AuthorNeuro Doc Gnanapavan

SIZOMUS randomized clinical trial is on the roll

SIZOMUS anti-plasma cell RCT I’m happy to notify that SIZOMUS (Safety of IxaZOmib targeting plasma cells in Multiple Sclerosis) is re-commencing after MHRA approval. This follows a pre-planned interim safety analysis. MHRA stands for Medicines & Healthcare products Regulatory Agency and without their say so this trial would not have been able to proceed. The Medicines and...

MS and other neurological disorders in India

This freely accessible article published in Lancet Global Health is the most comprehensive data on the prevalence of neurological disorders across India to date. Around 18% of the worlds population live in India and like other nations they also have a significant level of morbidity related to those with neurological disorders. But, owing to a lack of resources as well as cultural taboos, it has...

Gut instinct, the gut microbial changes in MS

It’s probably not the first time that you’ve heard about gut microbes and MS. Particularly, the role that they may play in the development and regulation of MS. Almost every study published in the literature has demonstrated differences in the gut microbiome in MS patients vs. healthy controls with the possibility that interventions on diet and the use of probiotics may have a...

Smell the mute sense

Your sense of smell is often called the mute sense because you experience memories and emotions without words. Normally the main neurological causes for a loss of smell are neurodegenerative disorders such as Alzheimer’s disease and Parkinson’s disease, however, it would now appear MS patients can also be affected. In a review of thousands of published articles the authors of this pre...

Infection risk secondary neutropenia with ocrelizumab

All drugs have a range of predictable side effects. In the case of immunosuppressants/immune depleting agents this is a low white cell count, which increases the risk of infection in the short- or long-term. Ocrelizumab is a monoclonal anti-B-cell (anti-CD20) treatment that specifically targets B-cells, but it may also have what we in the business call off target effects on other immune cells...

Neurofilaments have it – the story behind smouldering MS

Recently, smouldering MS or chronically active MS lesions have become an entirely new entity in disease progression. They are characterized by a rim of activated microglia/macrophages in both RRMS and progressive MS and are linked to more aggressive disease. These lesions are visible on a type of MRI called susceptibility-based imaging and individuals with MS can have 0, 1-3, or ≥4 of these...

Pets and MS, is there a link?

Over the years I have been asked about just about everything and anything that can cause MS. But, this is a new one on me. Do pets cause MS? Specifically, is childhood pet ownership or exposure linked to the development of MS. The concept is not as far fetched as it may initially appear. For instance, early on there were concerns over canine viruses causing MS. Pet ownership is common in the...

Living with MS – a story yet to be written

Conceptual model of quality of life for people with MS who are in a wheel chair an living at home. The model is developed directly from the themes that emerged after the thematic analysis (from Wiley Online Library) Living with an illness means different things to different people. It is all encompassing, personal and anxiety provoking. I’ve been told by an MS patient that living with MS is...

Not so much of a cure then? Anti-CD20s fall short of the finish line.

Drum roll please!…. It was only a matter of time before someone designed this experiment. Albeit, it’s in an animal model, but the content is still by far the juiciest I’ve seen in MS research this year. The major finding of this work is that depleting B cells alone using anti-CD20s doesn’t get rid of all inflammation in the neuronal tissue. The authors of this work...

Is Age the new stopping criteria for MS drugs?

“Stopping is not the same as giving up” – or at least we’re told that this is the case. The connotations of stopping MS DMTs, on the other hand needs to be handled with kid gloves, and importantly avoid having the discussion spiral into one about value-for-money economics. Because which ever way you slice the latter, you’re guaranteed that someone somewhere will be...

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