Intriguing interview

[erash]

Neuro with unique perspective on MS and DMTs and great pathophysiology description of MS

1 hour long youtu.be/ujEwmmifJX0(Not working as expected?)

[Sandydemop]

thanks E, really good information. very up to date. He explains it well.

[ahrogers]

Interesting thoughts, especially that he considers all DMTs (or what he considers symptom modifying therapy) are basically equally effective.I keep waiting for recommendations to take 2 DMTs that target different locations of the cycle. This might really help the progressive forms of MS.

[erash in reply to ahrogers]

I think his contention is that pharma has planted a seed in our minds that we bought hook line sinker about the efficacy of various DMTs. This is the first time I’ve heard this opinion but he is well credentialed 🤷‍♀️ I kinda agree with the “pick your poison”

But I als wonder about mix and match DMTs to target different points in the cascade.

[ahrogers in reply to erash]

I have picked a few poisons over the years 😁 it was a pill first, Gilenya, but relapsed in 6 months then Rebif since my JC level was too high for some other DMTs and it was pre-Ocrevus. Went on Ocrevus trial a year later with next relapse and have been stable radiologically since 2016.It seems most of the newer trials seem to compare their drug to Rebif. Would like to see trials with more arms comparing more DMTs to really know if any are truly superior. If I was a newly diagnosed pwMS I would want to go on whatever is most likely to prevent further damage so would be nice to know the truth. Would love to still have the same function I did after my initial diagnosis!

[kdali]

I watched it twice, thank you!

[starlight5]

A very clear explanation of ms, how ms is diagnosed, and the mechanism of ms meds, but his conclusion is disturbing😦 at least how I understood it. My take is that he was saying that

DMT's are only symptom modifiers rather then disease modifiers, that current DMT's modify the symptoms of the disease, not the disease itself, as we've been led to believe. That we've been sold the more encouraging "disease modifying" title by big pharma and most surprising, that I should take whichever med is most convenient for me as each one works as well as the next.

[erash]

Though disease modifying could be explained as symptom relief or easing but he didn’t seem to think these drugs had a significant impact on disease course 🤷‍♀️🤔 idk it’s all just food for thought

[Raingrrl in reply to erash]

erash …do you think he is referring to smoldering MS as the actual disease course and that’s why he is saying the current DMT’s are symptom relief? Smoldering MS seems to be a hot topic these days. Prof G has been discussing this for awhile and trying to get MS neuro’s thinking more about it.

[erash in reply to Raingrrl]

Idk he seemed to be referring to MS in general but I also think, based on the cascade he described, all MS is shouldering (no definitive stop/start)

[erash in reply to erash]

Spell check ugh *smoldering

[kdali in reply to Raingrrl]

That's what I was wondering also. I searched for him on YouTube and didn't find anything 😞

[erash in reply to kdali]

gnineuro.org/physicians-fin...

[kdali in reply to erash]

Thank you!