Since making a selection of our talks from the “2nd Barts and The London MS Research Day” available on-line, Dr Giles Elrington’s talk on “Emerging Therapies for Multiple Sclerosis” has been a run away success with the most viewings. Well done Giles!
1. Good to hear that "after 20 years 4 out of 10 will have benign disease". What about after 30 years or 40 years? Somebody diagnosed before age 15 will still be very young.2. Re Alemtuzumab & "… my guess is in a few years time we will offer this to everyone with new MS": Could this also be a natural next step for those completing 2 years of Tysabri? With current knowledge what would be better – stay longer on Tysabri, go back to Betaferon, start Alemtuzumab, (anything else) ?3. Prof G: Do you agree with everything he said?
In response to the points above:1. Given sufficient time MS causes disability in the vast majority of MSers. The actual figure varies, but hospital populations only 5% remain without physical disability at 30 years. The caveat to this statement is that these figures are derived from the pre-DMT era. I believe things will be much better in the future. In population based studies the prognosis is much better; this occurs because people with benign MS or inactive disease are more likely not to attend hospitals. In addition, post-mortem studies suggest a large number of cases of MS are not diagnosed in life. 2. Re Alemtuzumab. I am not sure if it will be available to all. It will depend on its license. The European Regulatory Agency (EMA), may limit its availability to high-risk patients as they have done with natalizumab and fingolimod. In addition, its availability in the UK will depend on its cost-effectiveness, which will be assessed by NICE. 3. Do I agree with Dr Elrington? How long is a piece of string? Not everything he says, but it is normal for neurologists not agree on everything.
Dr Elrington is an excellent presenter. More importantly, he focuses on what 95% of the attendees are really interested in – treatment which are available / should be available. Hopefully he will get a bigger and bigger slot in the coming years are more treatments move through the pipeline.
How about more of a focus on progressive MS next time. RRMS is too easy to be positive about. Truth is that nearly all RRMS patients still end up with progressive disease within 10 years of first attack.
I also find Dr. Elrington to be a very good presenter. He is easy to follow and his presentation was set out very clearly. More like this please!