ArchiveOctober 2019

Ocrelizumab touches a RAW spot, It also stops progression related disability

Before you read this paper you have to grasp the new concepts of RAW and PIRA. RAW is worsening in disability due to relapses and PIRA is progression independent of relapse activity. Therefore in PPMS, the progressive worsening would largely be a production of PIRA. RAW & PIRA a) Composite RAW and b) composite PIRA are the two non-mutually exclusive components/drivers of overall accumulation...

Do we really have equipoise about DMTs?

A guest post from Dr Emma Tallantyre, Cardiff. Definition: Clinical equipoise, also known as the principle of equipoise, provides an ethical basis for medical research that involves assigning patients to different treatment arms of a clinical trial. In short, clinical equipoise means that there is genuine uncertainty in the expert medical community over whether a treatment will be beneficial...

Catastrophe

Have you heard the term catastrophic health expenditure or CHE before? You should have as many MSers and their families are exposed to catastrophic health expenditure.  CHE occurs when the spending on health exceeds a pre-defined percentage of a person’s or household’s capacity to pay. CHE has a massive impact on MSers’ lives and usually discourages them from using healthcare services and often...

Counting the cost, T2 lesions

Counting the cost and paying the price are not one and the same. For decades MRI has been the way by which all and sundry have monitored MS disease activity. But, what does it all mean? And, how good is it really? Recently, in a natural history evaluation of MS disease activity, the Barcelona group looked at MRI scans of those presenting to their centre on whom they had at least 10 years of...

Do you know what GROLDI means?

Several things often happen together for a reason and then make you sit up and think.  Firstly, I got a tragic email from a young woman, who lives in Los Angles, who was recently diagnosed with MS. Unfortunately, she is unable to get herself onto a DMT due to being uninsured. She describes having quite active MS and unless she is treated early and effectively will almost certainly be unable to...

A week too late to be the first, but more info on metformin and the remyelination story

Last week we had the suggestion that metforin can act as an anti-aging agent to make oligogendrocyte precursor cells to promote remyelination. This wasn’t the first time it had been suggested and it clearly was not the last. So this new study claims to be the first study to show metformin-induced AMPK ,could potentially accelerate regeneration . What a difference a week makes, becuase first...

Our prize winners

You may recall Barts-MS held a competition before ECTRIMS to see if any of you could guess the results of OPTIMUM and ASCLEPIOS trials, i.e. “Oral Ponesimod Versus Teriflunomide In Relapsing MUltiple Sclerosis (OPTIMUM)” and “Efficacy and Safety of Ofatumumab Compared to Teriflunomide in Patients With Relapsing Multiple Sclerosis (ASCLEPIOS I & II)”. We now have our...

Can you change your lifestyle?

I don’t know much about diet and multiple sclerosis, so we got ProfB to blag his way into the Houses of Parliment for a multiple sclerosis meeting on lifestyle and diet Chatting to the stars of the film can you guess who. It was the last time you will see that shirt The building reeks of history and it was pleasure to attend says ProfB. It was rather funny watching the Extinction Rebellion...

Inhibition of B cell survival factors does not inhibit MS

You know me, I love to write papers, pharma seem to hate it, so I say to them just give me the data and save yourself a few grand paying medical writers. OK, they can’t dictatate what I am going to write, but the data generally speaks for itself. They just don’t want to let the data out:-(. After the excitement of HSCT- thursday…. and friday, its back to reality. This post...

HSCT and fake news

I post to manage expectations and counteract fake news.  There is a group of pro-HSCTers going around and saying HSCT is a cure for MS even in MSers with more advanced disease, i.e. it halts and reverses their disability. This is simply not correct and we have no published, peer-reviewed, data to support their position.  The meta-analysis below from Paulo Muraro and colleagues clearly...

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