[HN Gopher] Multiple Sclerosis
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       Multiple Sclerosis
        
       Author : luu
       Score  : 60 points
       Date   : 2026-03-26 22:37 UTC (5 days ago)
        
 (HTM) web link (subfictional.com)
 (TXT) w3m dump (subfictional.com)
        
       | functionmouse wrote:
       | Dead URL
        
         | d-us-vb wrote:
         | Worked for me.
        
           | ChrisMarshallNY wrote:
           | Hugged to death.
           | 
           | MS sucks. There's varying degrees, though. I know folks that
           | have it now, and ones that died from it.
           | 
           | Some of the treatments aren't very nice. I knew one chap that
           | was on Interferon, for life.
        
             | throwawaymsjs wrote:
             | The modern treatments are much more effective than anybody
             | had expected, Ocrecus went from something used in the last
             | resort to standard care in less than a decade. I have no
             | issue with it whatsoever though that's not the case for
             | everyone, and it's now available as a 6 month injection
             | rather than a 8+ hour infusion thankfully. The older drugs
             | were unbelievably bad (blindness, infection, you name it),
             | but Ocrecus has been very tame in comparison. Can't get
             | vaccinated for Measles (and have 0 immunity) but that's my
             | only limitation really.
        
               | SmellTheGlove wrote:
               | Glad to hear Ocrecus is working for you! My wife was
               | diagnosed last year and has been on Tysabri for about 6
               | months. So far, so good. Having to go in for a monthly
               | infusion isn't something she loves, but zero side effects
               | as of yet. Thankfully it's a 1 hour infusion not 8.
        
               | Mezzie wrote:
               | I was on Tysabri for a while and I always felt the
               | infusion time was a bit calming. Forced me to step out of
               | life and relax a little bit.
        
               | SmellTheGlove wrote:
               | If I can ask, what are you on now, and what happened that
               | took you off of Tysabri? Feel free to not answer - it may
               | be a bit sensitive to ask. I'm just trying to understand
               | this all better since this is very new for my family.
        
               | Mezzie wrote:
               | It's fine, ask me anything you'd like! I was diagnosed 10
               | years ago and had my first (luckily only so far) relapse
               | 11.5 years ago, so I'm very used to this and remember the
               | first years very well. They're scary.
               | 
               | I'm on Kesimpta now, and I like it. It's worked well for
               | me.
               | 
               | I went off of the Tysabri due to issues with getting it
               | paid for: while there was assistance for the medicine
               | itself, there was _not_ assistance for the administration
               | of the medicine, so I moved to a DMT that I could self-
               | administer. We tried Tecfidera first (this was...I want
               | to say 5 or 6ish years ago), and then when the side
               | effects of that proved to be a problem, we decided to
               | start me on Kesimpta. I 've been on the Kesimpta for
               | years at this point, and it seems to be working well,
               | though of course it's hard to tell with a DMT since no
               | news is good news.
        
               | throwawaymsjs wrote:
               | Very glad to hear, both Tysabri and Ocrevus tend to have
               | extremely good outlooks from what I've heard from
               | neurologists. I originally received it before it was
               | commonly perscribed and the assumption then was that it
               | would slow disease progression by 50%, for many like
               | myself it has been essentially a complete halt on
               | progression for nearly 10 years.
        
               | SmellTheGlove wrote:
               | I'm really glad to hear its going well for you! Her
               | neurologist told us the achievable goal was to stop
               | progression entirely. We were both surprised to hear
               | that. She chose Tysabri because her brother has also had
               | great results with it, and also because it mostly acts to
               | keep your immune system outside the blood-brain barrier,
               | rather than to target specific types of immune cells. Our
               | understanding is you can basically stay on this until it
               | stops being effective or you test positive for JCV
               | exposure, at which point it's on to Ocrevus most likely.
        
         | ser13 wrote:
         | Archive link:
         | https://web.archive.org/web/20260120080248/https://subfictio...
        
       | prplfsh wrote:
       | https://www.astrazeneca.com/what-science-can-do/topics/next-...
       | 
       | AstraZeneca is doing some really interesting research in this
       | area - cell therapies that reset the immune system to eliminate
       | the dysfunctional cells driving autoimmune disease, and then
       | allow a healthy immune system to rebuild (for diseases like
       | lupus, rheumatoid arthritis, and multiple sclerosis).
        
         | konschubert wrote:
         | Today, there is also AHSCT.
         | 
         | There are already clinics where they basically remove your
         | immune system and give you a new one. If you don't die in the
         | process, you are likely to be cured of MS.
         | 
         | (Any existing damage will remain.)
         | 
         | Currently this is reserved for the most quickly progressing
         | cases but if we can make this safer and cheaper, it might in
         | future be applied as an early stage cure, so people can go on
         | to live healthy lives.
         | 
         | That being said, Astra Zenecas approach does seem much safer,
         | if it's proven to be effective!
        
           | JoshTriplett wrote:
           | > There are already clinics where they basically remove your
           | immune system and give you a new one. If you don't die in the
           | process
           | 
           | Of side effects of the process, or of opportunistic diseases
           | during the transition?
        
             | SmellTheGlove wrote:
             | The latter is my understanding.
        
           | SmellTheGlove wrote:
           | Yeah AHSCT is no joke. I mentioned in another comment my wife
           | has MS - diagnosed last year in her mid 40s with thankfully
           | no severe impairment. They discussed AHSCT with us but didn't
           | recommend it unless another disease modifying treatment
           | didn't work. Thankfully, Tysabri seems to be working well for
           | her.
           | 
           | My mom passed from leukemia years ago. Or rather, from an
           | infection as she was starting HSCT. I'm sure it's safer than
           | it was 30 years ago, but being without an immune system for a
           | period of time really is still a last resort.
        
           | johnisgood wrote:
           | I would not mind remyelination + being on a DMT, heh.
        
         | mjlee wrote:
         | Anokion (now bankrupt) also seemed to have some progress along
         | these lines (link below).
         | 
         | A close family member suffers from MS and is on the more
         | effective but less safe drugs available. They haven't suffered
         | a relapse since starting them four years ago, but they have
         | been hospitalised twice as a result of side effects.
         | 
         | As we learn more about the relationship between the immune
         | system and various seemingly unrelated diseases the research
         | and understanding has massively increased over the last few
         | years. I'm cautiously optimistic that better treatments aren't
         | far away. An ancestor was lobotomised for hysteria in the
         | 1960s, before being diagnosed with MS.
         | 
         | https://clinicaltrials.gov/study/NCT04602390
        
           | SmellTheGlove wrote:
           | Which drug are they on, if you're okay sharing?
        
             | mjlee wrote:
             | Ocrelizumab/ocrevus. Initially as an infusion, but the
             | doctor recommended monthly injections after neutropenic
             | sepsis.
             | 
             | After moving to injections there was a hospitalisation for
             | an upper respiratory tract infection, but not nearly as
             | serious.
             | 
             | On a positive note, MRIs have shown no new lesions, and bio
             | markers seem to show no relapses.
        
         | SmellTheGlove wrote:
         | It would be amazing if this type of treatment worked out. MS in
         | particular seems to be a race between technology and your
         | immune system. You hope the next cutting edge treatment is
         | ready by the time the current state of the art stops working
         | for you.
        
         | caycep wrote:
         | not my primary field, but I will say, though, from the folks we
         | see in our clinic, nowadays w/ ocrevus/kesimpta/rituxan,
         | patients are way more stable and dealing with way less side
         | effects than 10-15 years ago.
        
       | maxall4 wrote:
       | I was part of a team researching MS at a university a while ago.
       | It truly is an endlessly fascinating disease. Most evidence
       | currently points to MS being caused by a combination of Epstein-
       | Barr infection and genetic factors [0,1]. It is hypothesized that
       | Epstein-Barr triggers autoimmunity which results in the
       | prototypical demyelination [2].
       | 
       | [0]: https://www.science.org/doi/10.1126/science.abj8222
       | 
       | [1]: https://www.pnas.org/doi/10.1073/pnas.2424986122
       | 
       | [2]: https://www.nature.com/articles/s41586-022-04432-7
        
       | freezystem wrote:
       | https://neurosciencenews.com/gut-immune-responses-ms-trigger... A
       | landmark study from Keio University (published March 2026 in
       | Science Immunology) has identified a key mechanism linking the
       | gut to MS. This opens the door to new MS treatments targeting the
       | gut itself -- such as modifying gut bacteria or blocking the
       | abnormal antigen-presenting activity of IECs -- rather than
       | broadly suppressing the immune system
        
       | moralestapia wrote:
       | >First, a request: We do not wish to receive treatment or
       | management advice for MS, including anything related to diet or
       | lifestyle.
       | 
       | This, please. People tend to think that publishing a blog is some
       | sort of "social" activity, a two-way conversation, a way to
       | build/keep a small community. It is not, as a reader you're just
       | expected to consume the content and move on; I hate when people
       | overstep that boundary, jeez.
       | 
       | >How you can help
       | 
       | >We will continue to need your support.
       | 
       | >I'm sure we're going to need help with things here and there.
       | Running errands, taking care of things around the house, etc.
       | 
       | >Gift cards have been suggested as one way folks can lend a hand
       | 
       | Hey, this is great! Thank you for being very clear on what your
       | needs are, that makes is so much easier to just reach out and
       | help in a way that it wouldn't bother you. As you say gift cards
       | are great because you don't even have to interact with the person
       | sending it (COVID reasons), we can just send it to you, you
       | receive it, if you're busy you don't even have to reply right
       | away.
       | 
       | >We will communicate those requests as needed.
       | 
       | Thank you for the trust you put in us. I will remain pending of
       | this, I can't wait to help.
        
       | Finbarr wrote:
       | MS treatments tend to take 3 forms:
       | 
       | - immune reset (sledgehammer that can "cure" diseases like MS but
       | with many side effects and potential complications)
       | 
       | - immune suppression (super effective but with increased risk of
       | infections and blunts vaccines)
       | 
       | - immune redirection (less effective but doesn't mess up your
       | immune system so badly).
       | 
       | It's only in the last ~10 years that super effective treatments
       | that can stop ~99% of lesion progression have existed- Ocrevus
       | and Kesimpta. These are anti CD20 disease modifying therapies
       | that destroy all your B cells. The memoir of Dr. Stephen Hauser-
       | "The Face Laughs While The Brain Cries"- provides a fascinating
       | insight into the development of these treatments over the last
       | ~40 years of his career.
       | 
       | There are active trials of newer types of treatment and a lot of
       | progress is being made in the MS space. It used to be a "death
       | sentence" disease but is quite manageable for many sufferers now.
       | It's different for every individual and I wish the blog author
       | good health.
        
       | jlukic wrote:
       | I've been on Tysabri for 3 years. I think anyone looking at this
       | problem should just at the network meta analysis of outcomes from
       | DMTs. You can think through each options risk profile, and then
       | make a reasonable choice for your preferences. consensus.app is a
       | good starting place for evaluating the research quickly.
       | 
       | if anyone needs to discuss i'd also be happy to share my
       | experiences if you reach out.
        
       | ninju wrote:
       | should add [2021] to title (old article)
        
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       (page generated 2026-03-31 23:01 UTC)