CategorySymptoms and treatments

The Match

No I am not talking about football. There is a lot of talk about whether smouldering lesions are something different, where their origins may be something other than immune attack. Whilst I have no problem with this, based on histology by the pathologists they accumulate over time. Smouldering lesions are lesions with microglial edge There are more smouldering lesions evident in progression Now...

Can rheumatologists stop causing demyelinating disease?

Hello, I am Charalambos Hadjicharalambous, a medical student at Barts and the London School of Medicine and Dentistry working with Dr Gnanapavan (aka NDG) and Prof Baker (aka Mouse Doctor). In my spare time during the COVID-19 pandemic, I have been helping the BartsMS team with their COVID-19 studies. I am writing here to discuss an article that we’ve written detailing a potential rare link...

Ocrelizumab removing infection protection in a small number of people

Alba Suárez EM, Tallón Barranco A, Puertas Muñoz I, Chamorro Hernández B, Robles Marhuenda Á. Non-late-onset neutropaenia following treatment of multiple sclerosis with ocrelizumab. Neurologia. 2021 13:S0213-4853(21)00026-8. Late-onset neutropaenia (loss of neutrophils which are our first line against infection) is defined as an absolute neutrophil count of <1.5×103cells/μL starting>4 weeks...

Teriflunomide as a neuroprotective

I do not normally post on the lower efficacy (on relapses) treatments, but teriflunomide seemed to outperform its effect on relapse rate when it comes to saving nerves. This week we had the Mr-CD20 (Prof Piehl) from Sweden come and give us a lab talk about yep you guessed it, anti-CD20. It is always a breathe of fresh air to hear the Swedish Neuros. They are very collaborative and just get on and...

Want a full or half dose?….Does it matter? Stop eating too much.

Yesterday, we had the online challenge from ProfG about whether MD is only interested in targeting relapse and not the real MS. I was asking about the interval between dosing with ocrelizumab and questioning how much more information we need to know that simply dosing at 6 months was more than is needed for many people. This is based on the idea that cells within the memory B cell pool are...

Living with MS – a story yet to be written

Conceptual model of quality of life for people with MS who are in a wheel chair an living at home. The model is developed directly from the themes that emerged after the thematic analysis (from Wiley Online Library) Living with an illness means different things to different people. It is all encompassing, personal and anxiety provoking. I’ve been told by an MS patient that living with MS is...

The Fourth eagle has landed

First we had fingolimod, then came siponimod, then oxazinimod and now we have ponesimod after the EMA approved it. These are all Sphingosine-1-phosphateone receptor modulators. Ponvory (ponesimod) is approved for the treatment of adult patients with relapsing multiple sclerosis (RMS) with active disease defined by clinical or imaging features. “Relapsing multiple sclerosis is an unpredictable and...

Anti-CD20 more than just B-cell depletion

Barts-MS rose-tinted-odometer: ★★ (amber; a sleep deprived colour somewhere between yellow and orange) It has become clear that the anti-CD20 therapies are more than just anti-B-cell therapies. Minority populations of both CD4+ and CD8+ T-cells and NK-cells express CD20 and are depleted after both rituximab and ocrelizumab treatment.  It looks as if ocrelizumab may be more effective in...

ChariotMS – we’re rolling !

And we’re off… Almost exactly three years after submitting our outline application to the NIHR-EME, the first site initiation visit of ChariotMS will take place TODAY at my home site, The Royal London Hospital. We are expecting the first of 200 people with advanced MS to enrol in June. And as the remainder of 20 sites across all nations of the UK will open over the next three months...

Early Natalizumab treatment

No sooner has the dust from ProfGs survey settled. When you suggested that natalizumab first line may be a nice addition to UK MS treatment…..no sooner have we said ATTACKMS butDr.Foxy has come out with some data looking at early treatment with natalizumab….and guess what have low lesion numbers and disability is a good sign Natalizumab in Early Relapsing-Remitting Multiple Sclerosis:...

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