TagDMTs

#MSCOVID19 asymmetry

Many of my colleagues have criticised and reprimanded me for being over-enthusiastic in stating that immunosuppressive MS DMTs are relatively safe for pwMS if they happen to develop COVID-19 whilst on treatment. However, the issue has been asymmetry of knowledge. I have known that patients on DMTs who get COVID-19 are doing well. This is based on knowledge acquired from multiple sources albeit...

#MSCOVID19: vaccines and DMTs

So if you are someone with MS who is shielding or being very careful about social distancing and want to avoid getting COVID-19 you may be considering what your own exit strategy is. How do you de-risk yourself and prevent yourself from becoming infected with SARS-CoV-2?  At present, it looks as if the UK government’s strategy is to ring-fence you with people who are immune to SARS-CoV-2...

#MSCOVID19 – DMT update (2)

This week saw several bits of information appear that has led me to change my position on several DMTs in terms of their risk for pwMS during the COVID-19 pandemic. Firstly, the verbal update by Maria Pia-Sormani on the Italian cohort of patients with MS who had COVID-19. These figures were given during the iWiMS weekly COVID-19 &MS webinar. There are now 380 cases of pwMS and COVID-19...

Pandemic

Yesterday I had the experience of a patient with highly active MS pull out of being treated with ocrelizumab (Ocrevus) because of concerns around being infected with the coronavirus COVID19. I suspect this will be the first of many patients with multiple sclerosis to do so.  It is clear that COVID19 epidemic is now a pandemic, i.e. it has involved enough continents and countries to be considered...

Medical fiction

Barts-MS rose-tinted-odometer ★★★  Using fiction to teach and learn about MS is what I am turning to more and more. An old-fashion case scenario is a powerful tool for illustrating the difficulties we have in clinical neurology. We can create a clinical problem that is not necessarily answered by trial data or reading the summary of product characteristics. This is where clinical acumen and...

Watchful Waiting

Barts-MS rose-tinted-odometer  ★ ★ ★ ★ ★ I have tried to include all the necessary information on MS DMT treatment decision-making into one easy to use and understand infographic. This infographic explains that when you see a patient with MS you have to decide if they have inactive MS or active MS. If they are active you have to decide how active their MS is (active vs. highly-active vs. rapidly...

#OffLabel

I am speaking at the Multiple Sclerosis International Federation (MSIF) Access to Treatment and Healthcare meeting next week in London. My talk is on “Off-label opportunities, barriers and risks in availability and affordability”. My journey to this point goes back 5-years and started when I was on sabbatical and was visiting countries all over the world and seeing how MS was managed. I soon...

Why some treatment is better than no treatment

For Relapsing-remitting MS we currently have option of highly active therapies, as well as first-line therapies that are less efficacious. You may question why anyone in their right mind would develop a treatment that was no good, then conversely ask yourself, why if there are treatments available, even not so good ones, are some people not any of it? This is not me pitching for the next...

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