CategoryDMT trials

Harnessing the pregnancy effect in Multiple Sclerosis

It is now well accepted that MS goes into a period of dormancy during pregnancy. This of course is a protective effect so that the female body doesn’t reject the foetus that is growing within (the foetus is a foreign entity as it’s whole genetic makeup does not come from the mother alone). Increasingly it has become apparent this effect is mediated via the oestrogen hormone, a female...

Mesenchymal stem cells lower neurofilament levels in progressive MS

You would have heard about HSCT for MS, but Mesenchymal stem cells (MSC) are a very different type of treatment and less well known than HSCT. In fact, I would go so far as to say that interest in this therapeutic option is almost non-existent. However, when I came across a recently published biomarker paper on this topic I thought it would be interesting to have another look at it. Further...

4 or 6 week natalizumab dosing

In a attempt to reduce the risk of PML dosing was extended and it was sugggested that you get reduced PML without an influence of disease activity. This study by the manufacturers of a natalizumab variant did a study and concluded that there was not PML risk difference by there were more lesions in the extended dosing group, with the acknowledgment that a few people (n=2), skewed the data alot...

Treatment is beneficial

I guess you know this already….wonder when the HST comment will arrive? Association of No Evidence of Disease Activity With No Long-term Disability Progression in Multiple Sclerosis: A Systematic Review and Meta-analysis.Rotstein D, Solomon JM, Sormani MP, Montalban X, Ye XY, Dababneh D, Muccilli A, Shah P.Neurology. 2022 Apr 26:10.1212/WNL.0000000000200549. Objective: We...

Instead of Monday Q&As – It’s MS Awareness Week!

You may be aware there is an annual World MS Day, celebrated every 30th of May since 2009, following an initiative by the MS International Federation. World MS Day 2020-22 has been themed *connections* There’s also MS Awareness *Week*, and if you live in the US that was early last month (sorry if you missed – I did), however here in the UK it’s *this week*. A number of events...

Les DMT en France

When we look at the DMT prescribed it seems that the use of platform agents are the most common, so the message of “Time is brain” is still not the Hymn sheet we are singing from Leblanc S, Lefort M, Le Page E, Michel L, Leray E. Trends in disease-modifying therapy use in patients with multiple sclerosis using a 10-year population-based cohort study in France. Expert Rev Neurother...

A call to arms, your upper limbs

ChariotMS is gaining traction, however not yet quite to the degree we would have liked. As you may remember, our trial milestones had to be revised, and our immediate target was to enrol 60 people with advanced MS (pwAMS) by the end of June, and we called this our “60:6 challenge”. At the time we took the decisions, it looked like a realistic plan. However, setting up trial sites for...

AAN 2022 Impacting on the Real MS

ProfG has argued that Slowly Expanding Lesions are the indicators for progressive MS and that we need to target these to inhibit the “realMS”. At the centre of these lesions we have microglia and these could be inhibited by Brutons tyrsoine kinases which inhibit B cell and macrophage function Douglas Arnold et al. Effects of Evobrutinib, a Bruton’s Tyrosine Kinase Inhibitor, on Slowly...

Th17 are a menace and must be stopped?

Eksin MA et al. Secukinumab in the treatment of psoriatic arthritis or ankylosing spondyloarthritis with multiple sclerosis: a case series with literature review. Immunotherapy. 2022. doi:10.2217/imt-2021-0128 Plain language summary Background/aim: Multiple sclerosis (MS) is a central nervous system disorder, with rare cases reported to have associated spondyloarthritis (SpA) spectrum...

Treat Early and Effectively

Some people make the case that there was a difference between T and B cell depleting agents and B cell depleting agents in stopping brain volume loss. This was based on the normalization (~0.2% per year) of brain volume loss in the alemtuzumab trials compared to two to three times more loss in people treated with ocrelizumab (OPERA) and Cladribine based on the phase III (CLARITY) cladribine...

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