Thoughts from the beach on 'Our Big Challenges'

Apologies, no reliable internet access today.

As the new academic year is about to begin we have to set our research and teaching priorities for the year.

From a research perspective we will continue to work on symptomatic therapies, mainly spasticity, and neuroprotectivte strategies for progressive MS. The most exciting and pressing challenge is to get funding to test an anti-EBV drug in RRMS using a classic phase 2 trial design with MRI as the main outcome. Our first grant was rejected, but we are wiser and more prepared for our second attempt.

We will have to go back for funding to use CSF neurofilament levels as an outcome fir progressive MS trials. Although the grant application was rejected the reviews were positive and there is room for improvement. We will ask you to help with a survey; we need to show the funding bodies that people with progressive MS are prepared to have 3 lumbar punctures as part of a clinical trial. The feedback from our previous posting suggested yes.

We will continue to work on EBV, vitamin D and smoking and how they interact with genetic and epigenetic factors. This work is critical for putting forward a convincing argument that MS is preventable. I was dissappointed that prevention was ranked so low in our last survey. Maybe the arguments we have been making on the blog are not convincing enough.

Despite the wrath of the wrath of the CCSVI'ers, we will continue to report on CCSVI. However, it is looking increasingly likely that CCSVI will disappear from the radar as independent studies start to report their results.

Teaching people about MS remains as important as ever. We will continue with the blog and hopefully improve it with more posts designed for teaching rather than simply comunicating and interpreting research findings. How about 'Espresso MS Facts'? Do you think there is a need for a weekly or monthly video blog on a specific topic?

We are partnering with shift.ms to report research results in a more quirky and relevant way. We must thank the Wellcome Trust for their generous grant that has made this possible.

Finally, we will continue to do commercial MS trials, this is part of our commitment to improving the lives of MS'ers at least in the short term. The combined ECTRIMS and ACTRIMS, meeting in Amsterdam, promises to be an exciting meeting with several phase 3 trials reporting results (Alemtuzumab, BG12, Laquinimod, Daclizumab, etc) so prepare for a data feast in October.

Signing off from a sunny Greek beach.

Prof. Gavin Giovannoni
Barts and The London
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