AuthorProf G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.

#ECTRIMS2021: ocrelizumab the game-changer

Barts-MS rose-tinted-odometer: ★★★★★★★ The first  7-star ‘Teal Blue Monday’ #367588 The next in the series of #ECTRIMS2021 long-term follow-up posts. This is the 7.5 year follow-up of the ocrelizumab OPERA 1&2 (relapsing MS) cohort. The efficacy data looks very impressive.  Annualised relapse rates well below one in 10 years or 0.1 p.a. 2. 82% of ocrelizumab treated subjects had...

#ECTRIMS2021: a potential cure?

Barts-MS rose-tinted-odometer: ★★★★★★★A 7-Starred Bright Pink Sunday Special #ff007f Some asked about the 10-year alemtuzumab follow-up data. Here are the headline results: 60% of subjects are free of disability worsening. 2. 50% had confirmed improvement in disability. 3. Annualized brain volume loss consistently below 0.2% (essentially normal). 4. Tragically, the trial subjects who were...

#ECTRIMS2021: how long does cladribine work?

Barts-MS rose-tinted-odometer: ★★★★★★★ A 7-Star Bright Yellow Saturday #FFFF00 How good is cladribine as an immune reconstitution therapy?  The CLASSIC-MS study was our attempt to get back all the pwMS who had participated in the original phase 3 programme, from 15 years ago. The following poster is from my late-breaking poster at ECTRIMS and describes what has happened to the subjects from the...

#ECTRIMS2021: Do you have inactive SPMS? How often are you having an MRI?

Barts-MS rose-tinted-odometer: ★★★★ Gray & White MRI Friday #808080 When we interrogated a large number of pwSPMS we discovered that what really determines if you have active vs. inactive SPMS is how frequently you have an MRI scan. The more frequently you get scanned the more likely your team are to find new MRI lesions. If you rely on having a clinical relapse you may wait a long time. For...

#ECTRIMS2021: EBV as a therapeutic target; another Lazarus effect?

Barts-MS rose-tinted-odometer: ★★★★★★ (6-stars calls for a bright orange Thursday, #FFA500) As you are aware by now I  am one of the people in the field of MS who thinks EBV is the cause of MS. My position is essentially based on epidemiological evidence and causal inference. At the moment I honestly don’t know how EBV causes MS, but one hypothesis is that ongoing EBV infection in the CNS or...

#COVID19MS: antibodies matter

Barts-MS rose-tinted-odometer: ★★★  (An ECTRIMS red Wednesday #e52330) I am getting endless questions about when is it the best time to have the 3rd and/or booster dose of the COVID-19 vaccine in relation to ocrelizumab infusions, which is why I did an MS-Selfie Case Study on this topic on the weekend.  Unfortunately, until we have good evidence that shows people on ocrelizumab who seroconvert do...

Should we reclassify MS as a sleep disorder?

Barts-MS rose-tinted-odometer: ★★ (Dark blue sleepy Friday #00008B) The study below is another demonstration of how MS affects sleep.  Sleepiness, abnormal sleep timing, and poor sleep quality is just the tip of the iceberg. Two-thirds of subjects were in the extreme ranges in at least two sleep domains studied. Worryingly, markers of sleep disruption were associated with more depressive...

Turkeys voting for Christmas

Barts-MS rose-tinted-odometer: ★★★ (dollar color Monday hex #6B8068) Did you know that the effectiveness of high-dose steroids to treat a relapse is small? In reality, there is no difference in outcome at 6 months between relapses treated with steroids and those managed without steroids. In reality, high-dose steroids simply speed up recovery of function by about 2 weeks. So if you are not...

To get a booster or not

Barts-MS rose-tinted-odometer: ★★★ (a red-eyed Tuesday #FF0000) I was doing a Q&A webinar with some US clinicians last night and they were asking whether or not pwMS should have a booster COVID-19 vaccine or not. The answer is simple, YES. The study below in 60+-year-old Israelis shows that people who had a booster or third dose of the Pfizer-BionTech RNA vaccine were 11.3x less likely to be...

#MSCOVID19: to delay anti-CD20 dosing or not

Barts-MS rose-tinted-odometer: ★ (It’s a Black-and-White Friday #000000 & #FFFFFF) At the beginning of the COVID-19 pandemic, we made the case that B-cells and antibodies against SARS-CoV-2 were not necessary to clear the coronavirus and protecting you from severe disease. However, almost all emerging data challenges this position, therefore I have changed my position.   It is now clear that...

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