ArchiveApril 2022

Treatment is beneficial

I guess you know this already….wonder when the HST comment will arrive? Association of No Evidence of Disease Activity With No Long-term Disability Progression in Multiple Sclerosis: A Systematic Review and Meta-analysis.Rotstein D, Solomon JM, Sormani MP, Montalban X, Ye XY, Dababneh D, Muccilli A, Shah P.Neurology. 2022 Apr 26:10.1212/WNL.0000000000200549. Objective: We...

T time….Looking for MS targets

Is MS an autoimmune disease…It is difficult to confirm this view and disease needs to e controlled by antigen-specific means to e more compelling. This study hunted and found 4 antigens that could induce T cell responses and some showed the capacity to induce histological disease. The study seems to re-affirm that the typical myelin antigens favoured by many immunologists give no better...

MSCOVID19 Therapeutic Antibodies

This study shows what we have seen before and that is if people with fingolimod or ocrelizumab treatment who make a poor SARS-CoV-2 antibody response get infected. They get a therapeutic antibody and they all make a recovery. This bodes well for anti-virals as many of the therapeutic antibodies have issues because they can’t deal with omicrons Manzano GS, Rice DR, Klawiter EC, Matiello M...

How does cladribine work?….An effect on monocytes/macrophages

It’s MS week and so we can focus on MS The classic way to talk about mechansisms of action in scientific publications is to say, they are “unknown” as a preamble for the work. However, they are often known but unproven. Whilst this paper does not start this way, it is hunting for the new explanations for the action of cladribine and so shifts the focus onto certain elements of...

MS controversies in India

Controversies in Neurology (CONy) launched about 15 years ago as an annual get together for neurologists to discuss topics where there is no single answer. And there are obviously many questions without a single answer in neurology just as in medicine as a whole. Over the years, CONy has become a fixture in the calendar of many of my colleagues. I co-chaired the MS section in March; here’s...

Rebound after switching with fingolimod

Rebound in MS disease activity occurs when coming off highly-active drugs. It refers to a return in MS activity that is more than before. The drugs most likely to demonstrate this are the highly-active treatments that are given on a regular basis (i.e. maintenance treatments, such as natalizumab and fingolimod – it is too early to say with ocrelizumab) that create a gating system for the...

Instead of Monday Q&As – It’s MS Awareness Week!

You may be aware there is an annual World MS Day, celebrated every 30th of May since 2009, following an initiative by the MS International Federation. World MS Day 2020-22 has been themed *connections* There’s also MS Awareness *Week*, and if you live in the US that was early last month (sorry if you missed – I did), however here in the UK it’s *this week*. A number of events...

Where do my Brain Macrophages come from?

When I was a scientific ameoba the big question was what are the antigen presenting cells in the brain. Those around blood vessesl were the most likely first point of contact for an invading white blood cell. Back in the day many people called them pericytes. Back in the day people used to say they were derived from smooth muscle. This is a type of muscle distinct from heart and skeletal muscule...

Alemtuzumab update

You may be interested to read this A review of the benefits and risks of alemtuzumab (including fatal reactions) in the treatment of multiple sclerosis has now concluded and recommended a revised indication, additional contraindications, and strengthened monitoring requirements before, during and after treatment. Patients offered alemtuzumab should be alerted to the early risks of cardiovascular...

MS COVID19. Can you be the next Omicron

What does this say? In this study immunosuppressed people including those taking B cell depleting therapies, were given an anti-viral therapy following infection with SARS-CoV-2. Most people recovered from their infections, which is what the anti-viral antibody therapy was supposed to do. However afew people did not clear the virus quickly and in these people they found mutations in the surviving...

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