Tagfingolimod

Stuck in a loop

Starting certain MS drugs may get you stuck in a loop that you never bargained for when you started them in your early thirties or forties. The ability to stop taking drugs at an older age is something we more or less take for granted, especially if we have been disease free for ‘X’ many years. However, in the MS world things are never that simple or straightforward; there is...

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...

Cost effectiveness of cladribine vs fingolimod in Portugal

Firstly, this is not about money (I say this without a tell as my accountant taps away at their calculator nonchalantly). Really, this concept of cost-effectiveness is only obtrusive if you dislike politicking in any form or kind, or you’re British. The easiest way to understand cost-effectiveness models in healthcare in my view is to understand the principles of bartering. In bartering...

JCV index and the effect of DMTs

JCV STRATIFY (anti-JCV antibody) test has been utilized for more than decade to de-risk natalizumab treatment and other DMTs for risk of PML (Progressive Multifocal Leukoencephalopathy). Cases of PML have occurred predominantly in natalizumab, but less commonly with fingolimod (Gilenya), dimethylfumerate (Tecfidera) and rituximab. A high JCV antibody index value indicates that the risk of...

Is fingolimod safe in pregnancy?

Safety of Disease Modifying Treatments (DMTs) whilst pregnant and breastfeeding (from Practical Neurology journal) The risk-mitigation strategies surrounding DMTs in pregnancy haven’t come that far over the last two decades. So far, we have abstain from pregnancy, stop treatment prior to pregnancy, stop if you discover that you’re pregnant, or switch to Copaxone during pregnancy...

MS DMTs that hit the regenerative note

Santiago Ramon y Cajal Who said that the brain doesn’t regenerate? Well, it was the neuroscience Dogma as far back as philosophy. But, not in certain quarters; Santiago Ramon y Cajal (1852-1934), widely believed to be the father of modern neuroscience in his treatise ‘Degeneration and Regeneration of the Nervous System’, alludes to the potential of the brain to regenerate in the...

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