Top 10 Multiple Sclerosis Controversies

Controversies in multiple sclerosis
1) Escalation vs. induction therapy
2) HSCT
3) CCSVI
4) Cost of MS drugs
5) “Me too” drugs
6) Nutrition and MS
7) Environmental causes of MS
8) The cause of progression in MS
9) The role of EBV
10) Age and disease modifying therapy
The Best Multiple Sclerosis Medication: • The Best Multiple Scle...
Epstein-Barr Virus Causes Multiple Sclerosis! [US Military Longitudinal Study]: • Epstein-Barr Virus Cau...
Smouldering Multiple Sclerosis: • Smouldering Multiple S...
CCSVI and Liberation Treatment (Theory, Skepticism, Clinical Trials)[2020]: • CCSVI and Liberation T...
Selected sources:
1)Defining Benign/Burnt-Out MS and Discontinuing Disease-Modifying Therapies: nn.neurology.org/content/8/2/...
DELIVER-MS: deliver-ms.com/
Traditional Versus Early Aggressive Therapy for Multiple Sclerosis Trial (TREAT-MS): clinicaltrials.gov/ct2/show/N...
Escalation vs. Early Intense Therapy in Multiple Sclerosis: www.ncbi.nlm.nih.gov/pmc/arti...
DISCOMS results: www.medpagetoday.com/meetingc...
Comment or ask questions below! I would be happy to answer!
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Check out my book “Resilience in the Face of Multiple Sclerosis” FREE on Amazon: amazon.com/dp/B07WP7H5LK It's about 5 people with MS who live incredible lives, the science and psychology of resilience, mindfulness, and ho’oponopono. Paperback priced to generate $0 royalty.
Dr. Brandon Beaber is a board-certified neurologist with subspecialty training in multiple sclerosis and other immunological diseases of the nervous system. He is a partner in the Southern California Permanente Medical Group and practices in Downey, California (South Los Angeles). He has several publications on MS epidemiology and has participated in clinical trials for MS therapeutics. You can follow him on twitter @Brandon_Beaber where he regularly posts about MS news and research.
Follow me on twitter: / brandon_beaber
Music: INNER GRACE - Copyright 2018 Wilton Vought Source: Really Really Free Music Link: • Video T
he video material by Dr. Brandon Beaber is general educational material on health conditions and is not intended to be used by viewers to diagnose or treat any individual's medical condition. Specifically, this material is not a substitute for individualized diagnostic and treatment advice by a qualified medical/health practitioner, licensed in your jurisdiction, who has access to the relevant information available from diagnostic testing, medical interviews, and a physical examination. To the extent that Dr. Beaber endorses any lifestyle change, behavioral intervention, or supplements, the viewer should consult with a qualified healthcare professional to determine the safety and efficacy of the intervention in light of their individualized information.

[@teslapolarisz1816]

Thank you! Thank you! Thank you! This is the best video you have ever done. You’ve explained all of the options that I wish every neurologist would explain to their MS patients. I had both CCSVI and HSCT performed. I am now in remission and I’m currently trying to recover the nerve damage that was caused prior to my treatments. I had HSCT done in May and have had no side effects. I will be posting this video on my nonprofit website and all of my social media. Thank you again for being the type of doctor every doctor should be!

[@debrawarman2658]

How are you doing today?

[@Sharona811]

Thank you so much for this video.I am 58, diagnosed at 49 and have accrued a lot of disability over the last few years. It often feels that patients my age are disregarded … no one wants to help us! It is interesting to hear about some of the background to how the whole system works.

[@DrBrandonBeaber]

Luckily, we are starting to see more studies with a higher age limit in the inclusion criteria. The ATA 188 study has an age cap of 65 years for part 1 (60 for part 2): clinicaltrials.gov/ct2/show/NCT03283826

[@roberture5903]

Vicki you hang tough girl, I'll be 56 myself this year and I'll keep fighting to make sure they don't forget us.

[@MysticalDreamFire]

I hear you! Often we MSers are told to suck it up, stop spreading awareness and that there's other diseases. Well MS is pretty bad one its own. Hang in their fellow MSer 🧡🦋

[@barbaradascalos4411]

Yes...older age and being african american are most often having quickest progression...problem is there are 20 medications and not a single one can stop ms progression...so the reason why neuros may avoid you is because they know they have no medication to stop ms in it's tracks..but they should at least be honest and direct with you.

[@yolandepersico8339]

Vicky, I'm 58 also. It's possible that staying on the MS med, for me, might not be a good idea.

[@topcat1tanks]

My wife, 67, was recently diagnosed with MS. Her doctor is a MS specialist at Shands in Gainesville. She feels she had her first MS attack at age 44 and was never properly diagnosed. Although two doctors wanted to put her on Ocrevus, this doctor doesn't think it is the right path to take. She only has one MRI to review and will have her do a second one next year to compare her progress. The doctor feels she has had progressive MS and since she shows no active lesions, may be at a point where there isn't going to be any major changes. This is something we are in agreement with so the doctor is now treating symptoms like spasticity instead.

[@israelbettymenachem6586]

I was diagnosed at age 68 and I don't believe I had any symptoms prior. I was put on generic Tecfidera. Was on this for 6 months but had to stop because of low lymphocytes. Will soon be starting Kesimpta. Giving much thought on how many years will I be on medication? The risk vs the benefit is a tough decision

[@paisbeyer7122]

Thanks for this informative content. Is it possible,the number of people diagnosed has increased due to an increase in knowledge regarding MS? I had my first flare (ocular neuritis) at age 22. Diagnosed myself in my mid 30’s (I worked in the medical field for 17 years) officially diagnosed at age 45. I’m still 45 and now on Tysabri every 28. On Valentine’s Day, I will receive my 6th infusion. I spent years trying to get diagnosed. My story is far too common. I had Neurologists read my MRI’s and miss it. Knowledge is power. You’d think loss of bladder control and extreme weakness in both legs along with excruciating pain, would be a big red flag 🚩 This was at Piedmont Atlanta…..

[@DrBrandonBeaber]

Yes I agree. I'm sure some people with "mild" multiple sclerosis were not diagnosed in decades past.

[@marierhodes9675]

Thank you so much for this lovely video.I really appreciate your openness and honesty with regards to what is not known about multiple sclerosis.Those of us who have lived with multiple sclerosis for goodly number of years are fully aware of this although very few people will acknowledge it.

[@jillpartain3546]

GREAT video! So informative & quite easy to understand. Thank You!!

[@sandyriley4772]

You are amazing! Thank you so much for your clear explanations on each of these topics. I want you to be my neurologist, your patients are blessed 😊

[@SmileyTheAxolotl]

Thank you for this video! Lots of good info! During the initial heyday of the CCSVI stuff, I incessantly asked my neuro about it until she finally added a MRV to my already planned MRI. The MRV didn’t show any venous abnormalities, but I appreciated her doing that despite seeming a bit skeptical (unsure how she feels about it these days). Also wanted to say that med price comparison by country is crazy! 😯 Looking forward to your next video!

[@EvenSoItIsWell]

Excellent video Dr. Beaber. Tell us more about multimodal MRIs! Should we be getting them? How do they help you as a neurologist?

[@DrBrandonBeaber]

I talk about some specialized imaging at around 10:30 in this video on smouldering MS: kzbin.info/www/bejne/i2WZmax9oN-aoa8 Right now, I personally would not find these tests to be helpful outside of the research setting because the information is not directly actionable. In the future, if there was evidence that a specific treatment would work better for someone with a specific finding, they could be helpful (such as the use of BTK inhibitors in people with evidence of active microglia and macrophages in the CNS). We have not yet achieved "personalized medicine."

[@EvenSoItIsWell]

@@DrBrandonBeaber thanks so much!

[@DoctorGretchenHawley]

Excellent source of information, per usual! Thank you for all you do for the MS community!☺

[@DrBrandonBeaber]

Thanks Dr. Hawley! I hope people enjoyed the video we did recently. I would love to hear some feedback on it.

[@Paul9735]

I love those faces you make in the thumbnails 😂😂😂 You’re something else man

[@theMSguide]

thank you, Brandon. I really enjoyed this video and watched the entire thing. This is a must-watch for pwMS who are finding that in everyone they talk to and everywhere they turn there is yet another opinion. Great to get an expert view.

[@DrBrandonBeaber]

Thanks Dominic!

[@annwalsh5377]

Really interesting video Dr Bieber and very well explained.. Thank you

[@RawrJesse]

Fantastic video! Very curious to hear more cohesively about the causes for Progressive MS (which I've read is really a very big pre-destined curve rather than a demarcation point). Dr. Boster has done videos on "the leaking pool" of functional reserve, but I'm still a bit unclear, and on "Smoldering MS/PIRA," but again, the solutions seem like vague suggestions, and nobody's collected it all in one place for patients.

[@barbaradascalos4411]

Yes..Boster has many vague suggestions just like the u.s. and u.k. ms societies...truth is sleep..diet..exercise will not stop disease progression and dmt either for that matter.. hsct can stop the smoldering but still fails close to 25%..plus you have to pay/leave the country.

[@desiredecove5815]

Excellent Vid Dr Beabs. Break it on down for us. Way to go. #Sharingiscaring

[@DrBrandonBeaber]

Thanks Desire

[@stonz42]

Great video Dr. B! The "me too" drug development reminds me of the current situation with tv/movies re-booting all the classics from the 90s. Seems like original ideas are hard to come by...hopefully the soon to be released BTK inhibitors make a significant impact on treatment. I would gladly switch from Ocrevus to those if they're as effective.

[@DrBrandonBeaber]

The BTK inhibitors would definitely be an example of a new and innovative treatment not previously used in MS. Hopefully they will be safer than b-cell depleters like ocrevus and relatively effective.

[@roberture5903]

@@DrBrandonBeaber one quick question for you Dr B, how far along are they with the BTK inhibitors?

[@DrBrandonBeaber]

@@roberture5903 Very far along. There are ongoing phase III trials, for instance with tolebrutinib (the PERSEUS trial)

[@roberture5903]

@@DrBrandonBeaber thank you so much for your quick response sir I just caught it, much appreciated. It would be great if I could get on something like this to replace tysabri.

[@barbaradascalos4411]

How about this controversy...why is that all the breakthrough therapies come from cancer research....1. Rituximab 2. HSCT 3. BTKI

[@dmphax]

This is a phenomenal video!!! Thank you so much!

[@DrBrandonBeaber]

Thanks Laura. I'm glad you enjoyed it.

[@alancoss]

Thank you Brandon. This information is really informative and really helpful.

[@pmooremoore2798]

Great video as always! Always interested in info re the older ms population. I'm 60, diagnosed age 58 w minimal issues so wonder if/how long I should stay on a DMT since it makes me mildly immunocompromised. Video suggestion: Are there studies done on the effectiveness of any DMT's taken at their lower doses? For ex, Tecfidera 120's must have some level of efficacy & maybe this dose can be effective for older people w mild ms & considered as a de-escalation dmt? Maybe we don't need the most potent DMT's as we age but still want to take something...Thank you for all the education!

[@lauriegray8781]

Thank you! Thank you! Thank you!

[@roberture5903]

Thank you for another great video Dr Brandon, I see you gave Syracuse a shout out again and I just happen to be there haha. Contrary to what some may think I don't think it's totally lifestyle. Syracuse in its day was a big Industrial town which means plenty of pollution and I feel that could be a cause also. I'm not saying my diet was always squeaky clean but I was always very active in my job and off the job. Thank you again for another excellent video.

[@DrBrandonBeaber]

A lot of the risk factors for MS, even though they are associated with modern society, may not be modifiable (pollution, low sunlight exposure, low parasite exposure, etc).

[@bg0013]

Thanks again dr B for your efforts

[@DrBrandonBeaber]

You're very welcome.

[@MysticalDreamFire]

Ty 🤗great video 🦋🧡

[@nonpareilstoryteller5920]

Here’s a golden oldie and a cheap as chips remedy for Relapsing Remitting MS, works on Fibromyalgia and ME and Sjogrens Syndrome, because it’s amazing how, if you start out with one autoimmune disease, like MS you may well end up with several which is brain meltingly awful to contemplate but it happens often: Low Dose Naltrexone, up to 4.5mg. If it works for you, it can work really very well. Take it from one who knows.

[@DrBrandonBeaber]

I have a video on LDN: kzbin.info/www/bejne/d6quZqmclLNgjaM

[@nonpareilstoryteller5920]

Thank you doctor. I have watched your video with interest. I had a diagnosis of Relapsing Remitting MS late, in my early 40’s, thankfully and tried Beta Interferon for a short period with no objectively helpful results. I ceased the therapy and lived with the disease, only using Modafinil for the debilitating exhaustion and amitriptyline which kept me working for another 20 years. 7 years ago I developed Fibromyalgia with ferocious pain that became life threatening, literally. I was lucky enough to find a pain Consultant who agreed to let me try LDN. Within 5 days, I kid you not, I went from untreatable pain to no pain so naturally, pain gone, my mood lifted. As well as Fibromyalgia, I had started to experience symptoms of Sjögren’s syndrome, with very bad mouth ulcers etc. That stopped also. In its tracks. I have seen a Rheumatologist recently for a check up who tells me not to stop taking LDN because it seems to have arrested damage and if I miss a dose of LDN the ulcers come back. I quit the amitriptyline about 10 years ago because it was harming my memory. I take Magnesium L-Threonate for brain fog, it works very well. II live with “glove and stocking” neuropathy and simply sleep it off when it becomes too much. No relapses of MS, fingers crossed. I have passed on the information about LDN to Fibromyalgia sufferers where I live and they too have found it helpful. It doesn’t work for everyone and I doubt it would be strong enough to help more serious forms of MS but, I have had a busy career, reared 3 children, cared for and elderly parent and am still functioning well. It is not for everyone but I’ll take my chances with it against these scourges. Thank you for all you do and I look forward to looking at more of your work. Best wishes. 😊

[@mathewembry4275]

Nice job!

[@CONTROVERSYRISING]

CCSVI is caused by lymphatic congestion which causes compression of the vascular system at local points. No one is covering lymphatic circulation, without it how does the system function correctly? 40 medications and if any of them actually worked, there would be 1 medication.

[@DrBrandonBeaber]

Your last sentence is easily refuted. There are well over 100 antibiotics; Are they ineffective? There are very few diseases where a single drug cures 100% with the condition.

[@CONTROVERSYRISING]

@@DrBrandonBeaber ignore the topic of lymphatic circulation to promote drug drug use? Antibiotics are over used and they cover a broad spectrum of medical issues. 40 medications for 1 disease that "science" still can't find the cause? The term "auto immune" doesn't make sense, the immune system just reacts for no reason? There is a sequence of operation to this disease but it is far too profitable to ignore it. Heavy metal toxicity in the brain causes cancer of the myelin sheath, that's what MS is... cancer. The brain has the glymphatic system all to itself to cope with it until it is overwhelmed. Glymphatic drainage is the key, very similar to CCSVI. I have been using amlodipine 2.5mg 3 times daily with 25mg of CBD at night to improve glymphatic drainage. Plus MS stand for magnesium supplements, CBD and amlodipine relax the blood vessels which requires magnesium, low magnesium will produce poor results. Proper hydration is also a must.

[@rollin-92992]

Hey dr. B thank you for your videos, watching your channel from Tbilisi. I am curious why can't we use Ocrevus and Gilenya together, why there are no such (or other combinations) studies? O and G work by different pathways - they could be combined to have better results, right?

[@yesl9893]

Highly interesting. I have reached that magic 55 number but it is good to see the data before I elect to stop taking glutamer acetate. what I wonder now is if I do decide to stop and my MS gets worse what is ability to reingagage with that treatment and for it be to successful?

[@RonaldBeirouti]

Would these also be controversies? - EDSS as a way to measure disability. You had a great video about it! - The "forms" of MS, are there actually such distinct categories or is it all the same with two different components: attacks and progression and it depends which is diagnosed first. Most often, attacks since they are not as insidious as progression. - The new "improved" drugs which become available by the same company right when patents expire: Gylenia > Mayzent, Tecfidera > Vumerity, Rituxan > Ocrevus. Hmmm. 😊

[@pelletey]

When I mentioned CCSVI it triggered my neurologist really bad, he is a decent neurologist too. Add to #11 Neurologists, while neurology is obviously super important for MS it is a complex chronic disease, people should not rely entirely on a neurologist to give them all the answers! this is one thing which is not obvious to people newly diagnosed.

[@timothycarter9208]

I agree. I’ve always thought that a functional medicine doctor and/or gastroenterologist would be just as crucial as a neurologist. 70-80% of the immune system is in the gut. If MS is truly an autoimmune disease (that’s still being debated) personalized probiotic treatment makes sense.

[@pelletey]

@@timothycarter9208 indeed, this is why plant based diets are having so much success.

[@pelletey]

@@timothycarter9208 I think cannabis, tumeric and vitamin d are helping to keep EBV at bay, I believe it is the trigger causing relapses in pWMS.

[@andrewkaldas3337]

Thank you so much, Dr. Brandon Beaber! In relation to #9, I heard it suggested that this opens the door to new strategies for putting MS into remission. I was thinking about it after watching the video "How to Put Your Autoimmune Disease in Remission" (Eric Berg channel). Is this reasonable in light of what we now know currently in 2022? I heard the video I mentioned was created in response to so-called new information in 2019. I'm not sure if better is known in 2022. Also whether I should stop now from going way out of my way to get that supplement). Could you please comment on the idea of using Neurotrophin PMG to possibly put MS into remission? Could you make a video response on this subject? What are your thoughts on Neurotrophin possibly acting as a decoy (where the immune system attacks it instead), as postulated in the old video I mentioned above, or will it be more likely just a supplement to my diet? Thank you very much for your time and hard work.

[@donnabolt5847]

I think it's kind of controversial about the whole relapse remit. We definitely relapse but its not exactly remitted. Sometimes we recover completely but a lot of times we don't and we definitely are never cured after relapse.

[@comedyplanofficalTM]

I have PRMS , and my first neurologist wanted my first drug to be Lemtrada, forgoing the required 2 failed drugs. I opted out because I had a new daughter. I'm on ocrevus now, but it's not cutting it anymore... The neurologist said I had the most aggressive case he'd ever seen, so lucky me! :D

[@DrBrandonBeaber]

Sorry you are battling this, but hopefully you find something which works for you.

[@tinapierce3088]

Hello from Syracuse, NY!!!

[@DrBrandonBeaber]

:)

[@simonthe.dealer7877]

Thank you for this subject But can you please talk about food and diet from neurologist point of view for MS patient?

[@DrBrandonBeaber]

You might appreciate this playlist on nutrition and MS: kzbin.info/www/bejne/eZbcZqCrjK91qZI

[@simonthe.dealer7877]

@@DrBrandonBeaber thanks

[@enajenaj6841]

I think MS in less developed countries is just not being diagnosed. I had four relapses before I was diagnosed & if I didn’t have numbness in my hands & double vision together. It would have been a couple more years till I was diagnosed.

[@iust25in]

Thank you :)

[@justinbrady9502]

Ofatumumab has worked quite well for me with little side effects. I am tired the day of injection and slightly fatigued the day after injection.

[@hellomynameis5520]

Hello :) I have been having symptoms for 1-2 years. Off and on. Recently I had a brain, c spine, thoracic, lumbar and sacral MRI spine. Scanned with 1.5 Tesla without contrast. All came back normal with no evidence of lesions of demyelination. My dad has MS. I wonder if the scan was strong enough or if something was missed or if this is all in my head now, what do you think or should I rule out MS? Thanks

[@tempest510]

Is Ozanimod a me too drug? I was told Ozanimod is a "cleaner" and more effective version of Gilenya, and that studies are showing Ozanimod causes cognitive betterment. Have you heard this as well? I've read MS meds are supposed to reduce progress, not heal, but I think I'm better because of the Ozanimod for two main reasons: (1) I can hold my own in an argument again, & (2) I don't cut myself when preparing meals anymore! 😅💖

[@galbert1476557]

can you talk about genetic screening for MS and possible customizing treatments based on genetic MS characteristics. Also what is the state of Crispr-cas treatments for MS

[@DrBrandonBeaber]

There isn't a specific gene which causes MS or predicts treatment response to specific therapies. You may like this video though: kzbin.info/www/bejne/gV7Jg6CFbN-Bmc0 I am not aware of any proven treatment for MS which involves the CRISPR-CAS9 system.

[@franceszapata951]

Thanks so much, Dr Brandon. I'm so afraid of getting older because my neuro says that MS gets worse with menopause😔

[@barbaradascalos4411]

..very true often progression/secondary progressive ms occurs from age 40-50... if you can get hsct now you may be able to avoid it entirely.

[@user-xk3lj3sc5p]

Frances, I have read articles that a drop in estrogen can affect people. Definitely look it up, print off and discuss with your gynecologist. They may be able to prescribe hrt if you do not have any risk factors against taking them.

[@franceszapata951]

@@barbaradascalos4411 it's too expensive😔 and they wont give me a loan for it

[@franceszapata951]

@@barbaradascalos4411 did you get it? I would love to talk to someone about it😔 Ive been losing hope because I'm 34 and I feel useless and unproductive

[@franceszapata951]

@@barbaradascalos4411 thanks so much! I will look her up

[@mattz5275]

I'd say go with the heavy hitters 1st imo that is.

[@ernietollar407]

I'm not a detractor of drug companies and am grateful for their efforts, however as I'm getting ready to start DMT (Ocrevus) at 58, I can't help wonder if its claimed effectiveness applies people my age.? Also 13:25 makes ME wonder. Having only had 1 MRi (which indeed showed lesions) I have little sense how fast my PPMS is progressing.

[@wendychan6679]

I don't expect anyone to follow what I did as it is a personal choice. When I got diagnosed I found myself surrounded by a bunch of instant 'experts pushing me to have this drug or whatever. I did my own research and found none of the drugs offered led to a cure and ALL of them had nasty side effects. Whatever benefits they may have provided was offset (in my opinion) by exposing me to other issues (e.g cancer etc) by interfering with my immune system. I asked myself am I willing to live with these drugs and their side effects and the answer was a resounding NO. After 20+ years of MS I am glad I made that decision. One side effect of that decision is I don't get colds or flu anymore so I'm not complaining. Like I said - it is a personal decision that each MS patient needs to make themselves but do your research and don't let others bully you about it either - it is your decision. Either way there is risk.

[@Py16777216]

It's fascinating. Lemtrada will be the only drug I consider after 16 years looking for a discontinuous very effective drug. Induction now that it is available to me in theory. HSCT is to expensive since I dont have several million dollars. Thankfully I should be able to access Lemtrada for free with the manufacturers program. CCSVI is very interesting but I don't think it will make any difference for me. The drug costs are fascinating though, I think Lemtrada is actually reasonably priced compared to the other drugs given it's discontinuous use. Lol 500k in lemtrada and 2 to 5 million over a life for other other drugs. Edit. I think it is probably microplastics and generally higher stress to weaken the BBB Progression is probably is smoldering as the disease goes from large inflammation to a brain wide less visible effect on MRI. There are probably multiple initial instigating factors in MS. I really don't want to be taking any drugs as I become much older. I'm 30 so I think it's reasonable i will have greater risk of MS damage over the next 25 years or so but it is very difficult because of that 5% that end up doing worse. I really think it is up to the patient as they age and what risk they might be wiling to take.

[@jirijanouch9350]

Really good work, nice summary

[@DrBrandonBeaber]

Thanks

[@ernietollar407]

How different is Ocrevus different from Rituximab ?

[@DrBrandonBeaber]

They are very similar, but the molecular structure of the drugs are somewhat different, so it is possible to have a drug-allergy with one but not the other. I may do a specific video on this.

[@ernietollar407]

@@DrBrandonBeaber Wow, thank you Dr. Beaber. Here in Toronto Ocrevus may be my only option (Health Insurance pending).

[@TrollinOn22s]

Avonex was prescribed to me in 1999, but I didn't like needles so I soon stopped taking Avonex, but we now know Avonex isn't very effective. If those ABC drugs aren't effective why are Doctors saying the sooner you get on a disease modifying drug the better your outcome when prescribing the ABC drugs?

[@donnabolt5847]

I agree. I feel like the neurologists really need continuing education classes to help get them up to 2022.

[@darrinburnette6916]

I'm on OCREVUES and feel like crap for months after every treatment

[@teakara]

Me too, my symptoms worsened, I feel terrible, I can barely walk and I had no such problems before it

[@darrinburnette6916]

@@teakara same here on TYSABRIE I could walk and drive now I'm in a wheelchair

[@teakara]

@@darrinburnette6916 I’m sincerely so sorry to hear that. Please, don’t give up on yourself. I’m definitely quitting Okrevus, no more for me. I’ll search for alternatives and hopefully one day there’ll be a medication that is right for me. Big 👋 from Bosnia

[@shelly7269]

How long have you been on it? I felt like crap for months right after and then again the couple of months prior to the next infusion, but now I don’t really feel different after or right before. I’ve been on it for over 2 years. Took a few infusions before I didn’t feel like crap.

[@keeferification]

Kesimpta and Ocrevus should be the standard MS DMT's out of the gate. Prescribing first line medications to a newly diagnosed individual is a joke. Unfortunately, I learned that lesson the hard way.

[@uptoeleven]

Absolutely - now that risk management practice is far more established it should be a "no brainer" - after all Time is Brain and if we leave it too long we end up with "no brain" rather than the "no brainer" of induction therapy (exaggeration obviously).

[@TrollinOn22s]

The biggest joke is Doctors are still prescribing Copaxone.

[@RawrJesse]

@@TrollinOn22s I've heard of it still happening in cases where there's activity, but not enough to satisfy criteria for a complete diagnosis.

[@MysticalDreamFire]

I started my first DMT in June and choice Kesimpta. I've had alot of opinions expressed by my neurologist about this even through it was one of my choices

[@merlelybird2726]

So na or ya to taking kesimpta when newly diagnosed?

[@ellenbower2261]

Dr B what is your opinion on the coimbra protocol ….using high doses of Vitamin D as treatment for MS

[@barbaradascalos4411]

no proof that it works....

[@barbaradascalos4411]

of course..am already familiar with this..but it reads as discussion..no results are given people try to use diet in cancer but chemo is proven best...same with ms but neuros don't like hsct cause it puts them out of business.

[@luciece]

What's your opinion on CAR-T in treating MS? Considering anti CD20 DMD are hightly effective but not in all cases, could it be even more effective given that it can actually penetrate BBB?

[@DrBrandonBeaber]

Are you talking about ATA-188 or something different? People have experimented with intrathecal rituximab but it was not clearly effective: www.ncbi.nlm.nih.gov/pmc/articles/PMC4774261/

[@luciece]

@@DrBrandonBeaber I meant CAR-T using autologous genetically engineered T cells which they used for successfully curing SLE recently, I believe it's slightly different than ATA. Heard there will be some studies for pwMS in USA in near future using CD19 CAR T probably, or maybe different CD depending of whether is needed to target plasma cells in MS as well. Not sure about this or if it could be more effective than recent anti CD20 DMD which unfortunately have still only 50-60% NEDA.

[@shannondotson7750]

Thank you @Dr. Brandon Beaber for your work and advocacy. I went from an EDSS score of 7.5 (after 8 years after diagnosis and four different medications) to an EDSS score reduction to 2.5 within six-ish months of doing Lemtrada five-ish years ago. I had some new spasticity and other issues flare up and did a 3rd round eighteen months after the second round. Now again, spinal cord lesions “re-flaring” up (and other assorted things) I’m doing a round four in a month. Sigh. I realize you cannot give medical advice over this platform, BUT do you have any anecdotal advice/suggestions you can share and/or links? Again, thank you in advance and you rock!

[@metalfan6666]

Yeah the price for MS drugs are sick. One month of copaxone is over 4000. With that price copaxone should cure me

[@user-xk3lj3sc5p]

You forgot to add to that $4000 figure the amount of bad reactions... from mild to deadly. My friend had an anaphylactic reaction. Luckily her kids were home & 911 sent ambulance in time. She had been on it a few years prior no issue. I wonder if they changed the med up a bit.

[@metalfan6666]

@@user-xk3lj3sc5p woah I thought Copaxson is the "safer" drug. But I guess everyone's body chemical is different and can react in a negative way. That's why I take Copaxson cause the side effects are less deadly

[@poolmotorrepairguyFL]

There's nothing wrong with him OR he's Faking it. > Jay the Florida pool pump motor repair guy. When Service Calls Longwood approved ! that was good info 2 know 👨‍🔧 DR. Brandon Beaber

[@MzMontana]

You look v handsome here.. 🫣🫣

[@harmcity9934]

I'm on the "Pizza and Beer" diet and it seems to be working pretty well for my MS

[@DrBrandonBeaber]

I'll let it slide