown to be effective in reduction in HERV replication and transmission. Since combivir is available as a generic why not use it in the study?

    • Steve S
      Somebody with RRMS is, by definition, expected to remit and show clinical improvement

      Why credit the combivir?

  • These results are very important as they show MS may be caused by a retrovirus. The INSPIRE trial was negative because we may have used the wrong drug (not unusual) or maybe we should have used a combination of antivirals. We may never know. Current treatment suppress the immune system which may just be a temporary fix (time will tell). This study shows we are getting closer to determine the cause or trigger for MS and that's why it is so interesting. Charcot would be pleased.

  • Thanks for this promising post Dr. G on neuroprotection and possible cause of MS. In this above study, I was wondering why the endpoints were only measurement of MRI? Did the EDSS, 9 hole peg test stabilize, 6 minute treadmill, 25 foot walk test and cognitive scores stabilize in addition to improvement in MRI results?

  • Brain atrophy was supposed to have been abandoned. Now it's back because it was the only metric affected. Another zero-value study pumped up to revelation levels. I bet you will be asking "Could MS be due to a viral infection?" for the next 20 years.

    "all groups improved from month 6 to month 12"
    "…no significant separation between groups"
    "The trend […] did not translate into a relevant result at 12 months."

    Can't wait to laugh at the published full results.

  • I'm not know for positive posts, so let's break the mould – fingers crossed this turns out to be as positive as it looks – and it looks good to me.

  • What a wonderful new!!!

    Fingers crossed so the end result is really positive.

    "Hope is the last that dies."

  • We will be waiting your analysis on this and the other antiretroviral treatments. It seems hot as hell.

  • Considering that a viral infection as a cause of ms has been flouted around for at least a decade now to my knowledge (or maybe longer)… i'd hardly say it's a black swan or news.

    the only news is that the first results of trial that should have been done a decade ago but was only done a couple of years ago have been released. we will chatter about these for a while then conclude more trials are needed to clarify the matters, and then sit on it for another decade or so

    Gavin GiovannoniMonday, March 26, 2018 10:32:00 am
    Yep, the apple cart is ready to upset. Wouldn't it be amazing if we started treating MS with antivirals rather than immunosuppressives?

    – well, i've read reports that some people with ms are already doing this if they can find a supportive gp who prescribes it to them.

    all the neurological community has done about the issue is chatter chatter guess theories and blah blah blah

    kinda like the hsct situation

  • The balance between scepticism and enthusiasm is what drives discovery. The great thing about this Blog is this balance has been maintained by everybody on both the treating and receiving sides. Prof G (London) and Mouse Doctor deserve credit for this. I'm on the enthusiasm team; so let's hope I'm right and the CharcotProject is alive and kicking.

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