In a world where it is easier to be lost than discovered, dissonance is the word of the day. When you have a serious medical condition, your day to day life is suddenly uncertain and unpredictable, your mood, a narrative from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition – DSM-5 for short, and its 186 footnotes. Being ill is a profound life experience, but not a fait accompli.
What does it mean to overcome adversity? The answer is yours to discover.
Sometimes, it’s the small gains that stand between obscurity and discovery.
This year alone there have been 2807 individual publications listed in PubMed for Multiple Sclerosis. This has been increasing steadily, year upon year. Thousands, upon thousands have participated around the world to create these figures and these dots in themselves hide the life story of MS.
- The dawn of the therapeutic area in MS began with the approval of interferon-β-1b by the FDA for the treatment of RRMS in 1993
- Natalizumab, the first monoclonal antibody therapy was published in two papers in 1999.
- In 2005, natalizumab is withdrawn as the risk of Natalizumab-associated PML is revealed.
- Three oral therapies are approved between 2010 and 2013: fingolimod, teriflunomide, dimethyl fumarate (DMF).
- The highs and lows of monoclonal antibody treatments: alemtuzumab and dacalizumab were approved between 2014 and 2016, but dacalizumab was unsucessful and alemtuzumab is temporarily under Article 20 restriction by the European Medicines Agency (EMA).
- Cladribine is revived in June 2017 as the EMA gives approval.
- Targeting B cells becomes a priority; 2017 sees the publication OPERA I and OPERA II Phase III trials of ocrelizumab in RRMS.
- Clinical dilemmas on best treatments as the number of choices for RRMS rises (in 2018 ECTRIMS/EAN and AAN formulate treatment guidelines for MS).
- New frontiers emerge in Progressive and Aggressive treatment of MS; ocrelizumab for PPMS is published in 2017, and siponimod for SPMS in 2018. Autologous haematopoietic stem cell transplantation (aHSCT) enters as a potential treatment option for aggressive and progressive MS between 2016-2018.
You can read about all of these milestones in Nature Reviews Neurology. The developments listed to date are a tribute to those who participated, and is something to be proud of.
This week Francesca (my Post Doc), informed this week that ‘X’ was here from Oxford for their lumbar puncture and MRI head scan for the alemtuzumab neurofilament study. A few months back, an MS Specialist nurse from Preston contacted me to ask if one of her MSers who’s interested in the SIZOMUS (anti-plasma cell drug) study could come all the way from Preston to London to participate. Now, what is unique about these two individuals is that they initiated first contact.
So, go out there and do your own piece of research. For those of you who have never participated in clinical research, a good starting point is clinicaltrials.gov.