ArchiveAugust 2020

Lithium

Animal studies suggest efficacy of lithium. This study in ms suggests lithium is tolerated and that it doesn’t work. So maybe the end of lithium. But the trial is too small to do efficacy so it was probably doomed before it started. People now see failure will a bigger trial be funded. I doubt it Background: Disability accumulation in progressive multiple sclerosis (MS) results from...

How does BTK inhibitor works

I thought interesting, BTK as the new kid on the block should inhibit B cell activity and it should inhibit memory B cell activity. I saw the title and thought interesting and then saw the contents and its mouse EAE and at this point I sort of switched off. Because mice have different B cells and importantly it is a hard core T cell mediated disease in mice. Indeed it was shown by the company...

I must have Wind as it seems I keep repeating myself

Todays B cell burp was reported as it came out of the Horse’s mouth when it came out at ECTRIMS2019, so I am not going to dwell on the take home message that it was positive and inhibited relapsing MS. This was an interesting trial design that recruitment was continued until set points were reached to ensure the trial delivered an answer. “Ofatumumab was associated with lower...

Ocvrelizumab can blunt the anti-COVID19 antibody response.

We have recently reported on the the possibility that taking ocrelizumab may reduce your chance of producing protective antibody against COVID-19-related virus. COVID-19 vaccine-readiness for anti-CD20-depleting therapy in autoimmune diseases.Baker D, Roberts CAK, Pryce G, Kang AS, Marta M, Reyes S, Schmierer K, Giovannoni G, Amor S.Clin Exp Immunol. 2020 Jul 16. doi: 10.1111/cei.13495. Online...

Infection risk and MS is higher

Infections in patients with multiple sclerosis: A national cohort study in Sweden.Castelo-Branco A, Chiesa F, Conte S, Bengtsson C, Lee S, Minton N, Niemcryk S, Lindholm A, Rosenlund M, Piehl F, Montgomery S.Mult Scler Relat Disord. 2020 Jul 23;45:102420 BackgroundMultiple sclerosis (MS) patients have an increased risk of infections, but few population-based studies have reported infections...

Innate immune response and COVID-19

Having reported on the T and B cells. SARS-CoV-2 and Multiple Sclerosis: Not All Immune Depleting DMTs are Equal or Bad.Amor S, Baker D, Khoury SJ, Schmierer K, Giovanonni G.Ann Neurol. 2020 Jun;87(6):794-797 This time DrLove shows off her immunological knowledge to give some insight into how the innate (macrophages and neutrophils) etc. are involved in COVID-19. Get a cup of Tea, and Relax and...

Neurofilament and vitamin D supplementation

In a moderately sized study from Finland, investigators wanted to know whether the addition of vitamin D to interferon-beta-1b (a first line disease modifying treatment) had a favourable outcome on disease activity. In order to assess this they measured serum (blood) neurofilament levels a protein found in neurones as a marker of MS disease activity. What they found was that the addition of...

Overdosing, does this happen with fingolimod?

Overdosing is a current theme in MS treatment and in the era of COVID-19 attention has focus on whether extended dosing intervals could be used. Fingolimod is a once a day treatment but it has a long half-life of about 6-9 days meaning that it take 6-9 days for half the drug to disappear. So do you need to treat every day, it looks like the answer is no, but as ever we need a study . Clinical...

Ozanimod How does it work? Have we got a real clue?

Last week I wrote a post about how pharma may report on the next Cladrimod (cladribine or ozanimod/posenimod) study in “Dr Dooley will be happy that their uncited work from 2016 has been repeated….MS drugs affect memory B cells!”. In that post I made a prediction on how the lymphocyte subset data would be reported from the next MS drug so that the potential for memory B cell depletion...

Q&A August 2020

For those reading on 1 August. Happy Yorkshire Day

Gods Own Country

You know the the drill if you have a question unrelated to the threads. This is the place for you

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