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Cladribine slowing brain loss

If you can remember back a few years ago and ProfG back-tracked from enthusiasm for cladribine and ocrelizumab to suggest that they were not as good as alemtuzumab at affecting atrophy of the brain, suggesting that T cells are important. This new study was done over a decade ago, in the CLARITY trial. Now I have no problems with the view of ProfG, but I did think that comparing results from...

Trial for progressive MS will it get in the brain?

Glutathione is a substance made from the amino acids glycine, cysteine, and glutamic acid. It is produced by the liver and is involved in many body processes. Glutathione is involved in tissue building and repair, making chemicals and proteins needed in the body, and in immune system function. Glutathione is an antioxidant in plants, animals, fungi, and some bacteria Glutathione is capable...

BTK inhibitors for relapsing & Progressive MS

The next major class of agents coming your way if the trials are positive and the liver issues are acceptable (I believe this is a drug-class effect) . Read this review about the drugs in development. I was going to do a review of these but this has surfaced Geladaris A, Torke S, Weber MS. Bruton’s Tyrosine Kinase Inhibitors in Multiple Sclerosis: Pioneering the Path Towards Treatment of...

Disease activity predicts worse prognosis

Yet more evidence that lesion accumulation utilmately is detrimental in the future in terms of disability. So again further emphasizing that one needs to do want one can to limit damage accumulation. Sorry its so brief but not near a computer Spinal cord lesions and brain grey matter atrophy independently predict clinical worsening in definite multiple sclerosis: a 5-year, multicentre...

Paedeatric MS and DMF.

Young people develop MS and they need treatment options too. This study examines dimethyl fumarate and compared it to beta interferon and guess what? Dimethyl fumarate has a greater efficacy . I hear some of you say “NSS”. I must admit it is rather sad that 72 individuals get put on a treatment that we essentially not as efficacious. Now we have to see that it is safe, but surely we...

Rituxi, ocri, ofatu and now Ubli

Prof Steinman has been heard calling this new agent “Ubli”….but this is yet another CD20 antibody on the way, but perhaps it is a bit surprising. Not surprisingly this inhibts relapsing MS Initially we had rituximab that was part mouse part human and then we got humanized and then a fully human antibody, but ubli is back to part mouse part human, but with augmented cell-mediated...

Sphingosine Kinase and S1P

Many moons ago it was suggested that fingolimod could be used against COVID-19. A trial was planned but it never got off the ground. Fingolimod mimics the action of sphingosine-1-phopsphate (S1P) and similarly needs to be activated before it works. This then downmodulates the S1P receptors and so blocks their function. Fingolimod is activated by sphingosine kinases. There are two of them...

No NDG tuesday…Check point inhibitors for PML

NDG has gone off grid with no computer and so no posts for the next few weeks…..Maybe she would have posted on this paper. The scurge of natalizumab and a few other agents is progressive multifocal encephalopathy caused by infection of the brain with JC virus, meaning that strategies have been developed to limit this potentially fatal disease. This has included switching fromm natalizumab...

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