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Interview with Gavin Giovannoni at ECTRIMS 2015: Highlights from ECTRIMS 2015
Professor Giovannoni described the initiative "Brain Health: Time Matters in Multiple Sclerosis".
This was because patients suffer delays in accessing services, both diagnostic and disease modifying.
There was low penetration of new treatments in the UK and elsewhere in Europe. The policy document emphasises that the times to diagnosis, starting active treatment, monitoring treatment and switching to more effective therapies should all be minimised. The whole idea was to focus on protecting the brain as much as possible. The document has just been launched and will be widely circulated during the next 6-12 months.
Much was discussed about the link between cognition and disability progression. Could this prove valuable as an early predictor, asked Professor Giovannoni? The meta-analysis of all placebo controlled studies shows that baseline cognition is highly predictive of disability progression over 2 years. In future cognition might be measured routinely in clinical practice. This may be the driver for early unemployment rates.
New data from the 5-year follow-up of the pivotal phase III show that alemtuzumab continues to be associated with low rates of degree progression and brain atrophy. The brain atrophy rate in years 3, 4 and 5 are within the normal range. Professor Giovannoni wondered how it would be in years 6-9. Does this means that some of these patients are cured of MS?
Ocrelizumab shows positive results in both primary progressive and relapsing forms. This opens the door to treatment of the primary progressive disease. This is also the first time we have had a drug which is both highly active and very safe in relapsing MS.
Gavin Giovannoni is Professor of Neurology, Blizard Institute, London UK.
This interview has been recorded at ECTRIMS 2015, October 2015, Barcelona, Spain.