CategorySymptoms and treatments

Progressive MS – Masitinib another duck lines up at MSVirtual2020

There is further hope in the horizon for progressive MS. The Phase III clinical trials were announced at MS Virtual 2020 this Sunday, adding a second third agent to the potential hopefuls in the progressive MS armamentarium. The first two being ocrelizumab and siponimod. Masitinib is designed to block the activity of multiple cell types, including microglia/macrophages, neutrophils, mast cells...

MSVirtual2020: ChariotMS

Whilst COVID-19 continues to be rather all-consuming, we’ve been extremely fortunate signing all relevant contracts at the start of the pandemic enabling us to keep the momentum of ChariotMS. Recruitment was meant to start this month, however COVID-19 threw us a final dummy, and we are now on course to enrol the first participant in Jan 2021. I can hardly describe how excited I am this...

#MSCOVID19 Whilst two swallows may make a summer…but it seems two COVID-19 papers make a bummer….for anti-CD20 therapy

Banksy and the Swallow bummer = a disappointing or unpleasant situation or experience. When it all started the Great and the Good (Neuro) experts looked at the different DMT and thought about the risks Disease-Modifying Therapies During the COVID-19 Outbreak: A Narrative Review of International and National Recommendations Smathorn et al.  International Journal of MS Care (2020) 22...

Fingolimod Trial from Years ago surfaces and guess what, the approved dose works…….Amazing

What is the optimum dose for fingolimod? In the early studies I think they used 5mg and 1.25mg and they both worked about the same. So Novartis dropped the dose and guess what? It worked. They dropped it again and guess what?, it still worked , well at least as good glatiramer acetate but not as good as the approved 0.5mg dose according to this trial started in 2012. Why go to all this trouble...

Reducing issues with CD20 depletion

What is the optimum dose and dosing schedule for ocrelizumab? We don’t know because the manufacturers haven’t done the studies, but rituximab it seems that we can reduce the dose. A common dose was 1000mg and it was reduced to 500mg. Efficacy was maintained and impotant it reduced the loss of circulating antibodies. This is important as the loss of such antibodies was associated with...

Rocky Mountain Ritixumab Fever

This is the real life experience of a single centre in the USA. As you can see their experience with CD20 depletion was essentailly as good or better to other commercial products, Rituximab versus natalizumab, fingolimod, and dimethyl fumarate in multiple sclerosis treatment.Vollmer BL, Nair K, Sillau S, Corboy JR, Vollmer T, Alvarez E.Ann Clin Transl Neurol. 2020 Aug 6. doi: 10.1002/acn3.51111...

Best Neuroprotection is to stop inflammation from occurring.

We hear about the “real MS” as so terms as if it is un-treatable….but if we want to stop nerve damage, we have to deal with the inflammarory reaction as quickly and as effectively as possible. Retinal and brain damage during multiple sclerosis course: inflammatory activity is a key factor in the first 5 years.Pulido-Valdeolivas I, Andorrà M, Gómez-Andrés D...

Lithium

Animal studies suggest efficacy of lithium. This study in ms suggests lithium is tolerated and that it doesn’t work. So maybe the end of lithium. But the trial is too small to do efficacy so it was probably doomed before it started. People now see failure will a bigger trial be funded. I doubt it Background: Disability accumulation in progressive multiple sclerosis (MS) results from...

I must have Wind as it seems I keep repeating myself

Todays B cell burp was reported as it came out of the Horse’s mouth when it came out at ECTRIMS2019, so I am not going to dwell on the take home message that it was positive and inhibited relapsing MS. This was an interesting trial design that recruitment was continued until set points were reached to ensure the trial delivered an answer. “Ofatumumab was associated with lower...

Ocvrelizumab can blunt the anti-COVID19 antibody response.

We have recently reported on the the possibility that taking ocrelizumab may reduce your chance of producing protective antibody against COVID-19-related virus. COVID-19 vaccine-readiness for anti-CD20-depleting therapy in autoimmune diseases.Baker D, Roberts CAK, Pryce G, Kang AS, Marta M, Reyes S, Schmierer K, Giovannoni G, Amor S.Clin Exp Immunol. 2020 Jul 16. doi: 10.1111/cei.13495. Online...

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