Archive2020

#T4TD when it comes to Anti-CD20 therapy body size counts

Did you know that if you are a large person standard dose ocrelizumab is not as effective as it is in a small person?  When looking at the efficacy of anti-CD20 therapies such as ocrelizumab you shouldn’t bother looking at relapses and focal MRI activity (Gd-enhancing lesions or new T2 lesions) when comparing effectiveness between doses and competing products. Relapses and MRI lesions are...

COVId breakfast-British Science

This cartoon was in a British Newspaper…I was sent it as I don’t read that paper:-). which suggests the state of the COVID research….I suspect some of you think this is the State of MS research SID asked “If you get time, could you do a T4TD on why the research / medical still can’t identify an approach (treatment + lifestyle factors) which would halt the progression of...

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The ocrelizumab phase II extension trial suggests the potential to improve the risk:benefit balance in multiple sclerosis (Follow the link) available for 50 days This suggests that there may be possible to maintain benefit by extending the dosing interval. We think a clinical study needs to be done to formally show this. If you want to look at a follow on study have a look at COVID-19 vaccine...

Metformin Good news for females?

We know that old age is a risk factor for severe COVID-19 and one finding is old-age of the immune system. We have suggested that macrophages may be an important line of defence. It has been suggested that the diabetes drug metformin can rejuvinate macrophages to promote remyelination. Therefore, metformin should offer advantage to the diabetics who get COVID-19. It seems there is in females...

COVID Breakfast

I haven’t done this for a while so whilst you are eating your cornflakes have a chuckle, but having ventured into a Garden Centre on Sunday, to witness some idiot cough his way through the shop, this paper took my attention about infectivity from a sneeze, a cough and breathing. The take home message is be cautious. We are told that the virus is spread by aerosols but after sunday, I think...

#T4TD falls and fractures

Did you know that people with MS have a six times higher risk than age-matched controls of having a long bone fracture of the lower limb? The reason for this is that pwMS often have balance problems, unsteadiness of gait (ataxia), lower limb weakness (dropped foot) and are maybe excessively sedated from their medications. All these factors increase your chances of falling. In addition, pwMS are...

COVID-19 vaccine and ocrelizumab

The proof of the pudding is in the eating of it, not in the pudding or its concealed ingredients. Don’t take my word for it. From New York come two cases that were SARS-CoV-2 (COVID-19) antibody negative after developing COVID-19 while on ocrelizumab. Both cases were aged 39 and 42, within an age range that would be considered immune competent and therefore fully capable of forming an...

#T4TD vascular comorbidities

Did you know if you have MS and vascular comorbidity you are likely to need a walking stick approximately 6 years earlier than if you did not have vascular comorbidity?  Importantly this 6-year difference in reaching EDSS 6.0 (requiring a walking stick) is larger than the treatment effect of a platform DMT. As vascular comorbidities are largely preventable are you doing anything to prevent or...

Why are MS treatments having limited influence on #MSCOVID19

Endotheliopathy in COVID-19-associated coagulopathy: evidence from a single-centre, cross-sectional study.Goshua G, Pine AB, Meizlish ML et al. :ancet Haematology What has this got to do with MS and MS-drugs….very little. I think and this is one of the reasons why MS drugs are not influencing COVID-19 in a negative way. It says that a problem for COVID-19 is that there is damage to the...

#T4TD menstruation

Women with MS may notice increased fatigue and intermittent symptoms in the second half of their menstrual cycle and during menstruation. Why? After ovulation, a woman’s body temperature rises by ~0.4℃ (range = 0.3 to 0.6℃) which in someone with MS is enough to cause temperature-dependent conduction block. In addition, the process of menstruation involves a mild systemic inflammatory reaction...

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