TagOcrelizumab

Food for thought

The gastrointestinal tract (image taken from The Conversation) You may not think much of your gut, which in most peoples mind is simply one giant hosepipe from start to finish. But, this week after eating something quite oily, I was painfully made aware of my gut’s existence. The gut from an energy and metabolic point of view is a very important organ, and without it you would simply be a...

#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...

Vaccines and Ocrelizumab (VELOCE): Old swords, new swords, and how to avoid stab wounds!

As approximately 70% of our newly diagnosed people with MS go onto ocrelizumab (a CD20 and thus B cell-depleting monoclonal antibody), a study that helps us understand how ocrelizumab affects the potential to mount (protective) antibody responses to vaccines and new antigens is more than welcome. Especially, as we are all hoping for the COVID-19 vaccine to be under the Christmas tree.  B...

Barts-MS Journal Club: vaccine responses on ocrelizumab

Dr Ide Smets discusses the Veloce study and its implications for managing MS. Bar-Or et al. Effect of ocrelizumab on vaccine responses in patients with multiple sclerosis: The VELOCE study. Neurology October 06, 2020; 95 (14) Objective: The phase IIIb VELOCE study (NCT02545868) assessed responses to selected vaccines in ocrelizumab (OCR)-treated patients with relapsing multiple sclerosis...

Anti-CD20 Derisk Study

Barts-MS rose-tinted-odometer: ★★★★★ Did you watch the anti-CD20 debate on the triMS-online platform yesterday? The question that was asked was ‘Can we use anti-CD20 therapies as immune reconstitution therapies rather than maintenance therapies?’. I am not sure the debaters answered the question.  When I asked Anders Svenningsson, who is probably the world’s biggest adopter of anti-CD20 therapy...

#MSCOVID19: woods for the trees

Barts-MS rose-tinted-odometer: ★★★★ I am sure you know the term “I can’t see the woods (or the forest) for the trees”. This means you are unable to understand a situation clearly because you are too involved in it. I think this is what has happened to the MS community when it comes to managing multiple sclerosis during the coronavirus pandemic.  We are so fixated on the...

#MSCOVID19: anti-CD20 nuances

Barts-MS rose-tinted-odometer: ★★★ I had to have a detailed discussion with a patient this week about starting ocrelizumab during the COVID-19 pandemic. This patient was concerned about (1) the data showing an increased risk of COVID-19 in anti-CD20 treated patients, (2) an increasing number of cases not seroconverting when being infected with the coronavirus and (3) she will not be able to have...

#MSCOVID19: good news

Barts-MS rose-tinted-odometer: ★★★★★ The late late-breaking session at the MSVirtual2020 meeting, which covered COVID-19 has already received a lot of air-time on social media. The big-data alliance confirmed the Italian data, i.e. that people with MS (pwMS) on anti-CD20 are at higher risk of getting COVID-19 and severe COVID-19 (hospitalisation, intensive care admission and/or ventilation)...

#MSCOVID19: getting ready for the vaccine

Informing patients about their potential coronavirus risks associated with anti-CD20 therapy is complicated and resulting in our patients being given different advice depending on who they see. The reason for this is that we don’t have the direct evidence to be able to dissect out why people on anti-CD20 therapy are at higher risk of COVID-19 and at higher risk of being admitted to hospital with...

#MSCOVID19: Fundraising

Two months ago we floated the concept of doing a UK-wide seroprevalence study in UK residents with MS to see how many had seroconverted to become anti-SARS-CoV-2 antibody positive and to see if there are differences in seroconversion rates between people on different DMTs.  The motivation was based on a prediction that people with MS on ocrelizumab would have lower titres of anti-SARS-CoV-2...

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