The cost effective way to increase effectiveness of immuno-modulation
Kah FangKhoo, Consultant Physician, Tanjung Medical Centrefangpenang@gmail.com
Submitted February 24, 2014
Ristori et al. presented a cost-effective way to increase the effectiveness of immuno-modulation therapy by giving BCG within 90 days of the first clinical event. [1] This has been done successfully in relapsing-remitting MS. [2] Our immunization program in Malaysia provides BCG immunization to all citizens but our program was excluded from this trial. It would be interesting to investigate if those previously immunized with BCG for clinically isolated syndrome or MS would benefit by another dose of BCG before immuno-modulation therapy and if the therapy would be more effective after 60 months. The low prevalence of MS in Malaysia (2/100,000) may be due to national BCG immunization or still undetermined Asian genetic markers. [3]
1.Ristori G, Romano S, Cannoni S, et al. Effects of Bacille Calmette- Gu??rin after the first demyelinating event in the CNS Neurology 2014;82:41-48.
2.Ristori G, Buzzi MG, Sabatini, et al. Use of Bacille Calmette???Gu??rin (BCG) in multiple sclerosis. Neurology 1999;53:1588-1589.
3.CT Tan. Multiple sclerosis in Malaysia . Nerol J Southeast Asia 1997; 2:1-5.
For disclosures, please contact the editorial office at journal@neurology.org.
Ristori et al. presented a cost-effective way to increase the effectiveness of immuno-modulation therapy by giving BCG within 90 days of the first clinical event. [1] This has been done successfully in relapsing-remitting MS. [2] Our immunization program in Malaysia provides BCG immunization to all citizens but our program was excluded from this trial. It would be interesting to investigate if those previously immunized with BCG for clinically isolated syndrome or MS would benefit by another dose of BCG before immuno-modulation therapy and if the therapy would be more effective after 60 months. The low prevalence of MS in Malaysia (2/100,000) may be due to national BCG immunization or still undetermined Asian genetic markers. [3]
1.Ristori G, Romano S, Cannoni S, et al. Effects of Bacille Calmette- Gu??rin after the first demyelinating event in the CNS Neurology 2014;82:41-48. 2.Ristori G, Buzzi MG, Sabatini, et al. Use of Bacille Calmette???Gu??rin (BCG) in multiple sclerosis. Neurology 1999;53:1588-1589. 3.CT Tan. Multiple sclerosis in Malaysia . Nerol J Southeast Asia 1997; 2:1-5.
For disclosures, please contact the editorial office at journal@neurology.org.