MS Update 23 June 2012 - Museum of Childhood

As promised yesterday the following is my talk that I have uploaded onto slideshare:MS Update 2012
View more presentations from gavingiovannoni.
The following are my main messages:
  1. MS is a bad disease; it has a poor prognosis if left untreated.
  2. Treat early and aggressively to prevent future disability.
  3. Early treatment with DMT impacts on mortality, i.e. life expectancy.
  4. First line DMTs (injectables IFNbeta/GA) are moderately effective and safe.
  5. Not all MSers respond to first line DMTs (injectables IFNbeta/GA); at present we can't predict who responds so if you fail therapy (relapses, disease progression, MRI activity) you should be switched to another therapy.
  6. More effective second-line therapies have risks; these risks depend on individual factors, therefore personal MSer choice is essential in deciding on which one to switch to or start.
  7. All current therapies target active relapsing MS; active means ongoing relapses and/or MRI activity.
  8. We have problems with doing trials in progressive MS; current trials need too many MSers and take too long. Therefore we need new trial designs, hence the proposal to use lumbar punctures to speed-up drug development for progressive MS.
  9. The good news is that there are several trials running in progressive MS (both primary and secondary progressive MS).
  10. Lumbar punctures don't have to be a bad experience; using non-cutting needles and ultrasound guidance reduces post-LP complications.
  11. NICE has it wrong; when they assess the cost-effectiveness of new DMTs or other drugs they only assess the impact on direct NHS expenditure. NICE does not take into account indirect or societal costs; e.g. loss of work, benefits, costs of carers, etc. 
  12. Sativex and Fampridine do not have a green light from NICE therefore we have difficult prescribing them for MSers in the UK.

The following are the two video clips of fampridine responders; you can make up your own mind if this treatment is effective or not (please note that not all MSers respond to this drug):






For those of you who asked the following is a short video clip explaining how fampridine works:




The following is the talk that was given by Dr Mark Baker in our group at the last MS Research Day:




If you have any further questions please do not hesitate to ask via the comment function on this post.

Labels: