Regular MRI is a key element in the follow-up of pwMS, particularly those on disease modifying treatment (DMT). Why? Because MRI is significantly more sensitive in detecting MS disease activity than counting relapses and measuring disability using the EDSS (Kurtzke’s Expanded Disability Status Scale). I’m quite precise here referring to the EDSS since other clinical instruments may be...
We are all aware this Blog has been deep cleaned from anything related to BartsMS, but hey here I am, as are NeuroDoc Gnanapavan with her fanbase, MD and his significant following, and then are Dr Smets, BartsMS doctor at large, and the more sporadic posters such as AdamsAcademic DrBenJ, and if you haven’t heard about his project I suggest you check here. So, BartsMS is alive and kicking...
After Cladribine tablets had been rejected by regulators in 2010/11, Merck-Serono binned their respective development programme. This was in spite of excellent data on disease control and adverse events – if there hadn’t been those three cancers in the active arm of the CLARITY study (and none in the placebo arm). Although it subsequently turned out the malignancy risk with cladribine...
SARS-CoV2 refresher/booster vaccinations are among us, and as a result, we have updated our respective advice once again. Here it is: COVID-vaccines-DMT_BartsMS-guidance_20211001 The key changes are on pages 3 & 4. This is the result of discussions involving members of BartsMS, consultants, junior doctors, nurses, allied healthcare professionals. Thanks to all of them. @KlausSchmierer...
And we’re off… Almost exactly three years after submitting our outline application to the NIHR-EME, the first site initiation visit of ChariotMS will take place TODAY at my home site, The Royal London Hospital. We are expecting the first of 200 people with advanced MS to enrol in June. And as the remainder of 20 sites across all nations of the UK will open over the next three months...
So, six weeks ago we said this: BartsMS – The latest “final” update on SARSCoV2 vaccinations in the context of disease modification However, in the COVID19 era, the life cycle of evidence emerging, and us reflecting on it, has shrunk. Hence, another update on our vaccine advice was overdue: COVID-vaccines-DMT_BartsMS-guidance_March-update_final There are two changes to the...
Fair enough, there has been a build up to this. After all, a couple of days ago MD ProfB explained – again – that whilst both cladribine and alemtuzumab are immune reconstitution treatments (IRTs) with significant long term effects on B cell subsets, particularly the memory B cell pool, this is where their similarity largely ends. Next came ProfG detailing 17 attributes of cladribine...
COVID-vaccines-DMT_BartsMS-guidance_20210211 So there it is, our latest “final” advice based on (i) what we believe the evidence tells us and (ii) high-level decisions within our healthcare environment. We’ve also listened to our colleagues, in- and outside of BartsMS, and mind you there are people with strong views… Only joking! The major change has been our Trust’s...
Evidence is only a small part of changing practice. A relatively recent reminder of this truism was our effort to convince colleagues across the UK to use ‘atraumatic’ instead of old school ‘cutting’ needles for lumbar punctures (LP) given the former have far fewer adverse effects than the latter, mainly of so-called ‘post-LP headache syndrome’. Although we...
The advice I posted on 29 Dec is already outdated. Meantime NHS England decided to introduce the 3 month gap between 1st & 2nd dose of any of the vaccines currently available in the West, and only a couple of days ago did the latest mRNA vaccine (Moderna) receive the green light from the MHRA. We have therefore updated our advice – here it is: COVID-vaccines-DMT-BartsMS...