AuthorProf G

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

MS@theLimits 2020

Barts-MS rose-tinted-odometer ★★★ The Barts-MS team is heavily engaged with the 2020 MS@theLimits meeting at the Royal College of Physicians. Two things to note is the gender bias in favour of female speakers. This was in response to criticism about the male dominance at the last MS@theLimits meeting in 2018. I am speaking today about some of my ideas around ‘the real MS’ or...

Check-point charlie

Barts-MS rose-tinted-odometer ★★★★★  The argument about whether or not MS is primarily a T-cell or B-cell disease is academic. Almost all the data suggests that both cell types are involved. Clinical trial data also suggests MS outcomes when it comes to end-organ damage (brain volume loss) is superior for therapies that target both  T and B cells, i.e. alemtuzumab and HSCT over say mainly B-cell...

The Hopebird is singing

Today the EU licensed siponimod for the treatment of active secondary progressive MS. It has been a very long and winding road to get here. Siponimod is not an eagle, phoenix or maven, but rather a hopebird which symbolises the importance of “an optimistic approach to what lies ahead”. Less than a decade ago we were telling our patients with a progressive course that they were beyond hope, that...

You don’t have to lose your marbles by taking a statin

Barts-MS rose-tinted-odometer ★★★★★  As you know high-dose simvastatin 80-mg per day is being tested in a phase 3  trial in the UK (MS-STAT2). I have referred several patients to participate in this study. Despite this, there has always been a worry about this treatment strategy because statins have been associated with changes in cognition, which is why I have always said that if I needed a...

The war on sugar (more posts below today)

Barts-MS rose-tinted-odometer ★★★  Just back from the NMSS ‘Pathways to Cures’ meeting in Washington DC during which we pledged to  STOP, RESTORE and END multiple sclerosis.  The END refers to prevention. We discussed at the meeting modifiable risk factors that could be tackled to reduce the incidence (new cases) of MS and one risk factor childhood and adolescent obesity. One...

Re exercise in MS: should we be flogging a dying horse?

Barts-MS rose-tinted-odometer ★★★  I am at the NMSS’ Pathways to Cures think tank where exercise is a major theme in terms of restoring lost function. A lot of discussions have been about how we motivate and get pwMS to exercise. Some suggested using motivational interviewing techniques and behavioural psychology to motivate and nudge pwMS to exercise. The elephant in the room is that some people...

Pathways to Cures

Barts-MS rose-tinted-odometer ★★★★★  I am en route to a ‘Pathways to Cures’ meeting in Washington DC hosted by the National MS Society. The aim of the meeting is to refine the ‘Stop, Restore, and End Pathways’ for MS and to develop an international consensus on what an MS cure looks like. I am honoured to be invited to participate in this meeting and would like to thank the NMSS for inviting me. ...

How healthy is your lifestyle?

Barts-MS rose-tinted-odometer ★★★★★  It is a no-brainer. A healthy lifestyle is one of the most effective preventive health interventions available. The study below shows that you can increase your chances, by a factor of over 20, of a life expectancy free of diabetes, cardiovascular diseases, and cancer at age 50 by making ensuring you maintain 4 or 5 low-risk lifestyle factors; i.e. not...

Ageing

Barts-MS rose-tinted-odometer ★★★  I belong to an international group that addresses important issues in multiple sclerosis that arise between HCPs and pwMS. For 2020 I have suggested we tackle the issue of ageing in MS. I have been asked why I think ageing an important topic in MS. I have put forward the following list of issues that have come to mind. Can you help me with suggestions or...

Induction-maintenance

Barts-MS rose-tinted-odometer ★★★  By definition an immune reconstitution therapy (IRT) for MS is given as a short course, i.e. as a one-off treatment in the case of HSCT or intermittently as in the case of alemtuzumab or cladribine. IRTs are not given continuously and additional courses of the therapy are only given if there is a recurrence of inflammatory activity. IRTs have the ability to...

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