CategoryTrials

The take on BTK inhibitors: AAN 2021 has the answers

The scientific sessions at AAN 2021 were pretty devoid of exciting new developments (not surprising given COVID19), but did present updates on the use of BTK (Bruton’s Tyrosine Kinase) inhibitors in multiple sclerosis (MS). For those of you who hearing this term for the first time today, BTK inhibitors target both B cells in the periphery and resident microglia in the brain (see slide...

RUN SIZOMUS RUN!

Mama Always Said, Life Was a Box of Chocolates. You Never Know What You’re Gonna Get – Forrest Gump, 1994  A few years back Prof G, whilst talking about MS at a conference was approached by Takeda Pharmaceuticals on whether we would be interested in targeting plasma cells; probably one of the last frontiers in MS. The ideas started spinning from there. Roll forward...

Can’t Neuros just flipping Read!

This is one of those posts where I bring our profession into disrepute. The neuros are gods when they do something that works and yes I am not worthy when it comes to licking the bosses boots, but eventually you have to crack. I have been reporting year after year as a stocking filler for when ProfG or some other neuros posts something of interest. Therefore I have read a lot and you see this...

Let’s get ready to rumble!

If the heavy weights of MS drugs go head to head in the boxing ring, it is anyone’s guess who will come out on top. The MS Base publication in 2019 states that starting on fingolimod, alemtuzumab or natalizumab is superior to glatiramer acetate or interferon beta. This March, the Italians have sneakily put together their own contest between fingolimod and natalizumab. You may say this one...

Clinical Trials in progressive MS. Is it time to bin Neurofilament Light?

Many year ago I was having a conversation with NDG and neurofilaments and she said neurofilament light was the wrong outcome. I didn’t really get it because, surely as a nerve dies it releases its contents (i.e. neurofilaments). However, I now think that neurofilament light is like a global MRI scan. If you can find neurofilaments then there is a lesion somewhere in the CNS. You may not...

The B-cell line up

Figure: Anti-CD20s (A) rituximab (yellow), (B) ocrelizumab (red), (C) ofatumumb (green), (D) ublituximab (brown) The B-cell line up for MS now reads: rituximab, ocrelizumab, ofatumumab, and ublituximab. A fair number of you believe that these four treatments embody some magical powers, but I am about to demystify some of these beliefs and explain the science behind them. The three main take away...

For the people who can’t get vaccinated or don’t have it yet, an alternative approach. Stormchaser Trial

Bookmark this page you may want it. Are you worried that you have been exposed to someone carrying coronavirus? Why not consider taking part in a COVID-19 prevention clinical trial? If you think your job or living circumstances has exposed you to someone who has tested positive for coronavirus, you may be able to take part in a COVID-19 clinical research study. You will have access to no-cost...

Cyclophosphamide kills immune cells dead

Most immunologists are well versed in the use of cyclophosphamide for all sorts of non-MS related inflammatory disorders; it is for all intents and purposes a ‘Domestos’. It’s dirt cheap – one 500mg vial costs £9.66 on the NHS, and is often only used as induction therapy with a few doses at time. It’s ‘Domestos’ action comes from its apoptosis (or cell...

New study testing an upper limb rehab tool – get involved!

The Barts MS team are running a study, investigating whether a new hand and arm activity called “Under & Over” can improve upper limb function for people with MS. The study is titled: “Under & Over: A controlled study to develop an upper limb rehabilitation tool for people with Multiple Sclerosis.”  This study is now recruiting – find out more information on the...

Delaying Ocrelizumab for up to 12 weeks

The ocrelizumab dosing is done every twenty four weeks. I have suggested that this may be overkill and is done more than is needed. However delaying treatment without evidence is not sensible. We have suggested doing a trial. Based on the phase II trial it looks like it takes about 60 weeks for the B cells to recover so for some dosing every 24 weeks maybe too much. Is it safe.? During the COVID...

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