CategorySymptoms and treatments

Clinical trials vs. real-world data in MS

We probably don’t really require a study to tell us that those participating in clinical trials are not exactly the same as the general population that may take a particular treatment – we already know this. However, when it comes to MS drugs it is worth noting what the differences between the two populations are. According to Rojas et al., upon reviewing 18 clinical trials and 73...

Adenovirus infection after HSCT

Adenovirus is pretty common in the general population, responsible for the common cold, sore throat, bronchitis, diarrhea and conjunctivitis. It is harmless in most instances and like the herpes virus, most of us remain latently infected. During periods of immunosupression, however, the adenovirus can reactivate causing untoward trouble. The latter can range anywhere from organ-specific...

To botox or not to botox

That is the question: Whether ’tis nobler in mind to sufferThe slings and arrows of bladder instability,Or to take arms against a sea of troubles,And by opposing end them? –Shakespeare a’la NDG Bladder botox treatment If you suffer from bladder dysfunction, ask yourself why put with the dry mouth from Vesicare and Co., when a few injections of botox per year will do? It works...

High Dose Biotin study fails to reach the mark

High dose biotin has led to many people to be chomping on loads of low dose biotin pills. But dooes it work? According to this report not very well. High-dose biotin in progressive multiple sclerosis: A prospective study of 178 patients in routine clinical practice. Couloume L, Barbin L, Leray E, Wiertlewski S, Le Page E, Kerbrat A, Ory S, Le Port D, Edan G, Laplaud DA, Michel L.Mult Scler...

Methotrexate in progressive MS

ProfG has argued that if hand-function was the major endpoint of clinical trials then you would have had an approved treatment for progressive MS over a decade ago. In this study they look at the influence of intrathecal methotrexate. Methotrexate is an anti-proliferative agent Safety of long-term intrathecal methotrexate in progressive forms of MS. Stark JW, Josephs L, Dulak D, Clague M, Sadiq...

Astrocytic disease control. Have we found the magic treatment for progressive MS

We have been spending all our time looking at T and B cells but there has been insufficient attention paid to the glial response, which is important given the the glial cells are probably very important in progressive MS. This study looks at astrocytes This paper looks at how astrocytes may be involved and the signalling molecules involved. I am sorry but I don’t have the time or the will...

Gripes about DMF

In real-world terms, figures from the Swedish MS registry demonstrate that most PwMS discontinue a first-line DMT within 2 years of starting. Side effects make up bulk of the reasons, followed by lack of efficacy. When you consider highly-active treatments, their high efficacy outcomes go a long way to compensating for their down-side. When faced with the low efficacy drugs, their side effect...

HSCT in Norge

The thing I learnt from the CCSVI saga was to light the touch paper and retreat, so make the post and say nothing. CCSVI has had its day and no we are frequented by the HSCT Brigade. This post will bring them out like abit of catnip. You can all read and have your opinion. I think targeting NEDA-3 is a more difficult ask, as progressive disability is a composite of two pieces of biology only one...

T cells and cortical Lesions is Siponimod the next thing to sort out cog fog?

What causes demyelination of the cortex creating grey matter lesions. Well in this study there is no difference to what causes demyelination in the spinal cord…It’s T cells, T cells, T cells. Cortical lesions have been associated with cog fog and so if you get rid of them surely that is great for progression. Siponimod is the new mod on the block and now we get data suggesting it...

Neutropenia with ocrelizumab

If you buy into the mantra that a B cell therapy only works on B cells, then think again. Like a debutante three years shy of their first season, successful targeted therapies in the immune world are disappointing to say the least, and most definitely fall short of initial expectations. B cell ontogeny Ocrelizumab a humanized monoclonal antibody targeting CD 20 on the surface of B cells during...

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