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Relapsing MS

Moudi Al-Nashmi, Safa Taha, Abdel Halim Salem, Isa Alsharoqi, Moiz Bakhiet
Multiple sclerosis (MS) has become prevalent in the Arabian Gulf area with high incidence in Bahrain due to environmental influences and genetic susceptibilities, but there is a lack of study into human leukocyte antigen (HLA) types in patients with MS in Bahrain. The present study aimed to study the HLA types expressed in MS patients compared with in control subjects. Blood samples from 50 Bahraini patients with MS and 50 Bahraini control subjects' were subjected to HLA tissue typing by polymerase chain reaction using sequence-specific primers...
December 2018: Biomedical Reports
Insun Chong, Kevin Yuqi Wang, Christie M Lincoln
Fingolimod is an oral medication approved by the Food and Drug Administration in 2009 for the treatment of relapsing remitting multiple sclerosis (RRMS). Initial clinical trials did not show a significantly increased rate of serious infections with fingolimod therapy. However, a mildly increased risk of less serious infections, such as varicella zoster virus and herpes simplex virus, was reported. Recently, however, several instances of serious opportunistic infections have been reported. In the years following approval of fingolimod for use in multiple sclerosis (MS), seven cases of cryptococcal meningitis in patients undergoing treatment have been described in the literature...
November 14, 2018: Clinical Imaging
Kenneth E Bujold, Smita Dandekar, Mustafa Barbour
Relapsed acute myeloid leukemia presenting as an isolated central nervous system myeloid sarcoma (CNS MS) is very rare and generally entails poor outcomes. CNS MS treatment is not well defined and can include systemic chemotherapy, intrathecal chemotherapy, radiation therapy, or hematopoietic stem cell transplant. Thiotepa, vinorelbine, topotecan, and clofarabine (TVTC) has been successful for reinduction therapy in relapsed/refractory leukemia to induce remission before hematopoietic stem cell transplant. There is no published evidence of TVTC being utilized for CNS MS...
December 12, 2018: Journal of Pediatric Hematology/oncology
Patrizia LoPresti
Central nervous system (CNS) degeneration occurs during multiple sclerosis (MS) following several years of reversible autoimmune demyelination. Progressive CNS degeneration appears later during the course of relapsing-remitting MS (RRMS), although it starts insidiously at disease onset. We propose that there is an early subclinical phase also for primary-progressive (PP) MS. Consensus exists that many different cell types are involved during disease onset. Furthermore, the response to the initial damage, which is specific for each individual, would result in distinct pathological pathways that add complexity to the disease and the mechanisms underlying progressive CNS degeneration...
2018: Frontiers in Neurology
Fang F Yu, Florence L Chiang, Nicholas Stephens, Susie Y Huang, Berkin Bilgic, Bundhit Tantiwongkosi, Rebecca Romero
PURPOSE: Quantitative susceptibility mapping (QSM) is influenced by iron as well as myelin, which makes interpretation of pathologic changes challenging. Concurrent acquisition of MR sequences that are sensitive to axonal/myelin integrity, such as diffusion tensor imaging (DTI), may provide context for interpreting quantitative susceptibility (QS) signal. The purpose of our study was to investigate alterations in normal-appearing white matter (NAWM) in multiple sclerosis (MS) using QSM in conjunction with DTI...
December 12, 2018: Neuroradiology
Bassem I Yamout, Nabil K El-Ayoubi, Johny Nicolas, Yehya El Kouzi, Samia J Khoury, Maya M Zeineddine
Objective: To evaluate the efficacy and safety of rituximab in multiple sclerosis in a clinical practice setting. Methods: Clinical data for all adult patients with multiple sclerosis (MS) treated with off-label rituximab at a single MS center in Lebanon between March 2008 and April 2017 were retrospectively collected from medical charts. The main efficacy outcomes assessed were annualized relapse rate (ARR) and proportion of patients free from relapses, disability progression, or magnetic resonance imaging (MRI) activity...
2018: Journal of Immunology Research
John J Moore, Jennifer C Massey, Carole D Ford, Melissa L Khoo, John J Zaunders, Kevin Hendrawan, Yael Barnett, Michael H Barnett, Kain A Kyle, Robert Zivadinov, Kris C Ma, Sam T Milliken, Ian J Sutton, David D F Ma
BACKGROUND: Autologous haematopoietic stem cell transplantation (AHSCT) has been explored as a therapeutic intervention in multiple sclerosis (MS) over the last two decades; however, prospective clinical trials of the most common myeloablative conditioning regimen, BEAM, are limited. Furthermore, patient selection, optimal chemotherapeutic regimen and immunological changes associated with disease response require ongoing exploration. We present the outcomes, safety and immune reconstitution (IR) of patients with active, treatment refractory MS...
December 11, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
Bahare Laribi, Mohammad Ali Sahraian, Mehdi Shekarabi, Rahimeh Emamnejad, Mohsen Marzban, Shokufeh Sadaghiani, Maryam Izad
Fingolimod is a novel immunomodulatory drug used in patients with relapsing multiple sclerosis (MS) which reversibly inhibits egress of lymphocytes from lymph nodes. In this longitudinal study, the frequency of Interferon- gamma (IFN-γ)+, IL4+, IL17+ and IL10+ CD4+ and CD8+ T cell subsets were measured in Fingolimod treated patients before and after 12 months'(12M) therapy using flow cytometry and compared to those of naive, Betaferon treated MS patients and healthy individuals. Additionally, the level of transcription factor IRF4 and IL-6, IL-23, TGF-β1 cytokines, required for differentiation of IL-17+ T cells, were assessed by RT-PCR and ELISA, respectively...
August 12, 2018: Iranian Journal of Allergy, Asthma, and Immunology
Jennifer E Hibma, Hagop M Kantarjian, Daniel J DeAngelo, Joseph P Boni
AIM: To characterize the effect of inotuzumab ozogamicin on QT interval in patients with B-cell malignancies. METHODS: Data were pooled from three clinical studies including 250 patients (N=2743) who received inotuzumab ozogamicin monotherapy. Patients with relapsed/refractory acute lymphoblastic leukaemia (NCT01564784 and NCT01363297) received 1.8 mg m-2 per cycle in divided doses (mean Cmax 371 ng ml-1 ; considered therapeutic) and patients with relapsed/refractory non-Hodgkin lymphoma (NCT00868608) received 1...
December 8, 2018: British Journal of Clinical Pharmacology
Jeremy Hobart, Tjalf Ziemssen, Peter Feys, Michael Linnebank, Andrew D Goodman, Rachel Farrell, Raymond Hupperts, Andrew R Blight, Veronica Englishby, Manjit McNeill, Ih Chang, Gabriel Lima, Jacob Elkins
BACKGROUND: Walking impairment is a hallmark of multiple sclerosis (MS). It affects > 90% of individuals over time, reducing independence and negatively impacting health-related quality of life, productivity, and daily activities. Walking impairment is consistently reported as one of the most distressing impairments by individuals with MS. Prolonged-release (PR)-fampridine previously has been shown to improve objectively measured walking speed in walking-impaired adults with MS...
December 10, 2018: CNS Drugs
Fangfang Ge, Hong Lin, Zhuyi Li, Ting Chang
BACKGROUND: Autologous hematopoietic stem-cell transplantation (AHSCT) has been utilized as a treatment option for multiple sclerosis (MS) since 1995. However, this procedure has not been widely implemented in clinical practice owing to its mortality risk. Here, we conduct a meta-analysis to evaluate the long-term efficacy and safety of AHSCT in MS treatment, aiming to optimize the benefit/risk ratio of this therapeutic strategy. METHODS: We searched the PubMed Web site and clinicaltrials...
December 10, 2018: Neurological Sciences
Johanna Balslev Andersen, Julie Yoon Moberg, Tim Spelman, Melinda Magyari
Background: The majority of persons diagnosed with multiple sclerosis (MS) experience their first MS symptoms in the reproductive age. Teriflunomide (TFL, Aubagio), was first released in Denmark for relapsing-remitting MS in December 2013. TFL treatment is contraindicated in women of childbearing potential who are not using reliable contraception. TFL can be transmitted via semen and a low risk of male-mediated embryo-fetal toxicity is described. Objective: To report pregnancy outcomes of TFL-treated women and partners to TFL-treated men: gestation week...
2018: Frontiers in Immunology
Maciej Juryńczyk, Anu Jacob, Kazuo Fujihara, Jacqueline Palace
The field of central nervous system (CNS) inflammatory diseases has recently broadened to include a new condition associated with pathogenic serum antibodies against myelin oligodendrocyte glycoprotein (MOG). This is distinct from multiple sclerosis (MS) and aquaporin-4 (AQP4) antibody neuromyelitis optica spectrum disorders (NMOSD). MOG antibody-associated disease phenotypes are varied and range from classical neuromyelitis optica to acute demyelinating encephalomyelitis and cortical encephalitis. The diagnosis depends on using a reliable, specific and sensitive assay of the antibody...
December 8, 2018: Practical Neurology
Farren B S Briggs, Justin C Yu, Mary F Davis, Jinghong Jiangyang, Shannon Fu, Erica Parrotta, Douglas D Gunzler, Daniel Ontaneda
BACKGROUND: The phenotypic presentation of multiple sclerosis (MS) may predict long-term outcomes and little is known about factors contributing to heterogeneity at MS onset. Given temporality, it is likely MS risk factors also influence presentation of the disease near onset. METHODS: Using a retrospective cross-sectional study of MS cases, we investigated: age of onset (AOO), number of impaired functional domains (NIFDs), time to second relapse (TT2R), and early relapse activity (ERA)...
December 4, 2018: Multiple Sclerosis and related Disorders
James S Krause, Clara E Dismuke-Greer, Melinda Jarnecke, Chao Li, Karla S Reed, Phillip Rumrill
OBJECTIVE: To identify demographic, educational, and disease-related characteristics associated with the odds of employment and earnings among participants with multiple sclerosis (MS). DESIGN: Cross-sectional using self-report assessment obtained by mail or online SETTING: Medical University in the southeastern United States. PARTICIPANT: Participants with MS (n = 1059) were enrolled from a specialty hospital in the southeastern United States...
December 6, 2018: Archives of Physical Medicine and Rehabilitation
Maxi Kaufmann, Rocco Haase, Undine Proschmann, Tjalf Ziemssen, Katja Akgün
Objective: Fingolimod is approved for the treatment of highly active relapsing remitting multiple sclerosis (MS) patients and acts by its unique mechanism of action via sphingosine-1-phosphate receptor-modulation. Although fingolimod-associated lymphopenia is a well-known phenomenon, the exact cause for the intra- and inter-individual differences of the fluctuation of lymphocyte count and its subtypes is still subject of debate. In this analysis, we aim to estimate the significance of the individual variation of distinct lymphocyte subsets for differences in absolute lymphocyte decrease in fingolimod treated patients and discuss how different lymphocyte subset patterns are related to clinical presentation in a long-term real life setting...
2018: Frontiers in Immunology
Danielle Bernardes, Alexandre Leite Rodrigues de Oliveira
Background: Although it has been suggested that healthier lifestyle may optimize effects of the immunomodulation drugs for treating multiple sclerosis (MS), the knowledge regarding this kind of interactions is limited. Objective: The aim of the present study was to investigate the effects of treadmill exercise in combination with pharmacological treatment in an animal model for MS. Methods: C57BL/6J female mice were subjected to daily treadmill exercise for 4 weeks before immunization and 6 weeks before clinical presentation of disease...
2018: Frontiers in Neurology
Evelyn Walter, Thomas Berger, Barbara Bajer-Kornek, Florian Deisenhammer
BACKGROUND: Multiple sclerosis (MS), a chronic progressive, demyelinating, inflammatory disease, affects 2.5 million people worldwide. Approximately 63% of cases are classified as relapsing-remitting MS (RRMS) at the time of diagnosis. The aim of this cost-utility analysis is to evaluate alemtuzumab versus interferon beta (intramuscular [IM] interferon beta-1a, subcutaneous [SC] interferon beta-1a, SC interferon beta-1b, and SC pegylated interferon beta-1a) in previously treated and versus SC interferon beta-1a, fingolimod, and natalizumab in untreated RRMS patients to determine the incremental cost-effectiveness ratio among the treatment alternatives as prices, the route, and the frequency of administration of considered products vary significantly...
December 7, 2018: Journal of Medical Economics
Laura Dumitrescu, Cris S Constantinescu, Radu Tanasescu
Multiple sclerosis (MS) is a chronic central nervous system immune-mediated disease with an important inflammatory component associated with focal demyelination and widespread neurodegeneration. In most cases, the clinical presentation is relapsing-remitting, followed by a secondary progressive phase, characterized by disability accrual unrelated to relapses. In a minority, the phenotype is progressive from the beginning. Major therapeutic achievements have been made concerning the relapsing phase but modifying the evolution of progressive MS remains an unmet need...
December 5, 2018: Expert Opinion on Pharmacotherapy
E D'Amico, A Zanghì, M Sciandra, G Borriello, G Callari, A Gallo, G Salemi, S Cottone, M Buccafusca, P Valentino, R B Bossio, L M E Grimaldi, C Pozzilli, G Tedeschi, M Zappia, F Patti
BACKGROUND: Teriflunomide (TRF) and Dimethyl fumarate (DMF) are licensed drugs for relapsing-remitting Multiple Sclerosis (RRMS). OBJECTIVES: We aimed to compare the rate and the time to discontinuation among persons with RRMS (pwRRMS), newly treated with TRF and DMF. MATERIALS AND METHODS: A retrospective study on prospectively collected data was performed in nine tertiary MS centers, in Italy. The 24-month discontinuation rate in the two cohorts was the primary study outcome...
December 4, 2018: Journal of Neurology
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