Barts-MS rose-tinted-odometer: ★ In my opinion, the term ‘progressive multiple sclerosis’ is a misnomer. In general, progression means improvement, which is one of the reasons I prefer the term ‘late-stage MS’, which not only differentiates the terminologies but captures the associated disability that comes with this phase of the disease. It is important to stress that the pathologies that drive...
There is further hope in the horizon for progressive MS. The Phase III clinical trials were announced at MS Virtual 2020 this Sunday, adding a second third agent to the potential hopefuls in the progressive MS armamentarium. The first two being ocrelizumab and siponimod. Masitinib is designed to block the activity of multiple cell types, including microglia/macrophages, neutrophils, mast cells...
Did you know if you have MS and vascular comorbidity you are likely to need a walking stick approximately 6 years earlier than if you did not have vascular comorbidity? Importantly this 6-year difference in reaching EDSS 6.0 (requiring a walking stick) is larger than the treatment effect of a platform DMT. As vascular comorbidities are largely preventable are you doing anything to prevent or...
Don’t mention the C-word as it raises unnecessarily high expectations is what many of my colleagues say. I don’t agree with them. Showing we have cured, or not cured, MS is how we will ultimately test the hypothesis that MS is an autoimmune disease. People with MS (pwMS) want a cure. However, even if we have an MS cure in hand we may not prevent or reverse progressive disease. ...
Barts-MS rose-tinted-odometer N/A Yesterday’s PMSA meeting was very interesting. It is clear the field of MS is at a cross-roads and that Pharma needs the wider MS community to help them change the game. If we don’t I suspect we won’t see the next generation of treatments being developed to target the ‘real MS’ or ‘smouldering disease’. It was clear...
Barts-MS rose-tinted-odometer – zero stars I am in Milan at the International Progressive MS Alliance Industry Forum Meeting. The aims of the meeting are to: Discuss challenges understanding and measuring progression and its impact on drug labelsDiscuss regulatory issues, opportunities and implications for drug labels and regulatory approvalsDiscuss links and opportunities for industry and...
MS-SMART was a multi-arm two year placebo (dummy tablet) controlled study looking at three putative neuroprotectants in secondary progressive MS (SPMS). The agents studied were amiloride, fluoxetine and riluzole, selected from previous successes at a smaller Phase II level. The scientific rationale is as follows:“Amiloride, widely used as a potassium-sparing diuretic, is an acid-sensing ion...
Cognition (thinking, memory and learning) is known to be affected in MS. This is more so in progressive MS. In a study last year, it was found that those with more structural damage to the brain at baseline were more likely to have cognitive issues. And more likely that not cognitive issues were encountered if the brain cortex was involved (the area comprised of the surface of the brain where...
MSers want a cure. However, even if we have an MS cure in hand we may not prevent or reverse progressive disease. How can this be? Focal inflammation damages nerves in two ways. It can shred and destroy nerve fibres as part of the initial inflammatory stage (acute neurodegeneration) or it can damage nerves and leave them functioning, but the resulting damage primes them to die off in the future;...
If you’d asked an year ago on whether I though MRI had a role beyond diagnosis in MS? My answer would have been an emphatic ‘NO’. The Achilles heel of MRI has always been the difficulty of standardizing scanning techniques to a large scale population level and adapting these accurately to work seamlessly during the day-to-day shortcomings of clinical imaging facilities within...