NIH Grand Round: what is an IRT?

As promised the following is my slide deck from my presentation at the NIH grand round on Tuesday morning (12-June-2018). I was surprised to find out that none of the MSologists at the NIH prescribe DMTs; they leave the decision up to the treating neurologist. The NIH MSologists only see patients as part of research protocols. However, the resources at their disposal for research is quite extraordinary. They are a very privileged group of researchers.

After the meeting, someone asked me what excites me most about MS research at the moment? Can you guess what I said?

The following is a list of my top priorities in relation to MS-related research:

  1. MS prevention: EBV vaccination study.
  2. MS prevention: Treating infectious mononucleosis to see if we can reduce the risk of MS.
  3. MS prevention: a very large big-data population-based vD supplementation trial (The 'Gary Cutter' Trial).
  4. MS prevention: getting high-risk children to not get obese, to remain vD replete and not to smoke to hopefully lower their risk of getting MS.
  5. MS prevention: to create a trial ready cohort of people at high-risk of getting MS for future interventions (I have some ideas about what these should be).
  6. #ThinkPlasmaCell: to test treatment strategies to scrub the CNS clean of OCBs.
  7. #ClinicSpeak: to equip pwMS with tools to self-monitor and self-manage their MS and to get them to change the way they are managed by the healthcare system.
  8. #ThinkHand: treating more advanced MS to protect upper-limb function (ocrelizumab in PPMS and cladribine in progressive MS)
  9. #ThinkCure: deep phenotyping of patients in long-term remission post an IRT to see if we can define an MS cure.
  10. #BrainHealth: getting HCPs in the field of MS to think beyond NEDA and to treat-2-target of maximised brain health over the lifetime of their patients
  11. Neuroprotection: combination therapy trials to slow down or halt worsening of MS disability. It is folly to expect neuroprotection to work as a monotherapy; it needs to be on top of a high-efficacy DMT. 
  12. Remyelination and Neurorestoration: to test novel treatments to try to promote recovery of function in pwMS with disability.


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