robbie wrote:Do you think Bob that with RRMS it is eaiser for companies to get better results because of the natural remission of attacks drugs or not.
My internet at home is down for a couple of days so I'm going to do a quick response from work which I hope is worthy of your questions. Obviously researchers have known for a while that permiable bbb, inflammation and lesions are involved in the RRMS process and considering that 85% of the people with MS have RRMS, those symptoms are what the researchers were aiming for when they designed the current drugs.
I think the problem is that the necessary solution would involve understanding the underlying MS disease process and designing treatments aimed at that, but researchers haven't identified the underlying mechanism so they can only direct treatments at secondary effects like the permiable bbb, inflammation and lesions.
Obviously that is like aiming a fire hose at the flames rather than the base of the flames. It does have an obvious effect but will never put out the fire.
Those treatments, which obviously have limited ability to do what they were intended to do and aren't aimed at the right mechanism, were used against other phases of MS with dissapointing results, which caused everyone to jump the gun and assume that there must be something vastly different about SPMS and PPMS.
I can't prove that their isn't something vastly different about SPMS and PPMS as opposed to RRMS but the evidence used to come to the conclusion that SPMS and PPMS are different was faulty on every count.
As far as I'm concerned the issue is back to a clean slate and there is no reason to think SPMS and PPMS wouldn't respond every bit as well to an "effective" treatment aimed at the "correct" mechanism.
With that in mind, there are a lot of people with SPMS and PPMS who are older and have advanced disability and what we are discussing at this point are treatments to stop the disease process. Stopping the disease process isn't going decrease everyone's EDSS. Probably isn't going to decrease MOST people's EDSS. It's not something I like but I think because of the effects of plasticity, older people and people with SPMS and PPMS are the least likely to experience decrease in EDSS after the disease process is stopped.
I hate to leave things this way robbie but my 1/2 lunch has already been an hour long!