ArchiveJanuary 2020

Rituxinavia in the Real World experience

Rituximab in multiple sclerosis at general hospital level. Hellgren J, Risedal A, Källén K. Acta Neurol Scand. 2020 Jan 28. doi: 10.1111/ane.13225. [Epub ahead of print]. OBJECTIVES: The use of Rituximab (RTX) in multiple sclerosis (MS) is a rapidly increasing choice of disease modifying therapy. Efficacy outside specialized university hospital-based care is not yet...

High salt intake, is it a risk factor for MS or have you been sold a used car?

There are some people I listen too at meetings and think wow!. Sadly there are some people that I listen too, I hear the dogma and feel like I am being sold a used car. We are told by our bossess that we should publish in journals like Nature and Science. As such, a couple of months ago, I saw a senior boss giving a junior scientist a hard time because they questioned the value of chasing a...

Rebound after fingolimod

Coss-Rovirosa et al. Severe fingolimod rebound syndrome after switching to cladribine treatment. Mult Scler Relat Disord. 2020 Jan 16;40:101938. We present the clinical and imaging characteristics of a patient whom presented with rebound syndrome after switching from fingolimod to cladribine treatment due to hematologic toxicity. Previous imaging studies had shown a non-aggressive phenotype of...

MS-SMART outcomes in SPMS

MS-SMART was a multi-arm two year placebo (dummy tablet) controlled study looking at three putative neuroprotectants in secondary progressive MS (SPMS). The agents studied were amiloride, fluoxetine and riluzole, selected from previous successes at a smaller Phase II level. The scientific rationale is as follows:“Amiloride, widely used as a potassium-sparing diuretic, is an acid-sensing ion...

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...

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...

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...

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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