AuthorIde Smets

The art of switching!

Natalizumab blocks the lymphocyte migration over the blood-brain barrier and is one of our more potent disease-modifying therapies (DMT). In the phase 3 trial, it reduced the annual relapse rate with 68% compared to placebo and it is typically given as a first/second line therapy to pwMS tagged with the unenviable label of ‘highly active’ disease. However, this is as far as the fairy tale...

Die Wende: Extending the anti-CD20 overdose

It’s a bittersweet fact that wars spark big leaps in science, and this has unfortunately also been true for our fight against the COVID-19 pandemic. When it comes to treating MS, susceptibility to common infections and ability to mount vaccine responses have become important themes among neurologists. Furthermore, pwMS prefer drugs that do not require regular hospital or phlebotomist visits. One...

To all MS earthlings: the DMT tool is ready for take-off!

Elon Musk has not been able to reach Mars yet but we have been able to officially launch the ‘DMT tool’ on the clinicspeak website! On April 29th, we invited all readers of The MS blog to share their opinions about our ‘DMT tool’. This online web tool was designed to help pwMS select a disease-modifying treatment that matches with their lifestyle and is fit for the literal and figurative long run...

Bladder care is self-care!

Over the past year, I became surprised how many pwMS consider their overactive or neurogenic bladder symptoms as ‘normal’, ‘part of the disease’ or ‘something you have to learn to live with’. I spent many hours explaining pwMS that this is not the case, that these symptoms are, at least partially, treatable, and that treating these symptoms is often more impactful on pwMS’s quality of life in the...

Artificial intelligence knocking on the wall!

Applications of artificial intelligence (AI) are becoming more and more common in daily life, and medicine. It’s public knowledge that AI algorithms are much better at detecting a pneumonia on a chest X-ray than radiologists of flesh, blood and … insomnia. A similar problem arises when judging whether MS lesions on a brain scan have increased in volume over time. (Un)fortunately, lesions never...

Un-follow your gut feeling!

One of the most important health insights from the last decade is the role of the gut microbiome. The gut microbiome corresponds to all microorganisms such as bacteria, viruses and fungi that are living in your gastrointestinal tract. In mice, some studies have shown that depletion of your gut microbiome with antibiotics leads to suppression of EAE, which is the mice equivalent of MS. Other...

Bad cop behaviour: Pushing NEDA over the RIM!

Over the last years, it has become apparent that some MS brain lesions are more detrimental than others. One MS lesion subtype that is specifically attracting attention is the “iron rim containing lesion” or IRL. A ‘normal’ MS lesion represents inflamed brain tissue. Over time, the ‘normal’ MS lesion is likely to shrink a little bit because of the resolution of inflammation-induced swelling and...

MS treatment baby-boom: quadruplets!

Good old uncle Frank (a.k.a. Fingolimod) used to be one of the first oral disease-modifying treatment available for pwMS, and enabled many pwMS to move forward from potentially bothersome injections with interferons or Copaxone towards a more convenient oral delivery method. Uncle Frank is part of the ‘sphingosine-1 receptor modulators’ and works by sequestering immune cells (lymphocytes) in the...

Pack your DMT tools for the long run!

Over the past year, I was privileged to counsel many people when starting an MS disease-modifying treatment (DMT), and reviewed even more pwMS whom had been on a DMT for a considerable amount of time. This has given me valuable insights in which drug-related characteristics matter in the long run, both literally and figuratively. First, there is no doubt about the fact that some drugs are more...

Happy dominos are the prettiest!

The prevalence of MS is not equally spread around the world, and is associated with latitude. Apart from some exceptions such as Sardinia, people living more closely to the equator are less likely to develop MS. Strikingly, when an individual moves before the age of 15 years old from for example Kenia (low MS prevalence) to the UK (medium MS prevalence), it will acquire the MS risk of his new...

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