Maybe because we are incapable of reading other people's work and assimilating what these papers say, we seem to go from one failed progressive study to the next when using immunosuppressive agents.
I don't think I am that bright, but at least I can read just about (OK I'm dyslexic).
I would be very surprised if we did not get the results presented in this paper, as we have seen them over and over again.
We know that relapses respond to immunosuppressive agents and indeed that was suggested.
You can see effects of DMT on gadolinium enhancing lesions within 6 months and relapses within a year, but for progression there is no chance.
So, likewise it was found that there was worsening of lower limb function, which is found in people taking alemtuzumab, ocrelizumab and HSCT, etc. etc, etc., etc., ugh!.
However, a trial of 64 people is too low to make any firm conclusions and a 12 month trial is too short to detect any meaningful change on lower limb function.
Although this isn't a trial and there can be further follow-up, no doubt this paper will now be used to show that mycophenolate is of no value to control progressive neurodegeneration.
Maybe that is the case, maybe it isn't
Maybe it would be if the study was longer and different outcomes (e.g hand function) were used and importantly if a neuroprotective/repair agent was put on top of the immunosuppression. I guess they can come back in 2 years time and give us the answer.
However, without some control arm will we know if a slowing of worsening occurred.
Why do I say this?
Behind the scenes we have been looking for agents to control progression, but the question I pose is, will we learn from the past or plough-on with the same old trial design..regardless.
However it does show that there is benefit to be had in so-called progressive MS as the relapsing elements clearly respond. However we need to be laying treatments within the therapeutic pyramid, probably with an induction therapy/immune-reconstitution therapy on the bottom