Tagcladribine

Early cladribine treatment prevents MS

Barts-MS rose-tinted-odometer: ★★★★★★ (6-star bull’s blood red #8a0303) Yesterday’s post on using cladribine to prevent CIS from converting to MS and whether this is MS prevention or an MS cure generated a robust debate. Good, this was the purpose of the post; i.e. to get you thinking.  As you are aware that as the diagnostic criteria for MS evolve many people diagnosed with CIS in the past...

Prevention vs. cure

Barts-MS rose-tinted-odometer: ★★★★★ (a bright blue buzz – #0096FF) I was at a mid-summer party last night when someone suggested that I should not waste my time trying to answer peripheral or trivial questions in relation to MS and focus on the really big questions.  This got me thinking about which are the biggest MS questions in MS that I can try to tackle and answer. Apart from (1) MS...

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...

Curing MS

Barts-MS rose-tinted-odometer: ★★★★★ I have been asked many times if we can cure someone who has MS. I have tried to explain what an MS cure may look like many times on this blog and have actually published articles defending the definition.  I explained in a previous post that you may be cured of your MS, but still, have worsening or progressive disease. The difference between progressive...

#MSCOVID19: Cladribine 3 vs. Ocrelizumab 1 vs. Fingolimod 0

Barts-MS rose-tinted-odometer: ★★★★★ Finally, the early Israeli COVID-19 vaccine seroconversion rates are out as a peer-reviewed publication. This data is not new but comes with being vetted by the scientific community and hence can be quoted and discussed at scientific meetings. Protective humoral immunity was 97.9% in healthy subjects, 100% untreated pwMS, 100% in cladribine-treated pwMS, 22.7%...

Prof G guilty as accused!

Barts-MS rose-tinted-odometer: ★★ Guilty as accused!  I did a very one-sided post this weekend on the pros of oral cladribine as a treatment for MS during the COVID-19 pandemic. One commentator asked ‘what about the cons?’. As with all immunosuppressive therapies, there is a risk of secondary malignancies. In fact, both the EMA and FDA labels mention secondary malignancies as a complication...

#MSCOVID19: specifically for NHS England

Barts-MS rose-tinted-odometer: ★★★★★ Early on in the pandemic, I did a blog post on why I thought oral cladribine was the ideal DMT for managing MS (26-April-2020) remotely. I summarised cladribine’s attributes in a simple 12-point list. This list can now be updated to include (1) data on good COVID-19 outcomes in pwMS who have been treated with cladribine, (2) about vaccine readiness, i.e...

#MSCOVID19: cladribine is being unfairly tarnished with alemtuzumab’s brush

Barts-MS rose-tinted-odometer: ★★★★★ I think the North American MS community have made some mistakes with their COVID-19 vaccine recommendations, in particular, the NMSS COVID-19 vaccine guidelines for cladribine. In view of the immunology of cladribine’s mode of action and new data that is emerging, I would suggest the NMSS considers updating its guidelines.  Lemtrada and MavencladIf...

#MSCOVID19: ABN Guidance Update

Barts-MS rose-tinted-odometer: ★★★ The ABN have updated their COVID-19 guidelines, which are beginning to move towards the evidence. However, the guidance on cladribine is not supported by the evidence nor the science, i.e. how cladribine actually works and its impacts the immune system. The latest guidance states “the risk of severe COVID-10 disease is increased for many months after...

#MSCOVID19: Why is cladribine so misunderstood?

Because cladribine and alemtuzumab are classified as immune reconstitution therapies (IRTs), and probably work in a similar way, they are tarnished with the same brush. However, cladribine’s immune depletion and reconstitution, and adverse event profile are very different to alemtuzumab’s and therefore cladribine should be considered on its own when weighing up the risks and benefits of...

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