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Relapsing MS

Lyndell L Lim, Diego G Silva, Tiffany C Lo, Ronald S Pimentel, Helmut Butzkueven, Anthony J Hall
OBJECTIVE: To determine the incidence and prevalence of uveitis and its effect on multiple sclerosis (MS) disease activity and outcomes in patients with MS who participated in the fingolimod clinical trial program. DESIGN: Analysis of pooled data (N = 27 528) from patients enrolled in fingolimod clinical studies and their extensions. Patients were stratified into four cohorts based on the history of uveitis at baseline and uveitis events during the observation period: no history and no uveitis events ('no uveitis'); history and no uveitis events ('history'); no history and uveitis events ('first event'); history and uveitis events ('recurrent event')...
October 10, 2018: Ophthalmology
Mar Tintore, Angela Vidal-Jordana, Jaume Sastre-Garriga
The modern era of multiple sclerosis (MS) treatment began 25 years ago, with the approval of IFNβ and glatiramer acetate for the treatment of relapsing-remitting MS. Ten years later, the first monoclonal antibody, natalizumab, was approved, followed by a third important landmark with the introduction of oral medications, initially fingolimod and then teriflunomide, dimethyl fumarate and cladribine. Concomitantly, new monoclonal antibodies (alemtuzumab and ocrelizumab) have been developed and approved. The modern era of MS therapy reached primary progressive MS in 2018, with the approval of ocrelizumab...
October 12, 2018: Nature Reviews. Neurology
Shukoofeh Torabi, Mona Tamaddon, Mojtaba Asadolahi, Gelareh Shokri, Rezvan Tavakoli, Nooshin Tasharrofi, Reza Rezaei, Vahid Tavakolpour, Hossein Sazegar, Fatemeh Kouhkan
MicroRNA-455-5p (miR-455-5p) seems to have an anti-inflammatory role in the immune system since its expression is induced by IL-10 cytokine. Multiple sclerosis (MS) is a chronic demyelinating neurodegenerative disease of the central nervous system that is caused by an autoimmune inflammatory attack against the myelin insulation of neurons. The expression level of miR-455-5p and its role in MS pathogenesis has yet to be elucidated. We found that miR-455-5p expression was highly correlated with disease severity in MS patients...
October 11, 2018: Immunogenetics
Julio Plata-Bello, Yaiza Pérez-Martín, Abril Castañón-Pérez, Cristián Modroño, Estefanía Hernández-Martín, Montserrat González-Platas, Francisco Marcano, José Luis González-Mora
The study of the relationship between function and structure of the brain could be particularly interesting in neurodegenerative diseases like multiple sclerosis (MS). The aim of the present work is to identify differences of the amplitude of low frequency fluctuations (ALFF) in the mirror neuron system (MNS) between MS patients and healthy controls and to study the relationship between ALFF and the gray matter volume (GMV) of the regions that belong to the MNS. Relapsing-remitting MS patients with minor disability were compared to healthy controls (HC) using resting-state functional magnetic resonance imaging (fMRI), anatomic T1 weighted images and diffusion tensor imaging (DTI)...
December 2018: IBRO Reports
Agnese Gugliandolo, Federica Longo, Maria Giovanna Marrosu, Giovanni Luigi Mancardi, Ilaria Gandoglia, Maurizio Melis, Fabrizio Lo Giudice, Placido Bramanti, Emanuela Mazzon
Purpose: We performed a pharmacovigilance study of 10 drugs used in patients with relapsing-remitting multiple sclerosis (RR-MS). Our aim was to provide an overview of the safety of these drugs by the evaluation of reported expected and unexpected adverse reactions. Patients and methods: We collected and analyzed adverse drug reactions from RR-MS patients belonging to four hospitals in three Italian regions, for a period of 24 months. Results: We received a total of 411 adverse reactions, of which 84...
2018: Therapeutics and Clinical Risk Management
Jonas Graf, Marius Ringelstein, Klaudia Lepka, Jörg Schaller, Helmut Quack, Hans-Peter Hartung, Orhan Aktas, Philipp Albrecht
BACKGROUND: Understanding the long-term effect of alemtuzumab on the immune system of multiple sclerosis (MS) patients is crucial. OBJECTIVE: To report a case of acute sarcoidosis (Löfgren's syndrome) in a relapsing-remitting MS patient, 1.5 years after the second course of alemtuzumab treatment. CASE REPORT: Sarcoidosis was confirmed dermatohistologically, radiologically, and serologically. Analysis of the lymphocyte subpopulations showed a persistent effect of alemtuzumab treatment (CD4/CD8 ratio increased, absolute lymphocyte count of CD19-positive cells increased while CD3/4/8-positive cells were decreased)...
October 11, 2018: Multiple Sclerosis: Clinical and Laboratory Research
Elizabeth A Mills, Joel A Begay, Caitlyn Fisher, Yang Mao-Draayer
Clinically effective immunomodulatory therapies have been developed for relapsing-remitting multiple sclerosis (RRMS), but they have generally not translated to a corresponding slowing of disability accumulation in progressive forms of multiple sclerosis (MS). Since disability is multifaceted, progressive patients are heterogeneous, and the drivers of disease progression are still unclear, it has been difficult to identify the most informative outcome measures for progressive trials. Historically, secondary outcome measures have focused on inflammatory measures, which contributed to the recent identification of immunomodulatory therapies benefiting younger patients with more inflammatory progressive MS...
October 10, 2018: Multiple Sclerosis: Clinical and Laboratory Research
Rosalind Kalb, Meghan Beier, Ralph Hb Benedict, Leigh Charvet, Kathleen Costello, Anthony Feinstein, Jeffrey Gingold, Yael Goverover, June Halper, Colleen Harris, Lori Kostich, Lauren Krupp, Ellen Lathi, Nicholas LaRocca, Ben Thrower, John DeLuca
PURPOSE: To promote understanding of cognitive impairment in multiple sclerosis (MS), recommend optimal screening, monitoring, and treatment strategies, and address barriers to optimal management. METHODS: The National MS Society ("Society") convened experts in cognitive dysfunction (clinicians, researchers, and lay people with MS) to review the published literature, reach consensus on optimal strategies for screening, monitoring, and treating cognitive changes, and propose strategies to address barriers to optimal care...
October 10, 2018: Multiple Sclerosis: Clinical and Laboratory Research
Markus Bock, Mirjam Karber, Hartmut Kuhn
BACKGROUND: Adapted ketogenic diet (AKD) and caloric restriction (CR) have been suggested as alternative therapeutic strategies for inflammatory, hyperproliferative and neurodegenerative diseases. Pro-inflammatory eicosanoids have been implicated in the pathogenesis of multiple sclerosis since they augment vascular permeability and induce leukocyte migration into the brain. We explored the impact of ketogenic diets on gene expression of biosynthetic enzymes for pro- (ALOX5, COX1, COX2) and anti-inflammatory (ALOX15) eicosanoids in patients with relapsing-remitting multiple sclerosis...
October 3, 2018: EBioMedicine
Sasan Andalib, Mahnaz Talebi, Ebrahim Sakhinia, Mehdi Farhoudi, Homayoun Sadeghi-Bazargani, Nooshin Masoudian, Tanja M Michel, Manouchehr Seyedi Vafaee, Albert Gjedde
BACKGROUND: Modern genetics has offered a fresh perspective on the pathology of Multiple Sclerosis (MS). As mitochondrial DNA (mtDNA) variations are held to be potential contributors to the complex pathobiology of MS, the present study tests the claim that mtDNA G15927A or G15928A variations, or both, are associated with MS in an Iranian population. MATERIALS AND METHODS: Following DNA extraction from blood samples of 100 subjects with relapsing-remitting MS, and 100 healthy unrelated control subjects, PCR-RFLP analyses was carried out by HpaII restriction enzyme reaction...
September 7, 2018: Multiple Sclerosis and related Disorders
Sibyl Wray, Eva Havrdova, David R Snydman, Douglas L Arnold, Jeffrey A Cohen, Alasdair J Coles, Hans-Peter Hartung, Krzysztof W Selmaj, Howard L Weiner, Nadia Daizadeh, David H Margolin, Madalina C Chirieac, D Alastair S Compston
BACKGROUND: Reduced MS disease activity with alemtuzumab versus subcutaneous interferon beta-1a (SC IFNB-1a) in core phase 2/3 studies was accompanied by increased incidence of infections that were mainly nonserious and responsive to treatment. Alemtuzumab efficacy was durable over 6 years. OBJECTIVE: To evaluate infections over 6 years in alemtuzumab-treated patients. METHODS: Three randomized trials (CAMMS223, Comparison of Alemtuzumab and Rebif Efficacy in Multiple Sclerosis (CARE-MS) I, and CARE-MS II) compared two courses of alemtuzumab 12 mg with SC IFNB-1a 44 μg in patients with active relapsing-remitting MS...
October 5, 2018: Multiple Sclerosis: Clinical and Laboratory Research
A Abdelhak, A Huss, J Kassubek, H Tumani, M Otto
While neurofilament light chain (NfL) measurement in serum is a well-established marker of neuroaxonal damage in multiple sclerosis (MS), data on astroglial markers in serum are missing. In our study, glial fibrillary acid protein (GFAP) and NfL were measured in cerebrospinal fluid (CSF) and serum of MS patients and patients with other non-inflammatory neurological diseases (OND) using the Simoa technology. Clinical data like age, gender, expanded disability status scale (EDSS) and MRI findings were correlated to neurochemical markers...
October 4, 2018: Scientific Reports
R R Mattay, K Davtyan, M Bilello, A C Mamourian
BACKGROUND AND PURPOSE: Patients with multiple sclerosis routinely have MR imaging with contrast every 6-12 months to assess response to medication. Multiple recent studies provide evidence of tissue deposition of MR imaging contrast agents, questioning the long-term safety of these agents. The goal of this retrospective image-analysis study was to determine whether contrast could be reserved for only those patients who show new MS lesions on follow-up examinations. MATERIALS AND METHODS: We retrospectively reviewed brain MRIs of 138 patients...
October 4, 2018: AJNR. American Journal of Neuroradiology
H Reginald McDaniel, Christopher LaGanke, Laura Bloom, Sharon Goldberg, Lucas C Lages, Laura A Lantigua, Steven E Atlas, Judi M Woolger, John E Lewis
Multiple sclerosis (MS) is a progressive neurodegenerative disease associated with increased infection rates, chronic inflammation, and premature death. Optimization of nutritional status via dietary supplementation may improve immune function in people suffering from MS and lead to decreased rates of infection. Fifteen individuals with a diagnosis of relapsing-remitting MS for an average of 12.4 years (SD =7.4; R = 2, 25) were enrolled in a one-year open-label clinical trial. Participants consumed a broad-spectrum dietary supplement regimen containing polysaccharides, phytochemicals, antioxidants, vitamins, and minerals three times per day...
October 4, 2018: Journal of Dietary Supplements
Laurie McLaughlin, Laura Clarke, Elham Khalilidehkordi, Helmut Butzkueven, Bruce Taylor, Simon A Broadley
OBJECTIVE: There is an association between latitude, relative vitamin D deficiency and risk of multiple sclerosis (MS), and an association between vitamin D and disease progression. We have performed a meta-analysis with the aim of investigating the role of therapeutic vitamin D in MS. METHODS: A systematic search of databases was performed to identify clinical trials assessing vitamin D in patients with relapsing-remitting MS. Studies were selected based on inclusion and exclusion criteria...
October 3, 2018: Journal of Neurology
Arie R Gafson, Kicheol Kim, Maria T Cencioni, Wim van Hecke, Richard Nicholas, Sergio E Baranzini, Paul M Matthews
Objective: To identify short-term changes in gene expression in peripheral blood mononuclear cells (PBMCs) associated with treatment response to dimethyl fumarate (DMF, Tecfidera) in patients with relapsing-remitting MS (RRMS). Methods: Blood samples were collected from 24 patients with RRMS (median Expanded Disability Status Scale score, 2.0; range 1-7) at baseline, 6 weeks, and 15 months after the initiation of treatment with DMF (BG-12; Tecfidera). Seven healthy controls were also recruited, and blood samples were collected over the same time intervals...
July 2018: Neurology® Neuroimmunology & Neuroinflammation
Patricia K Coyle, Bhupendra Khatri, Keith R Edwards, José E Meca-Lallana, Steve Cavalier, Pascal Rufi, Myriam Benamor, Karthinathan Thangavelu, Miqun Robinson, Ralf Gold
BACKGROUND: Patient-reported outcomes (PROs) can assist clinicians in understanding the impact of disease-modifying therapy (DMT) on the daily lives of patients with multiple sclerosis (MS). With an increased number of DMTs becoming available, patients are now switching treatments more frequently in clinical practice. The effects of switching DMTs on a patient's daily life and their disease course may be reflected in PROs. The global, multicenter, open-label, phase 4 Teri-PRO study (NCT01895335), which was conducted in routine clinical practice, previously showed statistically and clinically significant increases in patient-reported treatment satisfaction in patients switching to teriflunomide from other DMTs...
September 15, 2018: Multiple Sclerosis and related Disorders
A Carotenuto, T Costabile, M Moccia, F Falco, M R Scala, C V Russo, F Saccà, A De Rosa, R Lanzillo, V Brescia Morra
BACKGROUND: Both cognition and olfaction are impaired in multiple sclerosis (MS). However, little is known about the relationship between smell identification ability and measures of cognitive function in this disease. OBJECTIVE: To assess olfactory function in MS and to evaluate its relationship with cognitive and physical disability. METHODS: Fifty-five MS patients and 20 healthy controls (HCs) were tested. The University of Pennsylvania smell identification test (UPSIT) was administered to assess olfactory function...
September 22, 2018: Multiple Sclerosis and related Disorders
David Kremer, Rainer Akkermann, Patrick Küry, Ranjan Dutta
Current multiple sclerosis (MS) therapies are effective in reducing relapse rate, short-term measures of disability, and magnetic resonance imaging (MRI) measures of inflammation in relapsing remitting MS (RRMS), whereas in progressive/degenerative disease phases these medications are of little or no benefit. Therefore, the development of new therapies aimed at reversing neurodegeneration is of great interest. Remyelination, which is usually a spontaneous endogenous process, is achieved when myelin-producing oligodendrocytes are generated from oligodendrocyte precursor cells (OPCs)...
October 1, 2018: Multiple Sclerosis: Clinical and Laboratory Research
H Assadeck, M Toudou Daouda, É Adehossi Omar, Z Mamadou, F Hassane Djibo, D Douma Maiga
BACKGROUND: In sub-Saharan Africa (SSA), few studies have been reported on inflammatory demyelinating diseases of the central nervous system (CNS). Neuromyelitis optica spectrum disorders (NMOSD) seems to be the most frequent inflammatory demyelinating disease of CNS in sub-Saharan Africans or people of sub-Saharan African descent. METHODS: We report the observations of seven patients from Niger diagnosed with inflammatory demyelinating diseases of CNS over a period of 21 years (1996-2017)...
September 27, 2018: Revue Neurologique
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