ArchiveJune 2020

Do you smoke cannabis?

The findings from this study may interest some of our readers. Cannabis use in MS is licensed for spasticity management and to a lesser extent proven to be helpful with refractory neuropathic pain. Some also use cannabis to manage the psychological downsides of MS. Given it’s increasingly popularity since legalisation, the authors set out to determine whether discontinuing cannabis worsened...

Are we over dosing with anti-CD20? Evidence based on rituximab

People with stable MS who were treated with rituximab and then watched remained stable. This should come as nothing new for the general reader but in case you are new to the blog read on Maarouf A, Rico A, Boutiere C, et al. Extending rituximab dosing intervals in patients with MS during the COVID-19 pandemic and beyond?. Neurol Neuroimmunol Neuroinflamm. 2020;7(5):e825. Published 2020 Jun 25...

What happens with cladribine in the long-term

Abstract Long-term effectiveness in patients previously treated with cladribine tablets: a real-world analysis of the Italian multiple sclerosis registry (CLARINET-MS).Patti F, Visconti A, Capacchione A, Roy S, Trojano M; CLARINET-MS Study Group.Ther Adv Neurol Disord. 2020 Jun 10;13:1756286420922685 Background: The CLARINET-MS study assessed the long-term effectiveness of...

#MSCOVID19 French Registry Reports

The french registry has delivered their first taste of the COVID-19 pot and they support our suggestions that DMT are not creating mega problems if you get infected with SARS-CoV-2. The risk factors are age (co-morbidities increase with age), obesity (co-morbidities increase) and disablity (co-morbidities increase with disability). Interestingly, DMTs were associated with lower risks of severe...

What’s a Blood Spot test

When you are born you had a prick in your heel and you put the blood spot on a card called a Guthrie card. You let the card dry and then you can stick the card in the post. In terms of coronavirus, it will be dead in a couple of days max and it is not going to escape the enveloped to infect the postie A blood spot is about 50-75 microlitres in volume. When the spot is dry the contents are...

NICE not so NICE again

Siponimod is not recommended, within its marketing authorisation, for treating secondary progressive multiple sclerosis with evidence of active disease (that is, relapses or imaging features of inflammatory activity) in adults. Interferon beta-1b is currently the only disease-modifying treatment available for people with active secondary progressive MS. However, NICE says that few people take it...

Alemtuzumab exposes lots of interesting biology. #MSCOVID19 The macrophage is important for getting rid of SARS-CoV-2

Yesterday we (MD1&MD2) and others (MS researchers) were accused of being responsible for the downfall of alemtuzumab with the regulators. This is because they (other MS researchers) have drip-fed reported adverse events like these: Immune-mediated hepatitis induced by therapy with alemtuzumab in a patient with Multiple Sclerosis. Bolte FJ, Schmidt HH, Schlevogt B.Hepatology. 2020...

The #MSCOVID-19 vacccination window of ocrelizumab/rituximab and more evidence for the importance of memory B cells

Want the Quick Read. Do the stuff in Red! (SEE NEW PAPER AT THE BOTTOM) How long does it take for the vaccination window to open?DOI: 10.22541/au.159292858.82650822 As you know our initial paper on COVID-19 took a look at the biology of COVID-19 and its relationship to MS disease modifying drugs. How do MS drugs affect COVID-19. Read this paper. The answer, I think is not alot. Baker D, Amor...

COVID-19 has changed neurology

I generally don’t like to rock the boat on anything, this applies to what I wear, eat, the people I co-locate with and work. It should therefore come as no surprise that my response to our changing practice if anything luke warm. I understand fully (more so than you may credit) the impact that COVID-19 has had on hospitals, and continues to do so. But, in my opinion this should be temporary...

Ocrelizumab vaccine Readiness part 2

Attenuation of antibody response to SARS-CoV-2 in a patient on ocrelizumab with hypogammaglobulinemia. WL ContePublication stage: In Mulr scler rel disord. DOI:  A 48-year-old on ocrelizumab (last dose 1/24/2020) presented to a drive up COVID-19 testing site with two days of fever, upper respiratory symptoms, and malaise on March 30, 2020. They tested positive for the antigen to SARS-CoV-2...

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