{"id":2028,"date":"2026-05-18T05:00:00","date_gmt":"2026-05-18T05:00:00","guid":{"rendered":"https:\/\/wickedsister.evit.com.au\/index.php\/2026\/05\/18\/attack-right-from-onset\/"},"modified":"2026-05-18T05:00:00","modified_gmt":"2026-05-18T05:00:00","slug":"attack-right-from-onset","status":"publish","type":"post","link":"https:\/\/wickedsister.evit.com.au\/index.php\/2026\/05\/18\/attack-right-from-onset\/","title":{"rendered":"Attack \u2013 right from onset"},"content":{"rendered":"
Tweet<\/a><\/div>\n

Remember stroke management before the HASU and thrombolysis era? It was largely characterised by supportive care, rehabilitation, secondary prevention (aspirin, statins, blood pressure, weight & diabetes control, …). And whilst these measures all remain important, significant gains were made once Alteplase (thrombolysis) was introduced, and subsequently endovascular thrombectomy.<\/p>\n

AttackMS<\/a> is like the “thrombectomy of MS”: Remove acute ischemia caused by a thrombus thereby restore function (stroke). Remove acute inflammation in newly diagnosed MS (including at the stage of CIS), enable repair, and prevent dreaded PIRA<\/a>.<\/p>\n

Evidence suggests an association between PIRA and slowly expanding\/chronic active lesions\/smoldering lesion activity. Check out activated microglia cells, the brown semi-circle at the edge of a demyelinated lesion, on the histology pics C & D below:<\/p>\n

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These images and graph A are from Frischer, et al. 2015<\/a>. What the graph illustrates is that Frischer & colleagues found none of these slowly expanding (“smoldering”) lesions at the monosymptomatic (mono = CIS) stage and neither during the (presumably early<\/em> relapsing [RR]) phase of MS.<\/p>\n

Thus, attacking MS at first presentation, using a compound with a proven efficacy & safety record, certainly in the short term, may avoid the emergence of those pesky chronic active lesions and – thus – PIRA.<\/p>\n

Now, unless we MRI everyone who turns up in clinic with headache, it is unlikely we will catch a great number of people with MS at the stage of RIS (= radiologically isolated syndrome). AttackMS is therefore a testbed for the closest we can usually get to a powerful, early intervention with potential for wide adoption, provided rapid referral & review pathways can be generated.<\/p>\n

Let’s see what the data say – we’re open for recruitment until April 2027. Email bartshealth.attackms@nhs.net if you know somebody who has had first ever symptoms suggestive of MS<\/a> within the past 14 days.<\/p>\n

Is newly diagnosed MS a medical emergency? AttackMS addresses that question. <\/p>\n

<\/object>PIIS2211034825006777<\/a>Download<\/a><\/div>\n<\/p>\n

Disclaimer: I am the Chief Investigator of AttackMS<\/p>\n

Support: AttackMS (NCT05418010) is sponsored by Queen Mary University of London and funded by Sandoz (previous funding support came from Biogen).<\/p>\n<\/p>\n

Source: multiple-sclerosis-research.org<\/a><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Tweet Remember stroke management before the HASU and thrombolysis era? It was largely characterised by supportive care, rehabilitation, secondary prevention (aspirin, statins, blood pressure, weight & diabetes control, …). And whilst these measures all remain important, significant gains were made once Alteplase (thrombolysis) was introduced,…<\/p>\n","protected":false},"author":0,"featured_media":2029,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[11,15,9,8,13,14,12,10],"class_list":["post-2028","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-multiple-sclerosis-research","tag-brain-repair","tag-marburg-type-ms","tag-ms","tag-multiple-sclerosis","tag-myelin","tag-neuroregeneration","tag-oligodendrocyte","tag-remyelination"],"_links":{"self":[{"href":"https:\/\/wickedsister.evit.com.au\/index.php\/wp-json\/wp\/v2\/posts\/2028","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wickedsister.evit.com.au\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wickedsister.evit.com.au\/index.php\/wp-json\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/wickedsister.evit.com.au\/index.php\/wp-json\/wp\/v2\/comments?post=2028"}],"version-history":[{"count":0,"href":"https:\/\/wickedsister.evit.com.au\/index.php\/wp-json\/wp\/v2\/posts\/2028\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/wickedsister.evit.com.au\/index.php\/wp-json\/wp\/v2\/media\/2029"}],"wp:attachment":[{"href":"https:\/\/wickedsister.evit.com.au\/index.php\/wp-json\/wp\/v2\/media?parent=2028"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wickedsister.evit.com.au\/index.php\/wp-json\/wp\/v2\/categories?post=2028"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wickedsister.evit.com.au\/index.php\/wp-json\/wp\/v2\/tags?post=2028"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}