- MS is a bad disease; it has a poor prognosis if left untreated.
- Treat early and aggressively to prevent future disability.
- Early treatment with DMT impacts on mortality, i.e. life expectancy.
- First line DMTs (injectables IFNbeta/GA) are moderately effective and safe.
- Not all MSers respond to first line DMTs (injectables IFNbeta/GA); at present we can’t predict who responds so if you fail therapy (relapses, disease progression, MRI activity) you should be switched to another therapy.
- More effective second-line therapies have risks; these risks depend on individual factors, therefore personal MSer choice is essential in deciding on which one to switch to or start.
- All current therapies target active relapsing MS; active means ongoing relapses and/or MRI activity.
- We have problems with doing trials in progressive MS; current trials need too many MSers and take too long. Therefore we need new trial designs, hence the proposal to use lumbar punctures to speed-up drug development for progressive MS.
- The good news is that there are several trials running in progressive MS (both primary and secondary progressive MS).
- Lumbar punctures don’t have to be a bad experience; using non-cutting needles and ultrasound guidance reduces post-LP complications.
- NICE has it wrong; when they assess the cost-effectiveness of new DMTs or other drugs they only assess the impact on direct NHS expenditure. NICE does not take into account indirect or societal costs; e.g. loss of work, benefits, costs of carers, etc.
- Sativex and Fampridine do not have a green light from NICE therefore we have difficult prescribing them for MSers in the UK.
The following are the two video clips of fampridine responders; you can make up your own mind if this treatment is effective or not (please note that not all MSers respond to this drug):
For those of you who asked the following is a short video clip explaining how fampridine works:
The following is the talk that was given by Dr Mark Baker in our group at the last MS Research Day:
If you have any further questions please do not hesitate to ask via the comment function on this post.