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Progressive multiple sclerosis treatment

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https://www.readbyqxmd.com/read/28104250/impact-of-daclizumab-versus-interferon-beta-1a-on-patient-reported-outcomes-in-relapsing-remitting-multiple-sclerosis
#1
Ying Liu, Timothy Vollmer, Eva Havrdova, Katherine Riester, Andrew Lee, Glenn Phillips, Ping Wang, Guido Sabatella
BACKGROUND: Patient-reported outcomes (PROs) provide information on treatment effects from the patient's perspective that complement outcomes on clinical measures. In DECIDE, daclizumab demonstrated superior efficacy in reducing relapses, 24-week confirmed disability progression, and brain lesions (assessed by magnetic resonance imaging [MRI]) versus intramuscular interferon beta-1a in relapsing-remitting multiple sclerosis. OBJECTIVE: To examine the impact of daclizumab versus interferon beta-1a on PROs in DECIDE...
January 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28101629/treatment-of-ribbing-disease-with-5-year-follow-up-and-literature-review
#2
L L Zhang, W M Jiang, H L Yang, Z-P Luo
Ribbing disease, or multiple diaphyseal sclerosis, is a rare diaphyseal sclerosis of unknown etiology. Patients with this pathology usually present with asymmetric pain limited to the lower extremities. Though all efforts are made to relieve the progressive pain associated with Ribbing disease, no medical or surgical treatments have been established yet. In this case report, we followed up a Ribbing case with sclerotic bone fenestration for 5 years. The radiological changes and the clinical effects are described, and the different Ribbing treatments are then briefly reviewed...
January 18, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28100738/mir-142-3p-is-a-key-regulator-of-il-1%C3%AE-dependent-synaptopathy-in-neuroinflammation
#3
Georgia Mandolesi, Francesca De Vito, Alessandra Musella, Antonietta Gentile, Silvia Bullitta, Diego Fresegna, Helena Sepman, Claudio Di Sanza, Nabila Haji, Francesco Mori, Fabio Buttari, Emerald Perlas, Maria Teresa Ciotti, Eran Hornstein, Irene Bozzoni, Carlo Presutti, Diego Centonze
: MicroRNAs (miRNA) play an important role in post-transcriptional gene regulation of several physiological and pathological processes. In multiple sclerosis (MS), a chronic inflammatory and degenerative disease of the CNS, and in its mouse model, the experimental autoimmune encephalomyelitis (EAE), miRNA dysregulation has been mainly related to immune system dysfunction and white matter (WM) pathology. However, little is known about their role in gray matter pathology. Here, we explored miRNA involvement in the inflammation-driven alterations of synaptic structure and function, collectively known as synaptopathy, a neuropathological process contributing to excitotoxic neurodegeneration in MS/EAE...
January 18, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28100092/sample-size-requirements-for-one-year-treatment-effects-using-deep-gray-matter-volume-from-3t-mri-in-progressive-forms-of-multiple-sclerosis
#4
Gloria Kim, Renxin Chu, Fawad Yousuf, Shahamat Tauhid, Lynn Stazzone, Maria K Houtchens, James M Stankiewicz, Christopher Severson, Dorlan Kimbrough, Francisco Quintana, Tanuja Chitnis, Howard L Weiner, Brian C Healy, Rohit Bakshi
OBJECTIVE: The subcortical deep gray matter (DGM) develops selective, progressive, and clinically-relevant atrophy in progressive forms of multiple sclerosis (PMS). This patient population is the target of active neurotherapeutic development, requiring the availability of outcome measures. We tested a fully automated MRI analysis pipeline to assess DGM atrophy in PMS. DESIGN/METHODS: Consistent 3D T1-weighted high-resolution 3T brain MRI was obtained over one year in 19 consecutive patients with PMS [15 secondary progressive, 4 primary progressive, 53% women, age (mean±SD) 50...
January 19, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28099564/guideline-for-multiple-sclerosis-treatment-in-brazil-consensus-from-the-neuroimmunology-scientific-department-of-the-brazilian-academy-of-neurology
#5
Elizabeth Regina Comini-Frota, Cláudia C F Vasconcelos, Maria Fernanda Mendes
Multiple sclerosis has become an ever-increasing challenge to neurologists. With the release of the latest medications on the market, Brazilian neurologists feel divided between following their patients' evolution in accordance with the strict rules established by the Brazilian Ministry of Health regarding drug distribution, or following disease progression and worsening in accordance with the evidence in the literature. Therefore, a systematic review of the main published treatment guidelines was conducted and an escalating therapy proposed for guiding multiple sclerosis patient treatment in Brazil...
January 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28090375/autologous-bone-marrow-transplantation-in-multiple-sclerosis-biomarker-relevance-for-patient-recruitment-and-follow-up
#6
Ana C Londoño, Carlos A Mora
BACKGROUND: Despite the current availability of disease modifying therapies for the treatment of multiple sclerosis, there are still patients who suffer from severe neurological dysfunction in the relapsing-remitting or early progressive forms of the disease. For these patients autologous hematopoietic stem cell transplant offers an important therapeutic solution to prevent progression to irreversible disability. In spite of multiple studies in the last two decades, patient inclusion criteria, protocols for peripheral blood stem cell mobilization and bone marrow cell conditioning and methodology of follow up for autologous hematopoietic stem cell transplant in multiple sclerosis have not been strictly unified...
October 2016: Journal of Clinical & Cellular Immunology
https://www.readbyqxmd.com/read/28087821/selection-of-first-line-therapy-in-multiple-sclerosis-using-risk-benefit-decision-analysis
#7
David Bargiela, Matthew T Bianchi, M Brandon Westover, Lori B Chibnik, Brian C Healy, Philip L De Jager, Zongqi Xia
OBJECTIVE: To integrate long-term measures of disease-modifying drug efficacy and risk to guide selection of first-line treatment of multiple sclerosis. METHODS: We created a Markov decision model to evaluate disability worsening and progressive multifocal leukoencephalopathy (PML) risk in patients receiving natalizumab (NTZ), fingolimod (FGL), or glatiramer acetate (GA) over 30 years. Leveraging publicly available data, we integrated treatment utility, disability worsening, and risk of PML into quality-adjusted life-years (QALYs)...
January 13, 2017: Neurology
https://www.readbyqxmd.com/read/28081190/inflammatory-activity-on-natalizumab-predicts-short-term-but-not-long-term-disability-in-multiple-sclerosis
#8
Joel Raffel, Arie R Gafson, Samer Dahdaleh, Omar Malik, Brynmor Jones, Richard Nicholas
BACKGROUND: In people with multiple sclerosis treated with interferon-beta or glatiramer acetate, new MRI lesions and relapses during the first year of treatment predict a poor prognosis. OBJECTIVE: To study this association in those receiving natalizumab. METHODS: Data were collected on relapses, new MRI activity, and Modified Rio Score after initiation of natalizumab in an observational cohort of 161 patients with high baseline disability...
2017: PloS One
https://www.readbyqxmd.com/read/28080255/assessing-long-term-prognosis-improvement-as-a-consequence-of-treatment-pattern-changes-in-ms
#9
Ruggero Capra, Cinzia Cordioli, Sarah Rasia, Fabio Gallo, Alessio Signori, Maria Pia Sormani
OBJECTIVE: To assess whether the age at which multiple sclerosis (MS) patients reach Expanded Disability Status Scale (EDSS) milestones changed as long as new drugs for the treatment of MS became available. METHODS: We evaluated the long-term impact of therapies on disability progression assessing whether there is a detectable delay in the age at which patients reached EDSS milestones in more recent years. We used data collected over more than 30 years in the Center of Brescia, Italy...
January 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28080250/no-evidence-of-disease-activity-in-patients-receiving-daclizumab-versus-intramuscular-interferon-beta-1a-for-relapsing-remitting-multiple-sclerosis-in-the-decide-study
#10
Ludwig Kappos, Eva Havrdova, Gavin Giovannoni, Bhupendra O Khatri, Susan A Gauthier, Steven J Greenberg, Xiaojun You, Ping Wang, Giorgio Giannattasio
BACKGROUND: No evidence of disease activity (NEDA) is a composite endpoint being increasingly applied as an outcome measure in clinical trials as well as proposed for individual therapeutic decisions in multiple sclerosis (MS). OBJECTIVE: Assess the proportion of patients with relapsing-remitting MS achieving NEDA in the DECIDE study of daclizumab 150 mg subcutaneous versus intramuscular interferon beta-1a 30 µg for 96-144 weeks. METHODS: NEDA was defined as no relapses, no onset of 12-week confirmed disability progression (CDP), no new/newly enlarging T2 hyperintense lesions (NET2), and no gadolinium-enhancing (Gd(+)) lesions...
December 1, 2016: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28078314/onset-of-secondary-progressive-ms-after-long-term-rituximab-therapy-a-case-report
#11
H-Christian von Büdingen, Antje Bischof, Erica L Eggers, Shengzhi Wang, Carolyn J Bevan, Bruce A C Cree, Roland G Henry, Stephen L Hauser
A patient with relapsing multiple sclerosis (RMS) was treated with a standard immunomodulatory therapy, but due to ongoing disease activity was switched to rituximab. Relapses ceased, but secondary progressive MS (SPMS) eventually appeared, associated with new focal spinal cord white matter lesions. Cerebrospinal fluid (CSF) showed persistent oligoclonal bands (OCB) and clonally related B cells in CSF and peripheral blood. The treatment escalation approach failed to prevent evolution to SPMS, raising the question of whether initiation of B-cell depleting therapy at the time of RMS diagnosis should be tested to more effectively address the immune pathology leading to SPMS...
January 2017: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/28072907/symptomatic-treatments-for-amyotrophic-lateral-sclerosis-motor-neuron-disease
#12
REVIEW
Louisa Ng, Fary Khan, Carolyn A Young, Mary Galea
BACKGROUND: Motor neuron disease (MND), which is also known as amyotrophic lateral sclerosis (ALS), causes a wide range of symptoms but the evidence base for the effectiveness of the symptomatic treatment therapies is limited. OBJECTIVES: To summarise the evidence from Cochrane Systematic Reviews of all symptomatic treatments for MND. METHODS: We searched the Cochrane Database of Systematic Reviews (CDSR) on 15 November 2016 for systematic reviews of symptomatic treatments for MND...
January 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28069782/delivering-patient-centred-care-in-rural-family-practice-using-the-patient-s-concept-of-health-to-guide-treatment
#13
Jennifer M Charlesworth, Evelyn McManus
Through an examination of the life of an 83-year-old patient diagnosed clinically with secondary progressive multiple sclerosis (MS), general practice specialists, consultants and junior doctors will see the importance of assessing their patient's concept of health and how to use this understanding to target healthcare options within their healthcare system. This article highlights, in a resource limited context of rural family practice, the utility of a strong physician-patient relationship, recalls the definition of patient-centred care, and the role of judicious inaction in certain contexts...
January 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28069073/quantification-of-postural-stability-in-minimally-disabled-multiple-sclerosis-patients-by-means-of-dynamic-posturography-an-observational-study
#14
Lucia Grassi, Stefano Rossi, Valeria Studer, Gessica Vasco, Caterina Motta, Fabrizio Patanè, Enrico Castelli, Silvia Rossi, Paolo Cappa
BACKGROUND: Multiple Sclerosis (MS) is a widespread progressive neurologic disease with consequent impairments in daily activities. Disorders of balance are frequent and equilibrium tests are potentially useful to quantify disability and to verify treatment effectiveness. The fair sensitivity of the widely used not-perturbed tests to detect balance disturbances in MS patients have prompted the development of mechatronic systems capable to impose known equilibrium perturbations, in order to challenge the balance control and, consequently, to better assess the level of impairment...
January 10, 2017: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/28056103/healthcare-costs-for-treating-relapsing-multiple-sclerosis-and-the-risk-of-progression-a-retrospective-italian-cohort-study-from-2001-to-2015
#15
Marcello Moccia, Raffaele Palladino, Roberta Lanzillo, Antonio Carotenuto, Cinzia Valeria Russo, Maria Triassi, Vincenzo Brescia Morra
BACKGROUND: Disease modifying treatments (DMTs) are the main responsible for direct medical costs in multiple sclerosis (MS). The current investigation aims at evaluating possible associations between healthcare costs for treating relapsing remitting MS (RRMS) and disease evolution. METHODS: The present cohort study retrospectively included 544 newly diagnosed RRMS patients, prospectively followed up for 10.1±3.3 years. Costs for DMT administration and management were calculated for each year of observation...
2017: PloS One
https://www.readbyqxmd.com/read/28053511/the-state-of-multiple-sclerosis-current-insight-into-the-patient-health-care-provider-relationship-treatment-challenges-and-satisfaction
#16
Mar Tintoré, Maggie Alexander, Kathleen Costello, Martin Duddy, David E Jones, Nancy Law, Gilmore O'Neill, Antonio Uccelli, Robert Weissert, Sibyl Wray
BACKGROUND: Managing multiple sclerosis (MS) treatment presents challenges for both patients and health care professionals. Effective communication between patients with MS and their neurologist is important for improving clinical outcomes and quality of life. METHODS: A closed-ended online market research survey was used to assess the current state of MS care from the perspective of both patients with MS (≥18 years of age) and neurologists who treat MS from Europe and the US and to gain insight into perceptions of treatment expectations/goals, treatment decisions, treatment challenges, communication, and satisfaction with care, based on current clinical practice...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28045953/double-blind-controlled-randomized-trial-of-cyclophosphamide-versus-methylprednisolone-in-secondary-progressive-multiple-sclerosis
#17
Bruno Brochet, Mathilde S A Deloire, Paul Perez, Timothé Loock, Louise Baschet, Marc Debouverie, Sophie Pittion, Jean-Christophe Ouallet, Pierre Clavelou, Jérôme de Sèze, Nicolas Collongues, Patrick Vermersch, Hélène Zéphir, Giovanni Castelnovo, Pierre Labauge, Christine Lebrun, Mikael Cohen, Aurélie Ruet
BACKGROUND: Therapeutic options are limited in secondary progressive multiple sclerosis (SPMS). Open-label studies suggested efficacy of monthly IV cyclophosphamide (CPM) without induction for delaying progression but no randomized trial was conducted so far. OBJECTIVE: To compare CPM to methylprednisolone (MP) in SPMS. METHODS: Randomized, double-blind clinical trial on two parallel groups. Patient with SPMS, with a documented worsening of the Expanded Disability Status Scale (EDSS) score during the last year and an EDSS score between 4·0 and 6·5 were recruited and received one intravenous infusion of treatment (CPM: 750 mg /m2 body surface area-MP: 1g) every four weeks for one year, and every eight weeks for the second year...
2017: PloS One
https://www.readbyqxmd.com/read/28036121/study-of-the-anti-jcv-antibody-levels-in-a-spanish-multiple-sclerosis-cohort
#18
María I Dominguez-Mozo, Macarena Rus, Jose L Santiago, Guillermo Izquierdo, Ignacio Casanova, Victoria Galan, M Angel Garcia-Martinez, Ana M Arias-Leal, Marta García-Montojo, Silvia Pérez-Pérez, Rafael Arroyo, Roberto Alvarez-Lafuente
One of the risk factor to develop progressive multifocal leukoencephalopathy (PML) among natalizumab-treated patients is the presence and high levels of anti-JCV antibodies. Our purpose was to test the association of different clinical and demographic variables with the presence and levels of anti-JCV antibodies in a Spanish cohort of multiple sclerosis (MS) patients during natalizumab treatment MATERIALS AND METHODS: All MS patients from two hospitals with at least one measure of the anti-JCV antibodies levels (2011-2014) were recruited, among them two PML cases...
December 30, 2016: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28034466/modulation-of-host-immune-responses-following-non-hematopoietic-stem-cell-transplantation-translational-implications-in-progressive-multiple-sclerosis
#19
REVIEW
Giulio Volpe, Joshua D Bernstock, Luca Peruzzotti-Jametti, Stefano Pluchino
There exists an urgent need for effective treatments for those patients suffering from chronic/progressive multiple sclerosis (MS). Accordingly, it has become readily apparent that different classes of stem cell-based therapies must be explored at both the basic science and clinical levels. Herein, we provide an overview of the basic mechanisms underlying the pre-clinical benefits of exogenously delivered non-hematopoietic stem cells (nHSCs) in animal models of MS. Further, we highlight a number of early clinical trials in which nHSCs have been used to treat MS...
December 15, 2016: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/28027680/comparative-effectiveness-of-interferons-in-relapsing-remitting-multiple-sclerosis-a-meta-analysis-of-real-world-studies
#20
Thomas R Einarson, Basil G Bereza, Márcio Machado
BACKGROUND: Differences between interferons have been evaluated for over 20 years. While RCT data are mainly used for assessments and strong data for causal inferences, they do not necessarily reflect everyday practice. Real-world data may provide additional information. PURPOSE: To assess the results, quality, and representativeness of observational studies directly comparing IFNs in RRMS. METHODS: Medline and Embase were searched for observational studies comparing IFN-beta-1a 30 mcg IM (Avonex), IFN-beta-1a 44 mcg SC (Rebif) and/or IFN-beta-1b 250 mcg SC (Betaseron)...
December 27, 2016: Current Medical Research and Opinion
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