CategoryDMT trials

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...

Predicting Low lymphocytes on dimethyl fumarate

The week NDG reported on dimethyl fumarate-induced lymphopenia Low lymphocyte counts on Tecfidera in MS So it is rather apt that we report another paper that has just surfaced Diebold M, Galli E, Kopf A, Sanderson N, Callegari I, Ingelfinger F, Núñez NG, Benkert P, Kappos L, Kuhle J, Becher B, Claassen M, Derfuss T. Immunological predictors of dimethyl fumarate-induced lymphopenia. Ann Neurol...

HSCT verses cyclophophamide for progression is no better.

Cyclophophamide is an anti-cancer drug that is not approved for MS but is used sometimes off-label. This inhibits relapses, as shown in this paper, but not quite as good as abalative HSCT stem cell therapy (This is where you get rid of the immune cells and replace the immune response using bone marrow stem cells). This inhibits relapses well, but with regard to progression they are as good or as...

#AttackMS

AttackMS was conceived on the 29th of Nov 2017 over a beer or two (or was it Elderflower?) at the Lago Maggiore. Prof Jeremy Hobart (Plymouth), ProfG and I sat down on the eve of the annual meeting of the European Charcot Foundation in Baveno, and I said something along the lines of: “Why don’t we treat MS with highly effective disease modifying treatment (HE-DMT) at first...

What is the cancer risk with MS Disease-modifying treatments?

This question comes up time and again with MS treatments and probably is one of the most important negative selection choices secondary to PML for DMTs in MS. Every time a new drug is presented to the clinical community, the cancer stats are heavily scrutinised. For example, with ocrelizumab the greater number of breast cancers in the treated arm versus placebo impacted on who ultimately received...

Sipping siponimod and other SIPs

Go grab a cup of tea There are a group of drugs used in MS called Sphingosine-1-phosphate receptor modulators. These are known as “the imods”. Here, mod means modulator” and “i” means immune so the immune modulators have been shortened to “imod”. Some people get paid a load of cash to come up with drug names and they have come up with interesting ones...

Dieting.

I think I just wrote that I wouldnot write anything about diets, but I have been challenged You said “I know diet is seen as quackery on this blog. However it seams to be actually showing evidence of neuroprotection more than any of the drugs trialed so far”. I would argue not at all, ProfG may have talked about them, indeed he has just sent me a book on diets as has DoctorLove...

Difficulty is seeing Saving Nerves with Statins

Statins are agents used to reduce cholesterol. When used in a UK trial called MS-STAT they found that brain loss was slowed and suggested there was a benefical effect suggesting that nerves loss is inhibited by statins. “High-dose simvastatin reduced the annualised rate of whole-brain atrophy compared with placebo, and was well tolerated and safe”. So we now have MS-STAT2 on the go...

Another treatment for relapse

Wynn D, Goldstick L, Bauer W, Zhao E, Tarau E, Cohen JA, Robertson D, Miller A. Results from a multicenter, randomized, double-blind, placebo-controlled study of repository corticotropin injection for multiple sclerosis relapse that did not adequately respond to corticosteroids. CNS Neurosci Ther. 2022 Jan 4. doi: 10.1111/cns.13789 Introduction: About 20%-35% of multiple sclerosis (MS)...

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