When you are fighting a war, even if it is only a marketing war, small effects can be the difference between winning and losing. The TENERE study below would indicate that teriflunomide has similar efficacy to interferon-beta-1a (Rebif). However, this study was underpowered to show a difference between these two DMTs. Based on this and other data I suspect teriflunomide is more effective than IFN...
On Wednesday 11th September, we will be running another Burning Debate at ECTRIMS 2019 in Stockholm. We want MS clinicians and researchers to use social media (specifically Twitter) that can include people affected by MS in discussions and debates about MS research and treatments. The topic this year is: It is inappropriate to prescribe interferon-beta and glatiramer acetate for active...
This study examines what in the brain influences the generation of early myelinating cells and they find that the stiffness of the tissue makes a difference. They find that a protein called PIEZO is important. This is called FAM38 in mice. Data from Brainseq2 Lets hope that rodents translate to humans because the protein expression profile is different, is this because mice only last 2 years...
What do you do when you get recurrent disease activity on cladribine? I am repeatedly being asked what to do about disease activity in patients treated with cladribine. The following is my suggestions on how to approach this thorny issue. As you know disease activity on immune reconstitution therapies (IRTs) don’t necessarily mean you failed or are failing the therapy. Disease activity could be...
Multiple Sclerosis (From Reich et al NEJM 2018) Last week, I blogged on smoldering lesions visualized on MRI as a marker of progressive MS. Today, I will discuss the central vein sign. This publication in JAMA by the MAGNIMS group (a group of MRI bods from the world over) is therefore, timely. If you haven’t heard of the central vein sign, it is the presence of a vein within an MS lesion...
My thoughts are for our readers with MS who are having to live through and cope with the latest heatwave. The BBC has just reported that this is the hottest late August bank holiday on record; “Temperatures had reached 33.2C (91.8F) at Heathrow by 14:16 BST, the Met Office said, beating the previous record of 28.2C set two years ago. On Sunday, the record for the hottest late August Bank...
Sorry for the quick post but off for a break and no time to post today, maybe ProfG can fill in. So what have I picked for a 5 minute post When an octopus has MS: Application of neurophysiology and immunology of octopuses for multiple sclerosis. Naser Moghadasi A. Med Hypotheses. 2019 Oct;131:109297. doi: 10.1016/j. Multiple sclerosis (MS) is an immune-mediated disease which can cause different...
Cytomegalovirus primary infection in a patient with multiple sclerosis treated with alemtuzumab. Aguirre C, Meca-Lallana V, Sánchez P, Vivancos J.M ult Scler Relat Disord. 2019;5:270-271. This comes as no relevation to anyone. One person I know who had alemtuzumab described themselves as “fungus mungus” because of the infections that can occur when you have no T or B cells...
The following is an excerpt from the executive summary of ‘Health and Work Champions: a Pilot Training Programme’, (Martin et al. Feb 2018). I am highlighting it because it has relevance to MSers and MS-related HCPs. HCPs are being fingered as part of the unemployment problem; “healthcare practitioners, who may consider that giving advice to refrain from work is part of...
Interleukin-6 Disrupts Synaptic Plasticity and Impairs Tissue Damage Compensation in Multiple Sclerosis. Stampanoni Bassi M, Iezzi E, Mori F, Simonelli I, Gilio L, Buttari F, Sica F, De Paolis N, Mandolesi G, Musella A, De Vito F, Dolcetti E, Bruno A, Furlan R, Finardi A, Marfia GA, Centonze D, Rizzo FR.Neurorehabil Neural Repair. 2019 Aug 20:1545968319868713 Background: Synaptic...