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What about Atrophy?

ProfG has thrown the T and B curve ball by suggesting that brain atrophy data is better with the T and B depleters (Alemtuzumab and HSCT) than the relative B depleters (Ocrelizumab and cladribine). This is an interesting observation and if correct it needs to be brought into the MS World View. This may point the finger at CD8 T cells as this subset deleted less than CD4 by cladribine and is...

Maven has Landed on the other side of the pond

Thanks FDA….you made our REF2021 impact statement even better!!!!…… Only joking.. but today signals a new chapter in our journey with cladribine. The MDs became CLAD lads way back in December 2004, when we did our first experiment with cladribine. We saw the potential of the intravenous and subcutaneous variant in MS and had spotted that we could develop an oral variant, if we...

Trying to understand whether a sneaky fag is bad for you?

The Genetic Background of Mice Influences the Effects of Cigarette Smoke on Onset and Severity of Experimental Autoimmune Encephalomyelitis.Enzmann G, Adelfio R, Godel A, Haghayegh Jahromi N, Tietz S, Burgener SS, Deutsch U, Wekerle H, Benarafa C, Engelhardt B. Int J Mol Sci. 2019 Mar 21;20(6). pii: E1433. doi: 10.3390/ijms20061433. Multiple sclerosis (MS) is the most common inflammatory disorder...

Newsflash new addition for secondary progressive MS

Treatment arrives for secondary progressive MS. Siponimod has been approved by the FDA in the US. This can be used from clinically.isolated syndrome onwards. So why would you want fingolimod? I wonder. They work the same way but siponimod may have lesser side effects. What will NICE do? keep it second.line like fingolimod or.give it a first line licence. I guess it depends on what the EMA say...

If it looks like a duck , quacks like a duck..its a duck. DMT are worthwhile

Changes in the Risk of Reaching Multiple Sclerosis Disability Milestones In Recent Decades: A Nationwide Population-Based Cohort Study in Sweden.Beiki O, Frumento P, Bottai M, Manouchehrinia A, Hillert J. JAMA Neurol. 2019 Mar 18. doi: 10.1001/jamaneurol.2019.0330. [Epub ahead of print IMPORTANCE:Clinicians’ experience and findings from recent natural history studies suggest that...

Surviving from DMT

Multiple sclerosis: effect of beta interferon treatment on survival.Kingwell E, Leray E, Zhu F, Petkau J, Edan G, Oger J, Tremlett H. Brain. 2019 Mar 18. pii: awz055. doi: 10.1093/brain/awz055. [Epub ahead of print Worldwide, the beta interferons remain the most commonly prescribed disease-modifying drugs for multiple sclerosis. However, it is unclear if they alter survival. We investigated...

#IsitOK to publish ten years later..This time its cladribine

Effect of cladribine tablets on lymphocyte reduction and repopulation dynamics in patients with relapsing multiple sclerosis.Comi G, Cook S, Giovannoni G, Rieckmann P, Sørensen PS, Vermersch P, Galazka A, Nolting A, Hicking C, Dangond F. Mult Scler Relat Disord. 2019 Apr;29:168-174. BACKGROUND: Immune reconstitution therapies (IRT) for patients with multiple sclerosis are used for short...

Teriflunomide and brain atrophy

Background: Pathologic changes in cortical gray matter (GM) and leptomeninges contribute to disability worsening in patients with multiple sclerosis (MS), but there is little evidence whether disease-modifying treatments can slow down cortical pathology in MS. Objectives: To investigate the effect of teriflunomide (TFM) and dimethyl fumarate (DMF) in reducing cortical...

Young repair Whipper Snappers….Listen to an Old fart and don’t go there.

One of the beauties of getting older without Alzheimers is that you still have a memory. So a new study from the lab of Prof Franklinstein finds another new target to get repair. Transforming growth factor-beta renders ageing microglia inhibitory to oligodendrocyte generation by CNS progenitors.Baror R, Neumann B, Segel M, Chalut KJ, Fancy SPJ, Schafer DP, Franklin RJM. Glia. 2019 Mar 12. doi: 10...

Why did Atacicept make MS worse? Can you be Sherlock?

Response to therapy is the ultimate human experiment. It can tell us so much more than thousands of animal experiments. A successful trial tells us a load, but likewise a failed trial, if done properly and many failed trials are not done properly I would say, tells us alot. Now it may tell us something we don’t want to hear and a good example is the effect of anti-CD20 (Ocrelizumab for...

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