CategoryNews and events

The Time-to-Think DMT

At an MS Masters Forum in Rome yesterday I was teaching MSologists and MS clinical nurse specialists using a recently created board game, which I like to think of as being MS Monopoly. MS monopoly is based on a game of chance that lets you discuss case scenarios and make treatment choices. Then you roll a dice, which determines the outcome of your choice.  Two things emerge from playing the game...

Alignment

Professor Gavin Giovannoni (Prof G) and his team of clinicians and researchers at Barts and at the Royal London Hospital — like many of their medical colleagues — are in frequent contact with pwMS (people with multiple sclerosis), many of whom are untreated. The reason that these pwMS are on no treatment is often economic. No treatment due to economic reasons and can occur in both developed as...

Alcohol Awareness Week

This week is alcohol awareness week in the UK and the NHS is encouraging its patients/clients to look in the mirror and ask whether or not they are drinking too much. As part of the holistic management of MS and our marginal gains strategy for managing MS, we are encouraging all pwMS to do the same. Excessive alcohol consumption is bad for MS in several ways. It disrupts your sleep pattern and...

Affordable DMTs

My post on the ‘Damp Squib’ has upset several close colleagues. I need to explain my reasons for doing it; the main one being is that I am very frustrated that change happens so slowly, whereas shit happens so quickly. The catalyst for our Barts-MS off-label initiative was my sabbatical 5 years ago and kicked-off with a blog post I did on the 3rd October 2014. I am ashamed that it is now 5 years...

Azathioprine revisited

Has azathioprine been given a fair chance as a treatment for MS?  I have noticed over the years that most neurologists, including myself, don’t always use azathioprine correctly. In general, we under-dose azathioprine. Why?  As an example, one of my patients with myasthenia gravis, an autoimmune disease of the nerve-muscle junction, came in this week with a relapse. He weighs 107kg and was on...

GROLDI hits a wall

To help with our #OffLabel campaign to help HCPs treat pwMS in resource-poor environments I asked Gisela Kobelt, a health economist, who I have worked with for many years for help. What she said to me made me realise that the hurdles we face are much higher than I expected.  These are her relevant comments: “The economic case for any treatment in resource-poor countries is difficult, simply...

Food Coma @MSTrust conference

After my food coma blog post and survey in January, I was asked by the MS Trust to talk about food coma at their annual conference in Hinckley. It is always great to speak at this meeting. The audience is always very enthusiastic and I have had a lot of questions after my presentation. I used my talk to discuss some of the science and issues around excess sugar consumption. I suspect that my food...

The Phoenix

Like a phoenix rising from the ashes for the third or fourth time, alemtuzumab is given yet another life. I am sure many neurologists and people living with MS will be grateful, but I don’t agree with its positioning. EMA’s safety committee or PRAC has handcuffed alemtuzumab and is restricting it for adults with relapsing-remitting multiple sclerosis that is highly active despite adequate...

A new kid on the block

FDA APPROVAL OF DIROXIMEL FUMARATE FOR MULTIPLE SCLEROSIS Time for another me-too or better-tolerated fumarate to treat relapsing-forms MS.  The following is a summary and adapted version of yesterday’s press release.  Biogen and Alkermes announced yesterday that the U.S. Food and Drug Administration (FDA) approved diroximel fumarate, a novel oral fumarate with a distinct chemical structure, for...

Do we really have equipoise about DMTs?

A guest post from Dr Emma Tallantyre, Cardiff. Definition: Clinical equipoise, also known as the principle of equipoise, provides an ethical basis for medical research that involves assigning patients to different treatment arms of a clinical trial. In short, clinical equipoise means that there is genuine uncertainty in the expert medical community over whether a treatment will be beneficial...

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