ArchiveFebruary 2020

#COVIDMS COVID-19 pandemic changes the rules

I am at an MS meeting in Frankfurt and was speaking to an Italian neurologist about the COVID-19 or coronavirus pandemic and he informs me that in Milan, the epicentre of the Italian outbreak, they have stopped dosing their MS patients with ocrelizumab, alemtuzumab and cladribine until the epidemic has passed. Interestingly, they are not stopping fingolimod, which leaves a whole cohort of pwMS at...

#COVIDMS Coronavirus creates an opportunity for teriflunomide

Should I switch to teriflunomide?  Please don’t panic! The coronavirus or COVID-19 pandemic is a problem but needs a calm and considered public health approach, which is happening in the UK. At the moment the general public, including pwMS, are overreacting. Another patient emailed me yesterday to inform me they are going to stop their ocrelizumab and asked what the consequences will be. In the...

Maybe MD2 was right, there is no specific target in the OCB

In this study they looked at the specificity of the oligoclonal bands and came to the conclusion that they react to nothing that is consistent. We (the Royal we..i.e. one) have been hunting for years and the same answer has been there in every, yep every study….in that there is no consistent target in the oligolonal bands. B cells get in the CNS an survive for a very long time. MD2 came up...

Smouldering away

As you are aware we, or I depending on your perspective, have recently have hit a brick wall trying to convince the MS community that the big unmet need in MS is smouldering disease. The central hypothesis is that smouldering MS is the real MS. The following YouTube presentation summarises some of the main arguments for the hypothesis. Your comments will help me make a decision to giving-up...

The Scientific Process-If you can’t disprove it, it may be true!..But if you can, It’s not.

The scientific process is you set test a hypothesis that there is no difference between your idea and the control. If there is no difference you try something else and if there is a difference you move on. For regular readers you will have heard of Karl Popper before. Most of my peers have forgotten him. He told us we should not do experiments to prove our idea, we should do them to try and...

It’s a funny old world, this publishing business….Wanna know about T cells and have a laugh

T Helper Cells: The Modulators of Inflammation in Multiple SclerosisKunkl M, Frascolla S, Amormino C, Volpe E, Tuosto L. Cells. 2020 ;9(2). pii: E482. doi: 10.3390/cells9020482 …..The progress made in more than one decade of research in animal models of MS for clarifying the pathophysiology of MS disease validated the concept that MS is an autoimmune inflammatory disorder caused by the...

Pandemic

Yesterday I had the experience of a patient with highly active MS pull out of being treated with ocrelizumab (Ocrevus) because of concerns around being infected with the coronavirus COVID19. I suspect this will be the first of many patients with multiple sclerosis to do so.  It is clear that COVID19 epidemic is now a pandemic, i.e. it has involved enough continents and countries to be considered...

Anti-Drug Antibodies. Don’t SH1 on yourself when you have a problem…hatchet the others!

Rule #1 of “Pharma club” is Don’t admit you have a problem! Rule #2 of “Pharma Club” is “Don’t admit you have a problem”, Rule#3….Don’t admit… As you know. We have been looking at anti-drug antibody responses because they are important to the individuals who fail treatments as their drugs stop working. You can now get our latest...

CD20 wars under starters orders

How do you like your DMT served, long and slow or quick and easy? The regulators have the trial data for ofatumumab and it will now be up to the regulators to see how quick they approve the drug. It looks like the Americans will win with a Summer 2020 showing and the EMA will lag behind for 2021. In future what will the MHRA (UK regulators) do…follow the EMA or the FDA. Recently the FDA has...

Cannabis use in MS is here to stay

Muscle spasms, stiffness (also known in medical speak as spasticity) and pain are major problem areas in MS. Most are on tablets for this, commonly baclofen, with fewer individuals receiving botox for focal areas of stffness or intrathecal (via lumbar puncture directly into the CSF) baclofen for severe lower limb stiffness. Many also use cannabis for this indication, but the exact usage is...

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