CategorySymptoms and treatments

Optic neuritis as an early sign of Multiple Sclerosis

The occurrence of optic neuritis (ON, visual loss) over a persons lifetime is quoted as 50%, however the occurrence of ON as the first manifestation of MS is only 20%. If you’re not careful this can lead to misdiagnosis. Having ways of predicting those at a greater risk of going onto developing MS is therefore key. Many have looked at this in the past and this the latest iteration of it...

A rare life-threatening adverse event on Copaxone

Odd as it may seem, one of the safest DMTs in the MS world, Glatiramer acetate (Copaxone) can also give some nasty rare side effects. In this unfortunate lady the drug-related side effect involved her breasts (apologies for the pictures if it is distressing to some of our readers). But, in a previous case report a generalized skin vasculitis has also been described (see abstract below). An...

How does EBV influence MS

EBV appears to central to MS and other conditions. The big question is how? This is important because it depends on the the effect that you may get if you try and inhibit it. Some people think it is a target and so if you get rid of it, you get rid of MS. Most of the MS science world is not convinced and this is why it is difficult to get support to do trials. As it is sunday and if you are...

Long term safety of subcutaneous cladribine

Cladribine as an immune reconstituion therapy that is given over 4 courses over a year and a bit and then that is it for 4 years. But what happens next? If we look at alemtuzumab about 50% fail after their two courses and are given more antibody and about 50% fail who are given three courses, but it is an effective drug. So if you fail cladribine should you get another course of switch treatment...

New treatment arrival in UK

Diroximel fumarate is a new treatment used for the treatment of relapsing forms of multiple sclerosis (MS). Diroximel fumarate was approved for medical use in the United States in October 2019 and has now been approved in the UK and is awaiting final approval by the European Comission in the EU. Dimethyl fumarate works because it is metabolized to monomethyl fumarate. Diroximel...

Teriflunomide fails in Paediatric MS for primary outcome

Teriflunomide (Aubagio) holds a license for adult RRMS with an efficacy of roughly 30% relapse rate reduction versus placebo (dummy tablet). The long awaited study in paediatric MS (TERIKIDS study) recently published, however has failed to meet its primary endpoint – time to first confirmed clinical relapse in the teriflunomide group vs. placebo. The probability of first confirmed relapse...

Don’t be a technophobe – virtual reality therapy for Fatigue

As darkness falls on the Northern Hemisphere, fatigue, depression and anxiety creep upon the population. For those with MS these symptoms can become unmanageable during this period. Fatigue on average affects 75% of individuals with MS, and affects both physical and mental quality of life. Quality of life is an intangible barometer of well-being with a number of influences that adversely or...

Dimethyl fumarate for Primary Progressive MS? Is it all just MS

Figure of DMF action from Frontiers in Neurology A fair number of you probably take Dimethyl Fumarate (DMF) for your relapsing remitting MS, but did you realise that it may also work in Primary Progressive MS? This is what this latest piece of research suggests. There is one basic principle to MS treatments as a whole; which is that the treatment efficacy is very much in line with the extent of...

The plot thickens with Optic Neuritis

Optic neuritis (i.e. inflammation of the optic nerve at the back of the eye) is one of the most frequent presentations in MS. It can result in either semi-permanent or permanent visual loss. Attempts to aid visual recovery have been partially successful with the use of sodium channel blockers, but not with remyelination therapies, such as anti-LINGO. This paper on retinal oxygen supply may be the...

Repopulating B cells after B cell depleting therapy. Ofatumumab seems quicker than Ocrelizumab

This post is for your interest, but it is all useful for doctors nurses and pharma At the moment we have been talking about the possibilitiy of delaying anti-CD20 to allow your B cells to repopulate to increase your COVID-19 vaccine response. Obviously you need to consider the risks or lack of risks from such a delay and it is not my job to advise but I can help and supply relevent information...

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