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B cell depleting therapies are the safest and most preferred treatment of highly active multiple sclerosis?

This was a debate I fought yesterday in Gods own Country……. and I am still in shock that I lost:-(. As I pointed out all effective therapies (eg alemtuzumab,caladribine, ocrelizumab, interferons etc.) for MS depleted B cells and stop them entering the CNS and supplied fact. The opposition seems to use the “chubaccaba defence” and cited nothing relevant to the debate but...

#MSCOVID19 Learning from 4 Jabs

Sophie Caillard, Olivier Thaunat, Ilies Benotmane, christophe masset, Gilles Blanchodoi:  Third courses and Bossters are going to appear soon. We know that people who take fingolimod and ocrelizumab make a relatively poor response, but I think people offered a boost will benefit protection wise. However we have concern about fingolimod and...

Serum neurofilament light chain falls short of the bar

Is having a blood test version of this test simply a pipe dream I wonder? Will we have to do lumbar punctures to really find out what’s going on in the brain with MS? These are questions I grapple with on a regular basis in this field, and what complicates matters is that is positive data and negative data on blood NfL predicting disability progression in MS. This recent publication shows...

Third Jab

This is the third Jab advice and this is not the same as booster advice. Updated JCVI guidance for vaccinating immunosuppressed individuals with a thirdprimary dose The Joint Committee on Vaccination and Immunisation (JCVI) has issued updatedguidance in relation to COVID-19 vaccinations for individuals aged 12 years and over withsevere immunosuppression. This letter sets out the actions we are...

At the Limits 2021

Today I have been let out to my first International Meeting in two years and yep it is in London

Here is a copy of my slides

Baker At the Limits online from BartsMSBlog

EyeMOD Vaccine Responses. Give Me Some News!

Last week we put out a call to see what is happening with fingolimod, siponimod, ozanimod and ponesimod vaccine wise. Sad to say my phone has not been ringing and so far…..Radio Silence. Is it rule number one from Pharma club? or just the studies are ongoing With regard fingolimod we (royal we) have done our own studies. Fingolimod has surprisingly made a mediocre vaccine antibody response...

Booster.. Not good news for anti-CD20..Time to get thinking caps on quickly because the same old same old is probably not going to be good enough.

We can learn from other conditions and if they are seeing the same thing to MS they are more likely to be true. Here is a view on arthritis Fagni F, Simon D, Tascilar K, Schoenau V, Sticherling M, Neurath MF, Schett G. COVID-19 and immune-mediated inflammatory diseases: effect of disease and treatment on COVID-19 outcomes and vaccine responses. Lancet Rheumatol. 2021 Aug 27. doi: 10.1016/S2665...

Why I’m no longer talking to pwMS about wheelchairs

When newly diagnosed pwMS enter a clinic room, they have read up about MS and are often focused on the daunting idea of ending up in a wheelchair or having to use a zimmer frame. From natural history cohorts before disease-modifying treatments (DMTs) were introduced, we know that for an untreated pwMS it takes a median 11.4 years to reach EDSS 4/not being able to walk unrestricted anymore, 23...

Longer-term safety data on ocrelizumab

Watch does it say?.I dont know its behind a paywall. You spend the money to do the trials maybe the open access fee would be useful:-) Longer-Term Safety of B-Cell Therapy With Ocrelizumab in Multiple Sclerosis.Yeh EA, Bourdette D, Wiendl H.Neurology. 2021 Sep 2:10.1212/WNL.0000000000012716. doi: 10.1212/WNL.0000000000012716.  Safety of Ocrelizumab in Patients With Relapsing and...

The New Normal

Lab lessons: Read the documents and dont rely on the headlines You were talking about getting a vaccine after waiting for B cells to repopulate and someone asked “What was the number for the B cells that met the fully reconstituted level for you?” This asks the questions What is the normal Level of B cells? 2. Why may it be important to know? To answer 2 first. It is increasingly clear to me that...

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