Look on the regulators website in UK is MHRA in Europe its the EMA and the FDA in the USA and there are many more. You said “I never head about neutralizing antibodies” Search “Natalizumab and INN” look for a link with EMA and look for EPAR or in US ” Natalizumab and label” or “Tysabri and Label” In goolge this is what you get both the FA and the EMA websites click on the links In the PDF look for immunogenicityIn FDA often in section 6.2 In Europe search (Press control [ctrl], F)for “immunogenicity” And in 4.8 So you can see if you have reduced efficacy here is means new lesions or relap ..read more

I was once talking about the effect of CD20-B cell depletion and the data was largely based on rituximab data and then someone asked what happened with ocrelizumab…and I said I’ve just told you…but they were having non of it it hadn’t been shown with ocrelizumab and therefore what was done with other anti-CD20 was not important….I’m not sure I buy this….Which is better start on high or low eficacy drug treatment…..you can’t work that one out unless you do it….Em. What is better go from low to mediumm or low to high efficacy agent?….You have to do the experiment because you can’t work it out…Em ..read more

I don’t need to say much but their are many papers talking about imaging hot microglia with TSPO-PET. Don’t believe me? This maybe the case in mice, but when it comes to humans it is very evident that TSPO is found in nerves, astroctyes, microglia and here we see oligodendrocytes, so whilst TSPO imaging in humans may be detect inflammation you can’t say it is hot microglia. Mature oligodendrocytes (OLs) arise from oligodendrocyte precursor cells that, in case of demyelination, are recruited at the lesion site to remyelinate the axons and therefore restore the transmission of nerve impulses. er ..read more

Event-Agenda-Croydon.docxDownload Last week I was invited to speak at the MS Society Day in Croydon. It was a truly refreshing F2F event, exceptionally well organised by the local MS Society branch – big thank you. Following Clare Walton, the MS Society’s Research Lead, I spoke about… ChariotMS! Please have a look at the slides, and if you or somebody you know might be interested in participating, please visit our website http://www.chariotms.com or email chariot@qmul.ac.uk, and we will help identify your nearest available trial centre. We are enrolling until the end of this year; so far 137/2 ..read more

Well the first thing to say is the excellent research from ProfAngray who is actually a scientist in Dentistry and he and the students in Dentistry are doing some excellent MS research…making ProfGsome assay and underpinning our anti-drug antibody response work. Next up bad oral hygeine is a risk factor MS and other conditions. Now as I have more gaps than teeth.. and has a fair bit of drilling without ansethetic when I was at school. So I hear “Is it safe” every time I go into the dental practise. This saying comes from a film starring Dustbin Hoffman called the Marathon man. Here a German Do ..read more

Can you pick up markers associated with MS and in this study they find syndecan-1 (SDC1) which is a marker of antibody producing cells they also find CD27 which is a marker of T cells and memory B cells and antibody secreting cells in humans. CD27 and CD138 allows them to pick out MS from other conditions and so does it say MS is really an antibody mediated disease? I struggle with this. However there is no doubt that antibody produced in the central nervous system is a central paper of the disease process because this is what we use for MS diagnosis, namely oligoclonal antibody bands. In the ..read more

Natalizumab from Biogen is out of patent and as we are in poundland Britain, NICE will be telling the neuros to use the biosimilar to save a few pennies. Natalizumab is also known as Tysabri but the biosimilar is called Tyruko and it is known as natalizumab-sntz and is produced by Sandoz, which used to be the generic arm of Novartis. Studies suggest that it behaves in the same way as the original reference natalizumab….so view it as the same as the original in differenet packaging. Abit like ibruprofen and Neurofen. We have learned from natalizumab biosimilar and publications and this is the p ..read more

An old chestnut, but lets debate if we have consensus between MS physicians in treatment decisions. Stephen Krieger, Mount Sinai opened the floor with probably the most interesting case in the bunch that most of the audience got (but some didn’t) – see Picture below. But, hold your horses the interesting bit is yet to come… What treatment would you give if the patient wants you to pick the treatment? Below are the answers. According to Stephen almost a bell-shaped curve turned on its side (imagine a Pacific Northwest drawl). MD will be happy as we have a B-cell drug. Does the opinion change ..read more

As part of MS Awareness week there was a spot on TV…but I had a device free weekend as I saw DrProfLove and left my phone and computer at Home to avoid news of the football….I shouldn’t have bothered:-(. But when I got home I saw an email inviting me to go on Talk TV with Dr Bull…..Shit I thought is that an opportunity missed or Perhaps Did I dodge a bullet as they had talked about complementary medicine, microbiome and stem cells and it was quite clinical. I wonder what I would have said then…but maybe I could have plugged in for Attack-MS. Becuase look at Doctor Bulls (Left) when he heard f ..read more

Boyko AN, Alifirova VM, Lukashevich IG, Goncharova ZA, Greshnova IV, Zaslavsky LG, Kotov SV, Malkova NA, Mishin GN, Parshina EV, Poverennova IY, Prakhova LN, Sivertseva SA, Smagina IV, Totolyan NA, Trinitatsky YV, Trushnikova TN, Khabirov FA, Chefranova JY, Shchur SG, Dudin VA, Pokhabov DV, Artemeva AV, Eremeeva AV, Linkova YN, Zinkina-Orikhan AV. Long-term efficacy and safety of divozilimab during 2-year treatment of multiple sclerosis patients in randomized double-blind placebo-controlled clinical trial BCD-132-4/MIRANTIBUS]. Zh Nevrol Psikhiatr Im S S Korsakova. 2024;124(4):86-96. This is a ..read more