Unrelated BLOGGER Comments
Sometimes you what to say something that is unrelated to the threads. This is a spot for You.
You can access from the bar at the top of the page or view the post in the comments on the right. These are moved to stop the thread from becoming too long.
You can access from the bar at the top of the page or view the post in the comments on the right. These are moved to stop the thread from becoming too long.
- Why isn't spasticity on your 'diabling MS symptoms' poll? Spasticity os the bane of my MS, both in my legs and hands. I hear its a common MS symptom.
- Similar problem - the most disabling symptoms are ataxia in one hand and tremors in the other
- Is this video useful to you?
http://www.guardian.co.uk/science/video/2012/may/07/human-connectome-project-roadmap-brain-video?INTCMP=ILCNETTXT3486 - Yes it is important I don't know why Prof G missed it out, I'll ask him.
Hope it wasnt because of CoI as we are tying to develop a drug to treat spasticity. - I will email him (Prof G) to ask about ataxia, tremor and spasticity,
I guesss you could tick other in the survey - Re: "Why isn't spasticity on your 'diabling MS symptoms' poll?
Spasticity os the bane of my MS, both in my legs and hands. I hear its a
common MS symptom."
Spasticity is actually a sign that is detected and described by clinicians. Very few MSers actually complain about spasticity. It typically presents with walking difficulties, stiffness, pain and sleep problems. Ataxia is also a sign; most MSers will complain of unsteadiness. Tremor is one I missed. The purpose of the poll is to highlight the massive unmet need there is for symptomatic therapies. Please use other! We will do a more systematic study survey in the near future on this issue. Thanks. - Is the video useful...
Yes interesting thanks - Severe unsteadiness & tremors in the hands are very disabling. It's almost impossible to write and the handwriting looks nothing like what it was. For walking problems you can use a wheelchair. If hands don't work there is nothing you can do except depend on others
- What do you think about this study that concludes from a survey of MS
neuros that it is common for people to be incorrectly diagnosed with MS
and that this is wasting large numbers of healthcare dollars?
http://medicalxpress.com/news/2012-05-misdiagnosis-ms-health-millions-year.html - There is misdiagnosis for sure, I will have a look, I believe paper is supposed to be in Neurology from a group in Oregon but have not yet tracked down the source so if anyone has the link it would be useful.
- CAN YOU HELP ME
The story on disdiagnosis has made a splash,
Maybe I am blind but I cannot find the original article that the sites say went on line yesterday.
The story will have been from a press release probably from the University/VA Centre in Portland
but I cannot see on Neurology where the actual article has been posted. May be they got the embargo dates mixed up
If you know it, can you post the link to the title/abstract I can do the rest. I have written to the author. - I can't find the article either. I'll contact Neurology.
- Is this the article you're looking for?
http://www.neurology.org/content/early/2012/05/11/WNL.0b013e318259e1b2.abstract?sid=d8cfe149-cd4f-4e1b-ba97-453ae2cbc5d3 - Dear Maria
You are a star.
Thanks very much, us old farts was looking too early.
Doing the same search now finds it in a second. - Interestingly Neurology has only been loading new stories once a week or more for the past two months so it is interesting that this appeared 2 days after the last upload. Maybe the media interest or the MD2 nudge prompted action.
- I think my nudge this morning might have achieved the desired effect!!
- Heard From Dr. Bourdette
The paper should have gone public on the 9th May so a mistake at the Journal Neurology.....so MD2 saves the day Hurray - How do you guys feel about Novartis taking legal action against four NHS
trusts for using a cheaper drug to treat macular degeneration?
Isn't this further proof of big pharmas' greed?
Us MSers are a cash cow, as are all ill people. The money is not to cure people, merely to treat them with expensive drugs. If we don't pay, we don't get. Is this not why Fampridine is out of most of ours' reach?
http://news.bbc.co.uk/today/hi/today/newsid_9719000/9719186.stm - Yep...we have made comments on this before.
The reason here is people are using avastin to do the same job as Lucentis. Lucentis is massively more expensive (ten times) than avastin which is licenced for treating cancer and not the eye condition. Novartis is saying that this is affecting the regulatroy process and patient safety. Everyone else says it is affecting Novartis profits.
As was present last week however the NHS has sponsored a trial on this very issue and shows shows there was no difference between the two.
As can be heard from the radio interview the Novartis representative just wriggles around the questions.
As a result of the new trials lets hope that avastin gets a licence. If the regulators do that then pharma would have no leg to stand on.
The problem about costs, is not an issue of how much Europe will pay but how much the Insurance companies in the USA will pay. If the US stopped playing ball prices would not be so high.
For MS, what we need is a drug that is as good as the current drugs but is out of control of pharma and cheap. It exists, as I have been saying for sometime, it needs to be done, and actions such as taking on the NHS like this hopefully will come back to haunt them. - Re: "Isn't this further proof of big pharmas' greed?"
May be and may be not! Pharma is a business that has incentives to make money. Most Pharma companies are listed and therefore have shareholders; the major pharma shareholders are pension funds. Therefore, possibly your pension and some of mine depends on them doing well. In addition, pharma pay a large amount of money in tax. Our government does very well out of pharma; the pharma industry is ~6% of the UK's GDP. The development costs of novel drugs is so large and risky that Pharma is the only model for developing drugs. Usually the pay-back for risk is big profits. If we don't reward risk we don't get any risk-takers. The pharma industry is no exception.
Who created the beast?
So if you take a macro-economic view of pharma it is in everybody's interest that Pharma does well. The issue here is getting the balance right between reasonable and unreasonable profits and reasonable and unreasonable behaviour. I am not sure what the correct answer is. If we erode the incentives for developing new drugs we reduce the chances of getting new drugs for MSers. What we need is some give and take! There is no easy solution.
I wish Pharma didn't have such a bad reputation; it makes it difficult for them. - MD,
This drug that is as good as the current ones and is cheap- is it IV cladribine? Was the oral form withdrawn from going for FDA/EU approval due to safety issues? (although I think it was used in Russia). Do you have to go through all the trials again with a drug if it has a different mode of use, such as oral or IV cladribine, or IV or subcutaneous alemtuzumab, and why does it matter? - Oral Cladribine was withdrawn because the company (Merck Serono) decided not to develop it!
It would need additional trial for approval in USA and Europe, although it was licenced in Russia and Australia, because of a potential safety liability.
Was this liability any different from Gilenya, Nataluzimab, Altemtuzumab, BG12.
In some cases there may be advantages as there was no report of Graves disease that occurs in 20-30% of people with Alemtuzumab.
Would you need new trials if you change the route, I believe yes because the different routes affect the pharmacokinetics of the drug (i.e. how long it lasts in the body) and this impinges on safety profiles.
Perhaps see past posts.
http://multiple-sclerosis-research.blogspot.co.uk/2011/06/bad-news-regulatory-update-on.html - This isn't a question. I just wanted to say thank you for persevering with the blog despite all the hassles. I don't think there's another venue out there quite like this one and it fills an unmet need. This is probably illusory, but I feel better thinking that I know more about what is going wrong with my body rather than less.
- Thank you
- People who run this blog:
I too want to say thanks. You guys beat anything that so-called larger MS 'societies' offer, though I don't meant to devalue their contribution in any way.
To be honest, some MSers want a sympathetic ear, while others want to be clued up on what's going on and progress in research. I fall into the latter. In that sense this blog is seriously good becuase it provides an education. Education is king, is it not?
I have been watching the MS Life 2012 videos. It really seems the international effort to repair nerve cells is going to pay off in big ways one day, although I did notice Prof G was the most conservative participant on the pannel. I suppose he has learnt that us MSers can be a problematic lot, expecting miracles when small improvements will be suffice.
Good luck to you, and good luck to all living with the disease. - Prof G, I have just watched your lecture at MS Life. You talked about a
patient of yours called Graeme Wilson, a young man with MS that
unfortunately died recently. You said his progressive disease was very
aggressive, this despite him being on almost every DMT imaginable.
How commen is sudden death in MS? I take it it's rare but it is a real feature of the disease. The reason why it seems scary is because it seems Graeme Wilson was blogging up until his final days. He was active. So sad. - Re: "How commen is sudden death in MS?"
Rare, but under reported. I was at a meeting in London with 14 MSologists and four if us could recall a sudden death amongst the MSers we looked after.
http://multiple-sclerosis-research.blogspot.co.uk/2012/02/sudden-death-in-ms-or-sudmus-1.html
I was very sad when I heard about Graeme. He was an MS activist and did everything possible to get a shot at a treatment that targeted progressive MS. His father gave me permission to dedicate my lecture to his memory. If you read his blog you get an idea how intelligent and sensitive he was and what an impact MS had on his life. If only we all maintained a blog to let the world see the other side?
I hope the MS Life talk gave you some hope regarding progressive MS? - Re: "Prof G was the most conservative participant on the pannel."
Correct, not because I don't believe progress will be made, but I know the rate of progress is always far too slow for MSers with progressive disease. I try and justify my stance as one that tries to manage expectations. The backlash we had from the PROMISE2010 programme was overwhelming in that MSers expected treatments. In reality we have only just go to the point of starting trials in MSers to try and test some of the lab work we did as part of that programme. - Calling Vasilis Vasilopoulos, where are you?
I sincerely hope you are okay and have not had a major relapse or suffered any serious complications from your latest CCSVI treatment? - Nice of you to ask, thank you. I'm now more than 14 months relapse and
fatigue free. It's just getting increasingly disappointing to see that
everything about MS continues to be drug-business as usual, and that
cases like mine are still accounted to placebo or remission without
proper research or even second thought.
No neurologist bothers to explain why all improvements began 24 hours after the procedure, following a clear feeling of a head getting empty. Can anyone? - Everybody who visits this site should listen to the BBC Radio 4 documentary "THE END OF DRUG DISCOVRY".
It's an amazing insight into big pharma.
http://www.bbc.co.uk/radio/player/b01hxh76 - Hello Prof G.
I did enjoy your lecture and do feel hopeful. The other lectures on remyelination and stem cells were even more hopeful.
Graeme was a handsome lad and his writing was very sincere. I can't believe he died so young. What's more, Graeme seemed so healthy in his approach to MS, though he did confess to flying out to Eygept early last year for CCSVI treatment to curtail his progressive MS. He seemed to think that the CCSVI had stopped his progression. I suspect he may have been desperate for a cure and was willing to try anything in the hope it would help.
We have lost Graeme and Charles Fox in the last 6 months as a result of progressive MS. There is a ticking clock here for some MSers. Graeme, according to his blog, died within 8 years of his first symptoms. He was officially diagnosed in 2004 and passed away in 2011. That must have been a very agressive disease, but he was till active, travelling and writing. His writing is joyful and sincere, not always about his MS and more often about funny incidents in his past. He didn't seem to be defined by his disease, as so many MS bloggers seem to be.
The old adage that it's always the best people to whom bad things happens seems true. I hope progressive MS becomes treatable soon.
Prof G,
ReplyDelete4 months ago I started taking LDN and it has had a positive effect on my bladder control. I have not had an accident since I started taking it, Previously I would be caught short about once a fortnight, nothing serious but I would wet my pants and so I used to wear a pad to avoid embarrasment. I still need to do intermittant self catheterisation but now I no longer need to wer a pad.
I would like to know what LDN has done to the muscles and the nerves so that I am no longer 'caught short'. I have SPMS diagnosed with MS in 1995 and my first relapse was in about 1979 when my bladder unexpectedly emptied itself almost with out warning.
What does LDN do to improve the quality of my life and could it be used to reduce the effects of MS else where, for example drop-foot or double vision?
Naltrexone is an opioid blocker is used in th treatment of morphine heroin abuse. Low doses are used by many people including Msers.
ReplyDeleteIt is experimental and there is limited quality evidence concerning its use in MS.
However there are reports of LDN and control of spasticity and bladder spasticity (Gironi et al. 2008 Mult scler 14:1076). It is feasible, and probably that this can account for the effects you are reporting.
Prof G or other Neuro may wish to comment on this.
Re: "What does LDN do to improve the quality of my life and could it be used to reduce the effects of MS else where, for example drop-foot or double vision?"
ReplyDeleteThere is a good scientific rationale why LDN may work. It increases endorphins within the brain that improve mood and could make MSers feel better. In addition, it also cause an area of the brain called the hypothalamus to secrete a hormone that may result in increase steroid production from the adrenal glands. The latter could modify the disease course of MS. Despite this without proper evidence, i.e. at least two adequately powered double-blind placebo controlled trials, we can't use or recommend LDN. This is the nature of evidence-based medicine.
Does increased steroid production by the adrenal glands work the same way as methylpred? (no longterm improvement, various side-effects)
ReplyDeleteThe adrenal induced stress hormones work on the same targets as methylpred. The adrenals work on an on-demand system, whereas methylpred is "on" all the time. This makes the adrenal production shut down and no cortisone response is not good.
ReplyDelete