Tagprogressive MS

Please help I am getting worse

Barts-MS rose-tinted-odometer: ★ After my clinic last week I was emotionally drained and probably more than usual. Patient after patient was telling me the same story and asking the same questions. “Since lockdown last year things have gotten worse, what can I do about it?” My superficial interpretation is that most of these patients had gotten worse because of relative physical and...

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 multiple sclerosis is a misnomer

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...

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...

#T4TD vascular comorbidities

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

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. ...

MAKING ONCOLOGISING MS A REALITY

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...

Progressive MS is a misnomer

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 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...

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