ArchiveMay 2022

When should I stop my interferon-beta safely?

Figure: EDSS score There are two main reasons for stopping an MS drug: 1) it no longer works for you i.e. there is break through disease activity, in which case you should be on a better drug, or else 2) it no longer works for you as you have now entered the progressive stage of your disease. The latter has proven very difficult to define clinically and radiologically, making it harder to know...

Redefining the Disease in the beasties

This is for the science geeks and about the beasties. This study looks at how animsals that get MS-like disease are scored. This is used to suggest effects of treatment. Historically for a rat it was scored 0 = normal, 1= limp tail, 2= paresis paralysis (partial paralysis) and 3= hindlimb paralysis, in guinea pigs they have no tail. However, to do analysis it is easier to have more scoring points...

Aletuzumab and Autoimmunity…Looking for a needle

Why does alemtuzumab cause secondary autoimmunity? If we knew we could do something about it? It would make alemtuzumab use safer. We have reported that memory B cells and memory T cells are depleted for a long time after alemtuzumab and there are naive cells returning when there is limited regulatory cell activity and that may allow break though of autoimmunity. Others argue differently. However...

Switching from Fingolimod to anti-CD20

Migration inhibitors inhibit MS, but the question is what to do once you decide to switch to something else. If you wait to long between stopping fingolimod and presumably the others, before starting the next effective therapy and disease can reactivate sometimes with marked attack, known as rebound. It has been suggested that because they trap lymphocytes in tissues like lymph glands and bone...

Future Prospects

We all know that un controlled MS influences you future prospects for divorce and unemployement. This study looks at some of the factors and find some that make small influences. Relapses are often dismissed as being important to the outcome but here there are subtle effects. Being female is better for stability, but we know that females are more likely to exhibit relapsing MS and disability...

#MSCOVID-What I we learnt…Yep I’ve had enough of this too.

In the report below there is a view of what we have learnt about COVID-19 and MS. I guess anyone could have written this as you have probably heard about all this stuff and more. But here is a summary. Two years of COVID-19 in the MS community: What have we learnt so far? Zabalza A, Thompson AJ, Montalban X.Mult Scler. 2022 :13524585221099844. doi: 10.1177/13524585221099844. Two years have...

Association of British Neurologists (ABN) meeting 2022

The ABN meeting took place this year in Harrogate, North Yorkshire and was well attended by neurologists and pharma colleagues alike. The Town is very familiar to MD (aka. Prof David Baker) who has come through it all without any visible misgivings. The meeting was packed with a lot of discussions on current and upcoming MS clinical trials, service provision in the UK and treatment guidelines on...

ProfG has hope

ProgG is giving a rallying call, let’s hope he is correct and that people buy into the idea. However it is clear that this is no quick fix and to think that you get it right first time, is also a concern, because if you get it wrong is there the chance for another go. For example Epstein Barr Virus (EBV) RNA vaccines have been made and they are only designed to prevent infection, but are...

Progression occurs independent of relapse

Association of Brain Atrophy With Disease Progression Independent of Relapse Activity in Patients With Relapsing Multiple Sclerosis Alessandro Cagol, MD1,2; Sabine Schaedelin, MSc3; Muhamed Barakovic, PhD1,2; et al JAMA Neurol. 2022. doi:10.1001/jamaneurol.2022.1025 Key Points Question  Is disability progression independent of relapse...

Can we explain racial differences in MS?

I have copied this from the National Multiple sclerosis website “Historically, MS was believed to primarily affect white people, particularly those of European descent. Recent research, however, indicates a higher incidence (the number of people newly diagnosed with MS within a given period of time) of MS in Black people than previously thought , consistent with the rate of MS in white...

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