ArchiveJune 2021

MS COVID19 Sunday lunch.

During COVID the standard publication process has been thrown out of the windown. Whereas it may take 6-12 months for a standard paper to arrive, with preprint sites, stuff arrives online within 2-3days. In the COVID era these views are either supported or refuted 9-10 times in a few moments more. So sadly by the time the experts have got together to make a consensus, life has moved on and the...

Now a virus that isn’t associated with MS

Cytomegalovirus (CMV) is related to the herpes virus that causes cold sores and chick pox. It gets its name from making cells swell/go big. Like EBV Once you have the virus, it stays in your body for the rest of your life. Your immune system usually controls the virus and most people do not realise they have it. But CMV can cause serious health problems in some babies who get the virus before...

Obesity

Barts-MS rose-tinted-odometer: ★★★ (a dark blue Saturday; a chastised weekend warrior #00008b ) I was accused this week by some commentators on social media for blaming, and by implication shaming, people with MS about lifestyle factors that may impact the long term outcome of their MS.  One person said, “stop pushing ‘lifestyle changes’ code for lose weight on people as a fix...

A no-brainer?

Barts-MS rose-tinted-odometer: ★★★★★ (aquamarine on a very rainy Friday in London, #00FFBF)  I recently had a patient of mine who has been desperate to be treated with alemtuzumab actually ask if he can change his mind and rather be referred for AHSCT (autologous hematopoietic stem cell transplantation). Why? Because the chances of being put into long term remission, and hence potentially...

#MSCOVID19: get vaccinated

Barts-MS rose-tinted-odometer: ★ (Blue Thursday #000080) Where are all the new MS patients gone? We have national data showing that there has been a 30% fall in the number of new patients with MS starting on disease-modifying therapies (DMTs) during the COVID-19 pandemic. Where are these patients? I suspect due to the reconfiguration of the NHS because of COVID-19 many of these patients have yet...

The First Report of a Blunted vaccine response to Ocrelizumab, three months after the other first reports.

So in the race to get there quickly, we are seeing the case reports surface of people on ocrelizumab, not developing an antibody response. Below, we see a paper of 4 people…and they report “the first data“..which as ever is never the first data….They say the response is blunted…then say “data are urgently needed to confirm and expand these preliminary...

Ask not

Barts-MS rose-tinted-odometer: ★★★★ (black&white) I once proposed the question, “ask not what your healthcare professional (HCP) or MS research community can do for you, but what you can do for yourself?” and had quite a lot of pushback from some readers. Why?   I started developing this diagram more than a decade ago summarising the holistic management of MS. What I mean by this is that if...

A little more early hard hitting data…same answer!

After this weekends post you said “How much more “hit it hard and early” evidence do we need before neuros actually begin to adopt this and abandon the escalation strategy?“ I suspect abit more evidence, which they need to read However, one option could be to keep the escalation approach and just avoid using the CRAB drugs etc. The advantage of early effective treatment has been shown...

The 1st anti-plasma cell drug in MS. What should you ask?

SIZOMUS is a short name for “Safety of IxaZOmib targeting plasma cells in MUltiple Sclerosis” I first became the study Clinical Research Fellow on the “SIZOMUS” clinical trail last year. Instantly my brain filled up with questions. I thought I’d go straight to the horse’s mouth for the answers and sought out the two lead study investigators – Prof...

It’s a fine line

Barts-MS rose-tinted-odometer: ★★ (Monday feels like an orange day; an orange cocktail day) “I can’t wait for the next MS breakthrough; it will take 10-15 years to reach the clinic. I have smouldering MS and I need to do something about it now. Tell me Gavin what would you do if you were in my situation ?” PwMS I have just had a call with a person with MS who I know very well. This person is not...

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