Disclosure seems to be the theme of many MS strands at the moment, so I thought I’d add my two-penn’orth. My only advantage is greater hindsight as I was diagnosed with MS 28y ago. More than half my life has been lived with the diagnosis and it is fair to say that it has influenced every single aspect of my life. Recently, I started to reflect on what that has meant. Some insights are very...
Derisking anti-CD20: the ADIOS-IM study
Barts-MS rose-tinted-odometer: ★★★★★ (a London Grey day #666677) Can we use an anti-CD20 therapy as an immune constitution therapy (IRT), i.e. 2 years of treatment followed by no treatment unless there is EIDA (evidence of inflammatory disease activity)? This strategy is not new to the field of MS; this is how we use alemtuzumab, cladribine and AHSCT. So why not with ocrelizumab, ofatumumab or...
Severed
Cast your mind back… Can you remember the very first time when your body began acting independently? Was it an unexpected stumble, a bout of double vision that mysteriously came and went or a spell of numbness? And your reaction? Confusion, disbelief or even fear? Pre-illness, we take our bodies for granted. As healthy adults we move through the day, confident our body will simply “follow” our...
Off-Label Use of Drugs
I give you something that is not MS COVID (p.s. thats below). Laurson-Doube J, Rijke N, Helme A, Baneke P, Banwell B, Viswanathan S, Hemmer B, Yamout B. Ethical use of off-label disease-modifying therapies for multiple sclerosis. Mult Scler. 2021 Jul 26:13524585211030207. doi: 10.1177/13524585211030207. Epub ahead of print. PMID: 34304636 Background: Off-label disease-modifying therapies...
SIZOMUS randomized clinical trial is on the roll
SIZOMUS anti-plasma cell RCT I’m happy to notify that SIZOMUS (Safety of IxaZOmib targeting plasma cells in Multiple Sclerosis) is re-commencing after MHRA approval. This follows a pre-planned interim safety analysis. MHRA stands for Medicines & Healthcare products Regulatory Agency and without their say so this trial would not have been able to proceed. The Medicines and...
Please, please, please #GetVaccinatedASAP
Barts-MS rose-tinted-odometer: ★ (Black & White Friday) As the delta variant of SARS-CoV-2 is surging it is putting residents of Whitechapel at serious risk of getting COVID-19. This is important because the vaccination rate in Whitechapel is so low; less than 30% of adults have both dose of the COVID-19 vaccine. Why is the uptake of vaccines so low in our local community? Vaccine hesitancy...
73 tomorrow – some achievement
Barts-MS rose-tinted-odometer: ★★★★★ (Today’s colours are NHS blue & yellow #005EB8 & #FAE100) Tomorrow the NHS turns 73. If you love the NHS and want to give it and its staff a present please have your COVID-19 vaccine. Barts Health NHS Trust and many other NHS services are running walk-in vaccine centres. 📣Roll-up, roll-up! Or should we say ‘walk-in, walk-in’! 🚶🏽 🚶🏼♀️ 🚶🏿♀️ 🚶...
Ask not
Barts-MS rose-tinted-odometer: ★★★★ (black&white) I once proposed the question, “ask not what your healthcare professional (HCP) or MS research community can do for you, but what you can do for yourself?” and had quite a lot of pushback from some readers. Why? I started developing this diagram more than a decade ago summarising the holistic management of MS. What I mean by this is that if...
Second opinion
Barts-MS rose-tinted-odometer: zero-★s (black Monday; playing roulette with your patients’ brains) I recently saw a patient for a second opinion. He was about to start dimethyl fumarate (DMF), but his wife who had spent a lot of time reading about MS wanted him to be treated with something more effective. She had read the MS-Blog (formerly the Barts-MS Blog) and wanted him to have a higher...
CURE-3
Barts-MS rose-tinted-odometer: ★★★★★ (still seeing red, despite Summer having finally arrived) I am considering retraining as a medical philosopher. The thinking of the MS research community is riddled with fundamental errors that could be sorted out by applying basic philosophical principles. One example is the diagnostic tautology we are wedded to in how we define MS as a disease. Another...