Archive2020

The third reviewer

Prof G has been working all weekend responding to reviewer’s comments to a large and very important grant application for the Barts-MS group. Despite us all reassuring him that it will be okay and that the third reviewer has been neutralised he is having sleepless nights. What can we do to help him? We have suggested he watch this parody on YouTube, about scientific peer review, to lift his...

Year of the Rat

Happy new Year. It is the year of the Rat in the Chinese Calendar I predict that we will be doing some appropriate things things this year, but hopefully we will not be working with the furry kind (big teeth and hairy tail), but I am sure we will meet a few of the human kind. Indeed “Someone will be calling me a dirty rat by the end of the year”. But it won’t be James Gagney, if...

Curing MS

How close are we to offering some people with MS a cure? I am speaking at the Imperial College Neuroscience Society this morning on ‘how close we are to curing MS’. I think we are very close; in fact some of the longterm follow-up data of IRT (immune reconstitution therapies), in particular, alemtuzumab, non-myeloablative HSCT and myeloablative HSCT looks very promising. I suspect...

MS@theLimits 2020

Barts-MS rose-tinted-odometer ★★★ The Barts-MS team is heavily engaged with the 2020 MS@theLimits meeting at the Royal College of Physicians. Two things to note is the gender bias in favour of female speakers. This was in response to criticism about the male dominance at the last MS@theLimits meeting in 2018. I am speaking today about some of my ideas around ‘the real MS’ or...

Zeus HSCT trial is like Buses…Wait and two or is it three arrive at the same time.

Some of you tell us that we, AKA Prof G, don’t design and do enough investigator-led (non pharma) trials. But anyone who knows ProfG and thinks or says such a thing, I am sorry to say is a fool. OK, we have to hold our hands up and say yes we have been slow at writing some trials up…but we are not the only ones. I accept part of the blame for this, the Canbex trial was written over a...

Pollution as a Risk Factor for MS

I suspect I will be deluged by people telling me how they had the cleanest air on the island and they got MS. I suspect there are not many steel works on the outer hebrides, apart from a few Iron-Age settlements. Air pollution, a possible risk factor for multiple sclerosis. Türk Börü Ü, Bölük C, Taşdemir M, Gezer T, Serim VA. Acta Neurol Scand. 2020 Jan 18. doi: 10.1111/ane.13223. [Epub ahead of...

Check-point charlie

Barts-MS rose-tinted-odometer ★★★★★  The argument about whether or not MS is primarily a T-cell or B-cell disease is academic. Almost all the data suggests that both cell types are involved. Clinical trial data also suggests MS outcomes when it comes to end-organ damage (brain volume loss) is superior for therapies that target both  T and B cells, i.e. alemtuzumab and HSCT over say mainly B-cell...

Cost effectiveness of cladribine vs fingolimod in Portugal

Firstly, this is not about money (I say this without a tell as my accountant taps away at their calculator nonchalantly). Really, this concept of cost-effectiveness is only obtrusive if you dislike politicking in any form or kind, or you’re British. The easiest way to understand cost-effectiveness models in healthcare in my view is to understand the principles of bartering. In bartering...

The Hopebird is singing

Today the EU licensed siponimod for the treatment of active secondary progressive MS. It has been a very long and winding road to get here. Siponimod is not an eagle, phoenix or maven, but rather a hopebird which symbolises the importance of “an optimistic approach to what lies ahead”. Less than a decade ago we were telling our patients with a progressive course that they were beyond hope, that...

Childhood obesity, vitamin D, and MS risk

The cause of MS is still not known. Genetic studies have shown that over 200 sites in the genome determine susceptibility to MS, but altogether this only explains a fraction of MS risk. It’s also clear that ‘environmental factors’ – by which I mean anything not directly to do with genes – have an important role in determining who gets MS. Environmental factors that seem to increase...

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