ArchiveSeptember 2021

New DMT species: An efficacy sheep in wolf’s clothing

In MS, there is a distinction between first- and second-line disease-modifying therapies (DMTs). Newly-diagnosed pwMS often start with a so called ‘first-line’ drug. These drugs balance low to medium efficacy with a favourable long-term safety profile. This is a potentially interesting DMT choice when it’s not entirely clear yet how ‘active’ an individual’s MS will be. Protagonists are Tecfidera...

#MSCOVID19 B cell repopulation with MS treatments

You have seen the data but you can now read the full paper We have been examining the B cell repopulation potential from a trial data set, where access was provided by Roche. Thanks for that If it is the case that a certain level of B cell numbers are associated with a COVID-19 related antibody response after vaccination. we asked how many people on standard ocrelizumab dosing would reach that...

Multiple Sclerosis and being a woman

MS is commoner in women than men. In fact the incidence of MS is increasing all over the world but this seems to be preferentially in women. Now this new publication looking at cases and controls (through a process of enrichment from a large group of women with MS) is suggesting that there are marginal differences in non-natural menopause in MS females, with more cases observed in MS. Moreover...

Blood Spot Tips

If you are helping us with COVID-19 testing or providing a blood spot sample for other reasons here are som tips to help us help you Blood Spot Collection Instructions Preparation Wash hands with warm water and gently massage finger from palm to tip. Choose fingertip (middle or ring finger of non-dominant hand is best) and wipe with alcohol wipe. Sample Collection Twist and remove lancet cap (A)...

Is the real MS standing up?

You want some non-COVID stuff reported…ProfG has been doing this on his MS-selfie site and we can only report what people are publishing, so maybe this week we can do the “Real MS” for a change One school of thought thinks that MS starts in the central nervous system and then lesions form, this is the “inside-out” brigade, in this study they use scans from trials and...

#MSCOVID-19 Chances of making an antibody response after a COVID-19 booster Part 2. Cladribine and alemtuzumab

Yesterday I reported on the influence of ocrelizumab on B cell depletion and repoulation, today we look at other B cell depleting agents, but in contrast to ocrelizumab which hangs around for a long time, cladribine and alemtuzumab both are gone from the body within a month. So when we ask the question what happens in terms of repopulation of the B cells during therapy. What did we find? As you...

#MSCOVID-19 Chances of making an antibody response after a COVID-19 booster

After taking ocrelizumab it seems that many people make a T cell response but do not make much of an antibody response. The emerging data suggest that this is related to B cell levels. On the left you have antibody levles and along the bottom you have B cell levels. The more antibody you make the higher it is on the graph This is seen in a number of papers We asked if you take ocrelizumab how...

#MSCOVID19 vaccination. Yet another …….Guess what? Yep CD20-depleting antibodies inhibit antibody responses but there is a robust T cell response

So I think we can be confident that the headline is the reality. We have seen this over and over again and we will see it again and again.. It is amazing that fingolimod studies are yet to surface However……. Now what we need to know is…Is this important is there sufficient protection. Based on immunology 101 if the antibody levels are low then the capacity to stop the...

I did not know this….ozanimod

Fingolimod is a sphingosine-1-phosphate modulator and binds to S1P1, S1P3, S1P4, S1P5. S1P1 is expressed on lymphocytes and astrocytes…..S1P3 may be involved in some of the heart isssues, S1P4 people don’t talk about much and S1P5 is on oligodendrocytes and so is sold as a target for repair. So out come the new eyemods…..ozanimoid, siponimod and ponesimod to name three…...

Does true patient consent exists? – NO

In a recent MS Journal Club, my colleague Heather Mah  presented an article about patient involvement in research. This then prompted the discussion about research bureaucracy, patient information sheets, and the standard of consent. Patient information sheets (PIS) are often long, text heavy documents that are impossible to understand. They are intended to provide all the information about...

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