#ResearchSpeak & #ThinkSpeak: a new form of therapeutic nihilism
Professor Gavin Giovannoni
Department of Neurology
Royal London Hospital
A commentator asked about data to support the use of cladribine in PPMS. In reality there has not been a study particularly targeting PPMS, but several studies have investigated the impact of cladribine in chronic progressive MS, i.e. a population that includes both secondary and primary progressive MS. In general these trials have been under-powered and too short, based on recent insights, to give a definitive answer. The best study was the Rice or J&J (Johnson & Johnson) study that included 48 (30%) patients with PPMS. Importantly, in this study 71% of patients had a baseline EDSS score of >=5.5, which based on our therapeutic lag modelling would require a study duration of well over 3 years to give an answer using a lower limb outcome (EDSS). However, despite this study being too small and too short cladribine had a robust impact on T2 lesions, albeit more pronounced in the SPMS subgroup. It is clear from this study that cladribine is an effective anti-inflammatory in more advanced MS.
The aim of this Blog is for the Barts and The London Neuroimmunology Group to update you on the latest research in MS with an emphasis on the research we are involved in. A major reason for maintaining the Blog is to thank the funders of our research. Funders encourage us to engage with the general public, people with MS and their families and other people with an interest in MS. We believe you have the right to know what we are spending your research money on! The purpose of our work is to improve our knowledge and understanding of MS with the goal of improving the lives of people living with this disease.
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