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TREATMENTS / Re: Mayzent (siponimod, BAF312) for active SPMS, RRMS
« Last post by agate on April 05, 2019, 02:36:12 pm »

Dr. Fox of the Cleveland Clinic was interviewed about Mayzent in Multiple Sclerosis News Today (April 3, 2019):

In 2017 the Multiple Sclerosis Journal published a couple of brief statements about the controversial question: "Primary and secondary progressive MS have a similar age at onset of progression--Yes or no?" 

The "Yes" answer:

The "No" answer:

And the Commentary:

These controversial questions are a regular feature in this journal. This one is from the March 2017 issue but was indexed by PubMed only on April 4, 2019.
MISCELLANEOUS / Vegans have a "healthier biomarker profile"
« Last post by agate on April 03, 2019, 02:32:44 pm »
Vegetarians seem to do better than nonvegetarians when it comes to some health biomarkers according to this (Medical News Today, April 3, 2019). The article states that "semivegetarians" (those who eat meat more than once a month but less often than once a week) show results similar to results for "nonvegetarians" (those who eat meat at least once a week).
TREATMENTS / Cladribine (Mavenclad) approved for active SPMS, RRMS
« Last post by agate on April 01, 2019, 04:00:21 pm »
Another MS drug has been approved. Like siponimod (Mayzent), it turns out to be for SPMS only if it's still active SPMS (still having relapses). From the MSAA (April 1, 2019):
MISCELLANEOUS / Images of spring
« Last post by agate on March 31, 2019, 05:10:27 pm »
« Last post by agate on March 30, 2019, 06:42:32 am »

I browse around in the medical literature and have been noticing that lately there's been discussion of evidence that the MS drugs aren't effective in persons over a certain age--60 or 65 or thereabouts. The question is usually whether a doctor should recommend discontinuing them at that point.

Some people are finding that they're no longer covered for Tysabri, for instance, when they reach age 65. This is probably a determination aimed primarily at saving money, but there may be medical reasons to support it.

I have backed away from any neuro suggestions that I resume MS drugs mainly because of my age.  The MS drugs are powerful, and they involve the immune system--and they have their risks.

It's fairly well established that as we get older, drugs affect us quite differently. They are either more or less potent than in younger people, and the side effects can be quite different. It's for those reasons that I hesitate to try any drug aside from the ones I've been taking for years, and even with those, I'm trying to cut down the dosages wherever I can, just to be on the safe side.

They do know that older people respond differently to drugs. What they don't seem to know much about is just what goes on and with which drugs.

"Less is more" sometimes.
This is very sad. Readers might want to skip it. But it's one of the few instances of discussion of an actual case of this kind.

From PubMed (March 29, 2019)--"Wheelchair-assisted  ligature strangulation: An unusual suicide by a quadriparetic":
TREATMENTS / Novartis prices Mayzent at $88K/year
« Last post by agate on March 28, 2019, 02:21:45 pm »
More on this in SeekingAlpha, March 27, 2019:

Someone on another site stated that Mayzent (siponimod) is the generic form of Gilenya (fingolimod). This article (see link) states:

Siponimod, a synthetic derivative of fingolimod, is designed for an improved safety profile, including less deleterious effects on heart rate and nerves.

Is a "synthetic derivative" the same as a generic form?
The FDA has approved Mayzent (siponimod) but not for "inactive SPMS"--that is, SPMS without relapses. The MSAA has this informative article about it (March 27):

Mayzent is scheduled to become available in the first week of April.
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