Nov 8Liked by Gavin Giovannoni

Another possible question: How long can I stay on a DMT - is there an age limit?

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Nov 10Liked by Gavin Giovannoni

Off topic - i dont know where to post otherwise- i live in Wales and had more than 5 relapses in a year in 2020. Ive been dx 2021 and been on tysabri since shortly after even though my jcv titre was 3.10 from the beginning.

Can someone tell me how to get hsct because my ms nurses keep saying it's not available in Wales.

Thabk you

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Nov 9Liked by Gavin Giovannoni

I developed psoriasis last year after 4 years under Ocrevus. You do not mention it in your text but is this not a known side effect?

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Have there been any studies on Ocrelizumab’s potential as an IRT?

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Nov 8Liked by Gavin Giovannoni

This might not be relevant in the UK, but if you mean this for a broader audience, there have been a couple of papers published this year about a very increased risk of severe neuroinvasive arboviral infection while on anti-CD20s, including West Nile Virus. This seems to be getting very little attention and it could potentially be a very big deal. Neuroinvasive arboviral infection is every bit as bad as PML.



If you agree that this is as serious as it seems then it might be worth noting here.

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When Ocrevus does not succeed in slowing one's PPMS progression,

is there any way of knowing (or guessing) the reason for it's failure?

I had the first two half doses and then 'washed-out in anticipation of HSCT in Mexico? So far, so good but it's too early on to guess on any prognosis post HSCT. TheHSCT finished with Rituximab by the way, Ocrevus would be redundant at this time... but again, I'm staying fit and positive in hope's of the best outcome post HSCT

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Hi Gavin- with what this is saying about Ocrevus (anti cd20’s) does this mean anti cd19/20 won’t do anything for the smouldering ms in the background that most people have???

Also the second point about S1p’s- would they be better to use after immune reconstitution therapy’s to control smouldering ms??


At #MSMilan2023, future therapeutic strategies for people with multiple sclerosis was one of the Hot Topics under discussion. Several important clinical studies will be providing results within the next 2–3 years, and it is hoped that these data will ultimately guide future treatment decisions.

📌 The widely accepted anti-CD20 monoclonal antibodies, which target B cells, have shown to suppress clinical relapse for some individuals. However, these agents may not impact progression independent of relapse activity, and their size precludes penetration of the blood–brain barrier (BBB).

📌 Sphingosine-1-receptor (S1P) modulators can cross the BBB and so work directly within the central nervous system. These molecules may provide a more effective means of modulating disease activity in individuals with #MS.

📌 Bruton’s tyrosine kinase (BTK) inhibitors can also cross the BBB and have been suggested to slow disease progression. These data are currently in early stages, but suppression of the pathological features of MS has been shown in case studies.

Learn more about these developments in the latest ECTRIMS Insights ➡️ https://bit.ly/49y3FgE

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