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...

Thrown into the deep end

Barts-MS rose-tinted-odometer = zero I remember her so well. She was malnourished, bordering on anorexic. When I examined her she was literally skin and bone with abrasions over the bony protrusions, or spinous processes, on her back and an infected pressure sore on the heel of her right foot. She used to bum-hop down the stairs in her house and occasionally would slip and slide down the...

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...

Can MS be adoptively transferred?

Barts-MS rose-tinted-odometer ★★★  How much of your mother is inside you? Cells from the maternal circulation (your mother) cross the placenta into the foetal circulation (you) and set-up shop in your brain and body. This phenomenon is called maternal microchimerism and is very common and may be more common in people with autoimmune disease. The implications, or hypothesis, is that cellular...

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...

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...

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