Tagprogressive MS

Subcutaneous Cladribine as a Treatment Option

After Cladribine tablets had been rejected by regulators in 2010/11, Merck-Serono binned their respective development programme. This was in spite of excellent data on disease control and adverse events – if there hadn’t been those three cancers in the active arm of the CLARITY study (and none in the placebo arm). Although it subsequently turned out the malignancy risk with cladribine...

Cyclophosphamide kills immune cells dead

Most immunologists are well versed in the use of cyclophosphamide for all sorts of non-MS related inflammatory disorders; it is for all intents and purposes a ‘Domestos’. It’s dirt cheap – one 500mg vial costs £9.66 on the NHS, and is often only used as induction therapy with a few doses at time. It’s ‘Domestos’ action comes from its apoptosis (or cell...

Progressive MS – Masitinib another duck lines up at MSVirtual2020

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...

MS-SMART outcomes in SPMS

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...

Brain volume loss in MS

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...

Chronic lesion activity in MS as seen on MRI

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...

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