ArchiveOctober 2019

Zombie Science Today

Today is 31st October and it is Halloween. MD2 and I were taking about the shape of Science and sometimes it feels like we are fighting against some giant Zombie Army, who “can’t see the wood for the trees” You destroy the mindless naysayer only to be confronted by another and another and another. You can destroy them in so many ways but they keep on coming and coming. If you...

A new kid on the block

FDA APPROVAL OF DIROXIMEL FUMARATE FOR MULTIPLE SCLEROSIS Time for another me-too or better-tolerated fumarate to treat relapsing-forms MS.  The following is a summary and adapted version of yesterday’s press release.  Biogen and Alkermes announced yesterday that the U.S. Food and Drug Administration (FDA) approved diroximel fumarate, a novel oral fumarate with a distinct chemical structure, for...

Compounding Pharmacies

“It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of Light, it was the season of Darkness, it was the spring of hope, it was the winter of despair, we had everything before us, we had nothing before us, we were all going direct to Heaven, we were all going...

Buyers Club..Don’t Buy Duds.

ProfG has created an off-label list of DMT. Many of them are based on the generic version of current MS drug, or a generic pro-drug of an active MS drug. You perhaps would thought that Charities would want options for all people with MS, including those in resource-poor environments to have options. These studies could have been done by now, but my experience with generic cladribine told me...

Buyers Club

Have you seen the film Dallas Buyers Club? It is one of the movies that haunt me and keeps coming back to me in my thoughts and dreams. I now know why. Dallas Buyers Club is a 2013 American biographical drama about a patient diagnosed with AIDS in the mid-1980s when there were no licensed treatments for HIV. It was in an era when HIV infection was highly stigmatizing. Out of desperation, the main...

Your race in MS

Race, ethnicity, creed – all architectural descriptors, some complex, others less so, depending on your perspective. When it comes to illnesses however, you are largely referencing race (the inheritance of your DNA) and ethnicity (the branch of race that your DNA occupies). We may be different in a number of ways, but our illnesses are a great equalizer. There is no such thing as race...

NDG forgot the paper

NDG forgot the paper details Efficacy and Safety of Alemtuzumab in Patients of African Descent with Relapsing-Remitting Multiple Sclerosis: 8-Year Follow-up of CARE-MS I and II (TOPAZ Study). Okai AF, Amezcua L, Berkovich RR, Chinea AR, Edwards KR, Steingo B, Walker A, Jacobs AK, Daizadeh N, Williams MJ; CARE-MS I, CARE-MS II, CAMMS03409, and TOPAZ Investigators. Neurol Ther. 2019 Oct 25. doi: 10...

Off-label methotrexate

Prior to interferon-beta being licensed, I used to manage several patients under Prof. W. Ian McDonald who were insistent on being on treated with some form of DMT. The rationale was better to be on something rather than nothing. At the time there was some evidence that methotrexate was effective in MS and as it was relatively safe, so Prof. McDonald acquiesced. In retrospect, I have no idea if...

Real life in Poland

When you select a DMT it is clearly not based on efficacy. Why not? I guess it is safety. If it were efficacy GA would not be doing so well in the sales. This study says what you all know, that GA is bottom of the pile. The label says it works by “mechanisms thought to be responsible for MS” and so we get a new mechanism with every new idea of how MS occurs. Therefore, it says to me...

Politician G

If I was a politician I would change the way drug regulation works to stimulate repurposing of off-label and unlicensed drugs. The wider MS community thinks off-label prescribing is accepting second-best. This is not the case.  The fact that a drug has a license or a label for a certain indication is because a pharmaceutical company has submitted an application to one of the regulatory...

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