Multiple Sclerosis: Joyful Living Guide - Healthy Lifestyle and Brain Health

12 November, 2025 Easy Explained MS by Dr Agne Straukiene

Advancements in MS Treatments 2025 ECTRIMS

Join Dr. Agne Straukiene, a neurologist specialising in Multiple Sclerosis, as she unveils ground-breaking treatments discussed at the ECTRIMS 2025 conference. Discover how BTK inhibitors like Tolebrutinib, Evobrutinib, Orelabrutinib, Remibrutinib, and Fenebrutinib could revolutionize MS care by targeting both B cells and brain cells to reduce inflammation and progression. Learn about #Frexalimab's novel mechanism and promising trial results, the potential of combining Clemastine and Metformin for myelin repair, and remarkable long-term outcomes of autologous haematopoietic stem cell transplantation. Explore the exciting advent of CART cell therapy poised to change the future of MS treatment.

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Hi, I'm doctor Agni Strakiena, a neurologist specializing in multiple sclerosis. Today, I'm excited to share some advancements in MS treatments from the Ektrims twenty twenty five conference. Have you ever wondered how immune cells react to multiple sclerosis treatments? Today, I'll take you on a fascinating animated journey into the world of cells, how they behave, respond, and transform with therapy. Let's discuss about one of the most talked about treatment topics at Ektrym's twenty twenty five, BTK inhibitors, or Bruton's tyrosine kinase inhibitors. These are oral drugs that may change the future of MS care. So how they work in our bodies, they calm the immune system especially overactive b cells that play a big role in MS. They reach into the brain and spinal cord, where they may help reduce chronic active inflammation, something older treatments can't always target. So these drugs could work both in the bloodstream and inside the central nervous system, which is big news. At Ektrims twenty twenty five, several BTK inhibitors were discussed. Here are the main ones. On, Tolabrutinib is one of the most advanced BTK inhibitors. What makes it special is that it crosses the blood brain barrier very well, meaning it can act directly inside the central nervous system where inflammation and nerve damage occur. In clinical trials, tolebrutinib reduced new brain lesions and showed encouraging signs of slowing disability progression. It did face some safety concerns in the past due to liver changes, but trials have now resumed at lower, safer doses with improved monitoring. Two, evobrutinib has shown sustained benefits over time, fewer relapses and fewer MRI lesions. It acts on both b cells and brain immune cells known as microglia, which are thought to contribute to progression even when relapses stop. Most side effects were mild, like headache, diarrhea, and small changes in liver tests. Three, orelobrutinib also penetrates the brain well and works selectively, meaning it targets only what it needs to. Early results showed fewer new inflammatory lesions with generally good tolerance, some mild nausea, infections, or minor liver changes. Four, rimebrutinib stands out for its twice daily dosing and quick action. It's been shown to reduce relapses and new MRI lesions, making it a convenient and effective oral option. Reported side effects were mild, mainly headache, rash, and fatigue. Five. Phenibrutinib takes a broader approach. It doesn't just act on b cells, it also targets myeloid lineage cells, which include microglia, the brain's resident immune cells. You can think of microglia as the brain's internal housekeepers. They clean up damage, but when they become overactive, they can fuel ongoing chronic active or smoldering inflammation. By calming these cells, fenibrutinib could help prevent silent progression in multiple sclerosis, not just relapses. This dual action on both b cells and microglia makes fenibrutinib one of the most promising BTK inhibitors being studied, especially for progressive MS. It's also been generally well tolerated, with mild infections and headaches reported. Unlike many current MS treatments that suppress the immune system broadly, BTK inhibitors may be more targeted. They could reduce relapses, prevent new brain lesions, slow down silent progression, offer oral dosing with fewer clinic visits, and possibly help with chronic active MS, the slow burning type that doesn't show up as clear relapses. These drugs are still being studied, but we're moving closer to having options that work deep in the brain something we've never had before. BTK inhibitors generally appear safe, but because they act on the immune system, we still watch for liver changes, mild infections, headaches and gastrointestinal symptoms. Long term safety is still being studied. I would like to take your attention on Frexelumab was another spotlight treatment at Ectrem's twenty twenty five, offering a completely new way of calming down the immune system in multiple sclerosis. Unlike many treatments that work broadly, frexelomab targets a specific molecule called CD 40 l, an essential signal that activates immune cells during inflammation. By blocking this signal, frexolumab helps reduce the autoimmune attack on the brain and spinal cord. In clinical trials, it showed impressive reductions in new brain lesions and signs of ongoing inflammation by over eighty five percent in some patients. Importantly, it's a non depleting therapy, meaning it modulates the immune system without wiping it out entirely. That could mean fewer infections and potentially a better safety profile. Side effects were generally mild, with headaches and minor infusion reactions being the most common. As more results emerge, frexelimab is shaping up to be a promising option for people looking for effective targeted control of their multiple sclerosis with a lower impact on their immune defenses. Interestingly, researchers shared promising findings from a trial combining two well known medications, Chlamastine, an antihistamine and Metformin, a diabetes drug with regenerative properties. Together, these two medications appear to stimulate the body's own oligodendrocytes, the cells responsible for creating new myelin, the protective coating around nerves showing potential despite still being in experimental stages. But what really got attention was their effect on the optic nerve, which is often affected early in MS. Participants who received the combination showed measurable improvement in visual evoked potentials or VEPs. This test tracks how quickly signals travel from the eye to the brain. In MS, that signal is often delayed due to demyelination. After treatment, these signal delays improved, suggesting actual repair of damaged myelin in the optic pathways. One of the most striking updates at Ektrim's 2025 came from the long term outcomes of stem cell therapy, specifically autologous hematopoietic stem cell transplantation for people with aggressive forms of multiple sclerosis. Compared to standard disease modifying treatments, stem cell therapy showed a dramatic reduction in disability progression. After ten years, only ten percent of patients treated with stem cells experienced worsening disability from progression compared to nearly fifty percent in those on conventional treatment. Even relapses were nearly eliminated, only seven percent had a relapse over ten years versus eighty one percent in the control group. Importantly, AHSCT almost completely prevented new disability that accumulated independently of relapses. It also kept more people in a no evidence of disease activity state called NEDA three for years. The treatment was particularly effective in younger patients with lower disability scores at baseline. There were no deaths or cases of cancer during follow-up, although a small percentage developed autoimmune disorders. This data reinforces that for the right patients, AHSCT is not just an experimental option, it's a powerful intervention that can halt inflammation, prevent progression, and even potentially change the trajectory of the disease. But identifying who might benefit most based on age, baseline disability, and risk markers will be key to offering this treatment earlier and safely. One of the most cutting edge treatments discussed at Ektrims twenty twenty five was CAR T cell therapy, a breakthrough approach already making waves in cancer, now being explored in multiple sclerosis. CAR stands for chimeric antigen receptor. In this therapy, a person's own immune cells are taken out, reprogrammed in a lab to specifically target the b cells that drive MS inflammation, and then infused back into the body. In a small early phase trial conducted at Stanford University, this therapy was tested in people with progressive multiple sclerosis. It involves modifying a patient's own immune cells to eliminate b cells that are believed to drive disease progression. The results were encouraging. The treatment was well tolerated with only one case of mild cytokine release syndrome and one case of temporary neurological side effects. Both were transient. By one month after infusion, b cells in the blood were completely depleted. By six months, the immune system began to reconstitute, and over 90% of the b cells that returned were of a naive type, not memory cells that tend to cause inflammation in multiple sclerosis. These advancements signify a profound shift towards more effective long term MS management. I hope you enjoyed this imaginary world of immune cells and new advanced treatments in MS. Stay informed and share this vital information with others who could benefit. As you can see, there is hope for better tomorrow, and don't forget to always be well.

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25 October, 2025 Easy Explained MS by Dr Agne Straukiene

Botox in MS for Aesthetics

In this episode, we delve into the use of Botox for individuals with Multiple Sclerosis (MS), focusing on its benefits for both therapeutic and aesthetic purposes. We discuss how Botox can help manage MS symptoms like muscle spasticity and facial muscle issues while also considering its cosmetic applications to improve appearance and self-confidence. Key points include the importance of coordinating Botox with existing MS treatments, selecting appropriate injection sites, and closely monitoring potential side effects. Ethical considerations and the psychological impact of aesthetic treatments in MS patients are also examined.

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Welcome to our exploration of Botox in multiple sclerosis aesthetics. We'll examine how this treatment option intersects with the complex needs of individuals living with multiple sclerosis. Multiple sclerosis is an autoimmune condition that affects the central nervous system causing various symptoms including muscle spasticity, tremors, and facial muscle issues. These physical manifestations can sometimes affect facial expressions and appearance. Botox or botulinum toxin has long been used therapeutically in MS to manage muscle spasticity but its aesthetic application offers additional benefits for some patients who wish to address visible signs of their condition or aging. When considering Botox for aesthetic purposes in MS patients, medical professionals must carefully evaluate several factors. The treatment must be coordinated with existing MS medications and therapies. The injection sites need to be carefully selected taking into account areas affected by ms symptoms. Additionally, the dosing may need to be adjusted compared to standard aesthetic treatments as ms patients might respond differently to the medication. The risks and potential complications require special attention. While Botox is generally safe, MS patients might experience different side effects or reactions compared to the general population. Common side effects like temporary weakness or bruising at injection sites need to be monitored more closely it's crucial for patients to work with health care providers who understand both aesthetic medicine and MS management to ensure safe treatment planning. The psychological impact of aesthetic treatments in MS patients is significant. Many individuals with MS experience changes in their appearance due to their condition or its treatments. Aesthetic interventions like Botox can help improve self confidence and quality of life. However, it's important to maintain realistic expectations and understand that these treatments are optional and should be part of a comprehensive approach to managing MS. Ethical considerations also come into play when discussing aesthetic treatments for individuals with chronic conditions. Health care providers must ensure that patients are making informed decisions free from external pressure. The focus should be on enhancing well-being rather than conforming to societal beauty standards. It's essential to discuss both the benefits and limitations of aesthetic treatments in the context of overall MS management. As we conclude it's clear that the use of Botox for aesthetics in MS patients requires a thoughtful individualized approach. While it can offer benefits beyond cosmetic enhancement, careful consideration of medical, psychological, and ethical factors is essential. Always consult with health care providers who understand both MS and aesthetic medicine to determine if this treatment aligns with your overall health goals and MS management plan.

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17 October, 2025 Guided meditation with Dr Agne Straukiene

Guided Meditation for MS: Climbing the Mountain Within

Guided Meditation for MS: Climbing the Mountain Within Join us in this calming guided meditation designed for individuals managing Multiple Sclerosis (MS). Find a comfortable position and allow yourself to relax and center your mind as we take you through a journey of inner strength and balance. Enhance your mental well-being through visualisations that incorporate breath awareness, physical relaxation, and positive affirmations. This session is perfect for those looking to alleviate MS symptoms, complement their disease modifying treatment, and incorporate mindfulness practices into their MS diet and exercise routine.

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Climbing the mountain within. Find a comfortable position lying down or seated with your back supported. Close your eyes if you wish. Take a slow few deep breaths in and gently exhale. Allow the body to feel heavy, supported by the earth. Bring an intention to your heart like a seed to plant. It might be 'each step brings me strength' or 'I move forward with balance and courage'. Repeat your intentions silently three times. Now we move awareness slowly through the body, right hand thumb, index finger, middle finger, ring finger, little finger. Palm of the right hand, wrist, forearm, elbow, upper arm, shoulder. Left hand thumb, index finger, middle finger, ring finger, little finger. Palm of the left hand, wrist, forearm, elbow, upper arm, shoulder. Awareness to the right foot, toes, ankle, calf, knee, thigh. Awareness to the left foot, toes, ankle, calf, knee, thigh. Now the pelvis, abdomen, chest, back, neck, face, forehead, crown of the head. Notice your natural breath, inhale rising like the lift of your trekking pole. Exhale, releasing like the steady planting of the pole into the ground, breath and movement becoming one rhythm. See yourself holding the poles in your hands. Your boots crunch on the rocky trail. Step by step you climb higher. Sunlight warms your skin, cool air brushes across your face. The poles guide you, supporting each step. With every lift, every plant, you move upward with confidence. The trail winds to the summit ahead, to your left vast valleys open beneath clouds, to your right towering cliffs rise with strength. You pause, look around, breathe deeply. Feel the steadiness of the earth beneath your feet. Feel the strength in your legs, your arms, your heart. Feel the body light almost weightless as if carried upward by the wind. Now feel the body heavy, rooted deeply into the mountain. Feel the warmth of the sun on your skin. Now feel the cool shade of stone and air. Light, heavy, warm, cool, balanced, whole. Return to your intention, silently repeat it three times. Let it echo within you like your footsteps on the mountain path. Bring awareness back to your breath, the rise and fall of your chest, the ground supporting you. Gently move your fingers and your toes. Take a deep refreshing breath in and release. When you are ready, open your eyes if you have them closed. Carry with you the calm, courage and balance of climbing your inner mountain.

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