MSVirtual2020: ChariotMS

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Whilst COVID-19 continues to be rather all-consuming, we’ve been extremely fortunate signing all relevant contracts at the start of the pandemic enabling us to keep the momentum of ChariotMS. Recruitment was meant to start this month, however COVID-19 threw us a final dummy, and we are now on course to enrol the first participant in Jan 2021.

I can hardly describe how excited I am this trial is finally getting underway in earnest. What started as a chat between MouseDoctor and myself almost exactly eight years ago will finally see the light of day. Over those years, and through the ups and downs of several rejections, we built an ever stronger network of supporters. Neurologists, scientists, trial managers, pwMS, and many more joined in developing the program, making the case to convince the NIHR-EME, MS Societies in the UK and US, Barts Charity and Merck KGaA. Thanks to them, standing on the shoulders of early seed-corn supporters, such as the Morris-Saady Charitable Trust, Lipomed, the North Thames Clinical Trials Network and others, ChariotMS will happen, and hopefully underpin that targeted immunotherapy is beneficial at any stage of MS.

As we’re getting ready, I will over the next few weeks introduce you in more detail to ChariotMS, key people involved, and what further we have up our sleeves. The slides above and below are from our presentation at MSVirtual. I will put the full deck on Twitter (@KlausSchmierer) once the meeting has kicked off Friday afternoon. You can find the abstract here (P0196).

@KlausSchmierer

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9 comments

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  • Great news! So thought this one would drift away My Neuro was keen to put me forward for this. I’m a wheelchair user but physically very fit and active still. I hope that it isn’t a long protracted roll out. An attempt to keep upper body and brain function for as long as possible is everything to me. Well Prof K you’ve made my day and I’ve not even had breakfast yet!

  • Brilliant-can’t wait to sign up ( hopefully!) appreciate the hard work, dedication and tenacity that has gone into making this happen

  • Hi All

    Well done and really great news to read & feel that with determination, great minds, support and all the other ingredients that it takes to make this happen. As mentioned, to start this Friday off on such a good note has made my day and we thank you all so very much for caring and wanting to help halt this dreadful disease and ultimately, I’m sure in the not too distant future, find the cure.

    Have a great Friday and weekend 🙂

  • Prof. K – this is great news and another example of the commitment the Barts team continues to display towards the MS Community. Mouse Doctor has mentioned your work around IV cladribine and I am very interested in the IV versus oral approach. Is there any publicly available research or data related to IV vs. oral cladribine? Hope your presentation today was well received.

    • It is subcutaneous cladribine but iv is essentially the same. Subcutaneous and IV cladribine are 100% bioavailable meaning that every thing you inject is available in the body, oral cladribine is about 40% bioavailable so a 10mg dose gives 4mg of cladribine whereas a 10mg dose of iv cladribine gives 10mg of cladribine.

    • As MD says its quite straightforward to compare, and indeed at an early stage we went to the MHRA who were happy to accept bioequivalence (but not dose equivalence, see MD’s comment). There have been early studies looking at route of administration. We’ve published a first review of our s.c. population here: https://pubmed.ncbi.nlm.nih.gov/30419510/ The follow-on paper with more data and longer duration is on my desk for editing.

    • Thank you for the additional information ProfK & MD. I look forward to reading the results of the follow-up paper. I would be particularly interested in lymphocyte subsets results, if those data sets were gathered during the study. The conclusion in the provided first review paper, “Personalized dosing of cladribine avoided severe lymphopenia in all but one patients and was very well tolerated across a large spectrum of disease severity”…….this is why I am so grateful to the Barts Team, your commitment to safety and advancing patient care.

      As a pwMS, I am constantly conducting researching and building a database around all possible DMTs. The unfortunate, yet true, reality is most pwMS will have to use multiple DMTs over the course of the disease. When I was diagnosed in 2018, I determined the “early and aggressive” treatment approach was the most well supported and appropriate decision given my age (<40yrs) and severity of clinical symptoms/MRI lesions. However, I recently had to stop my first-line high efficacy anti CD20 due to adverse infusion related side effects (MD knows what I am talking about). I began taking a somewhat lower efficacy DMT (with anti-viral aspects) while my circulating b-cells repopulate. I am 9 months post my last anti-CD20 and remain b-cell depleted. I am hopeful in my current treatment approach and feel luckily to have a local neurologist who understands and appreciates my "academic" approach to individualizing my treatment plan…..the way it should be!

  • Fantastic news Prof K, huge well done to all! So excited for you and all trial participants. Can’t wait to hear more as ChariotMS finally, finally gets underway 🙂
    My favourite line from abstract:

    ‘Evidence suggests that slowing or stopping disease deterioration is possible even past this arbitrary (loss of ambulatory function) threshold.’

    It’s that key word ‘arbitrary’ that’s so-ooo important…. it’s been like, all these years, can’t walk?… forget it, what’s the point????

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