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Multiple Sclerosis

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591 papers 25 to 100 followers
By Alexandros Tsichlakis Medical representative
Louisa von Baumgarten, Gerald Illerhaus, Agnieszka Korfel, Uwe Schlegel, Martina Deckert, Martin Dreyling
BACKGROUND: Primary central nervous system lymphoma is a diffuse large B-celllymphoma with exclusive manifestation in the central nervous system (CNS), leptomeninges, and eyes. Its incidence is 0.5 per 100 000 persons per year.Currently, no evidence-based standard of care exists. METHODS: This review is based on pertinent publications (2000-2017) retrieved by aselective search in PubMed. RESULTS: The clinical and neuroradiological presentation of primary CNS lymphoma isoften nonspecific, and histopathological confirmation is obligatory...
June 22, 2018: Deutsches Ärzteblatt International
Robert Hermann, Mats O Karlsson, Ana M Novakovic, Nadia Terranova, Markus Fluck, Alain Munafo
Cladribine Tablets (MAVENCLAD® ) are used to treat relapsing multiple sclerosis (MS). The recommended dose is 3.5 mg/kg, consisting of 2 annual courses, each comprising 2 treatment weeks 1 month apart. We reviewed the clinical pharmacology of Cladribine Tablets in patients with MS, including pharmacokinetic and pharmacometric data. Cladribine Tablets are rapidly absorbed, with a median time to reach maximum concentration (Tmax ) of 0.5 h (range 0.5-1.5 h) in fasted patients. When administered with food, absorption is delayed (median Tmax 1...
July 10, 2018: Clinical Pharmacokinetics
Nadia Terranova, Christine Hicking, Fernando Dangond, Alain Munafo
INTRODUCTION: Cladribine Tablets (MAVENCLAD® ) selectively reduce absolute lymphocyte counts (ALCs) in patients with multiple sclerosis. The recommended cumulative dose of Cladribine Tablets is 3.5 mg/kg over 4-5 days in months 1 and 2 of treatment years 1 and 2, followed by prolonged efficacy with no additional treatment. After the cladribine-induced reduction, ALCs recover to normal within each treatment year in most patients. Those patients with slow ALC recovery can develop Grade 3-4 lymphopenia, especially those patients with Grade ≥  2 lymphopenia at the start of year 2...
July 11, 2018: Clinical Pharmacokinetics
Karen Schreiber, Matthias Kant, Claudia Pfleger, Henrik Boye Jensen, Ole Oesterberg, Anne Rieper Hald, Frederik K Nielsen, Sune Rubak
Purpose: Treatment adherence is a prerequisite for treatment success and therefore an important consideration to assure that therapeutic goals are achieved both from a patient point of view and for optimal health care resource utilization. Published data on treatment adherence with fingolimod (Gilenya® ) are limited. Therefore, this study investigated treatment adherence in patients with relapsing-remitting multiple sclerosis (RRMS) treated with fingolimod in Denmark. Patients and methods: This was a 24-month, multicenter, open-label study, investigating treatment adherence, satisfaction, motivation, and health-related quality of life (QoL) in RRMS patients treated with fingolimod...
2018: Patient Preference and Adherence
Veria Vacchiano, Nicola Frattaruolo, Luca Mancinelli, Matteo Foschi, Antonio Carotenuto, Cinzia Scandellari, Maurizio Piattelli, Vincenzo Brescia Morra, Alessandra Lugaresi
BACKGROUND: Teriflunomide is a once-daily oral immunomodulator approved for the treatment of relapsing-remitting multiple sclerosis (RRMS) with a consistent safety profile in clinical trials. We report three cases of multiple teeth loss during teriflunomide treatment. CASE REPORTS: Case 1: a 39 year-old woman started teriflunomide for RRMS, switching from interferon beta. Four months later she complained about mandibular pain followed by the sudden loss of 4 teeth, in the absence of bleeding or trauma...
June 30, 2018: Multiple Sclerosis and related Disorders
Hiroaki Yokote, Tomoyuki Kamata, Shuta Toru, Nobuo Sanjo, Takanori Yokota
No evidence of disease activity-3 (NEDA-3), defined as absence of clinical relapse, disability progression, and brain magnetic resonance imaging (MRI) activity, has emerged as the therapeutic target of disease-modifying therapy for multiple sclerosis (MS). However, recent studies have revealed that NEDA-3 might not be sufficient to prevent cognitive deterioration and predict long-term disability. In addition to NEDA-3, brain atrophy has recently been recognized as a pivotal biomarker that is closely associated to disability in patients with MS...
July 4, 2018: Neurological Sciences
Yasuo Oshima, Tetsuya Tanimoto, Koichiro Yuji, Arinobu Tojo
OBJECTIVE: To investigate characteristics of multifocal leukoencephalopathy (PML) in multiple sclerosis (MS) patients associated with drugs other than natalizumab since our experience in other disease-modifying drugs (DMD) is still limited. METHODS: This is a descriptive observational study within the FAERS database, registered between July 2015 and June 2017. RESULTS: The primary cohort for the analysis consisted of 100,921 MS patients (mean (standard deviation (sd)) age, 48...
July 1, 2018: Multiple Sclerosis: Clinical and Laboratory Research
Floriana De Angelis, Domenico Plantone, Jeremy Chataway
Multiple sclerosis is an immune-mediated inflammatory disease of the central nervous system characterised by demyelination, neuroaxonal loss and a heterogeneous clinical course. Multiple sclerosis presents with different phenotypes, most commonly a relapsing-remitting course and, less frequently, a progressive accumulation of disability from disease onset (primary progressive multiple sclerosis). The majority of people with relapsing-remitting multiple sclerosis, after a variable time, switch to a stage characterised by gradual neurological worsening known as secondary progressive multiple sclerosis...
July 3, 2018: CNS Drugs
E Le Page, G Edan
The concept of induction followed by a long-term maintenance treatment has attracted much attention for the treatment of multiple sclerosis over the 30 past years. It was first demonstrated by the combination of induction therapy with mitoxantrone (six-monthly courses) followed by maintenance therapy with an immunomodulatory treatment such as an interferon-β or glatiramer acetate. Long-term observational studies confirmed that this therapeutic regimen provides a rapid reduction in disease activity and sustained disease control up to at least five years in 60% of patients...
June 2018: Revue Neurologique
Brandi Vollmer, Justin M Honce, Stefan Sillau, John R Corboy, Timothy Vollmer, Kavita Nair, Enrique Alvarez
BACKGROUND: Due to the recurrence of disease activity in multiple sclerosis (MS) patients, a washout period of <3 months has been suggested for the transition from natalizumab (NTZ) to fingolimod (FTY). However, very short transition periods of <1 month may be more beneficial. METHODS: Retrospective analysis of patients from the Rocky Mountain MS Center at the University of Colorado who were: a) on NTZ for ≥6 months prior to switching to FTY; b) had a transition period ≤ 6 months; and c) initiated FTY treatment prior to November 2013...
July 15, 2018: Journal of the Neurological Sciences
Marloes H J Hagens, Jessica Burggraaff, Iris D Kilsdonk, Marlieke L de Vos, Niamh Cawley, Emilia Sbardella, Michaela Andelova, Michael Amann, Johanna M Lieb, Patrizia Pantano, Birgit I Lissenberg-Witte, Joep Killestein, Celia Oreja-Guevara, Olga Ciccarelli, Claudio Gasperini, Carsten Lukas, Mike P Wattjes, Frederik Barkhof
OBJECTIVE: In the work-up of patients presenting with a clinically isolated syndrome (CIS), 3T MRI might offer a higher lesion detection than 1.5T, but it remains unclear whether this affects the fulfilment of the diagnostic criteria for multiple sclerosis (MS). METHODS: We recruited 66 patients with CIS within 6 months from symptom onset and 26 healthy controls in 6 MS centers. All participants underwent 1.5T and 3T brain and spinal cord MRI at baseline according to local optimized protocols and the MAGNIMS guidelines...
June 20, 2018: Neurology
Ariana Helena Ribeiro de Barros, João Paulo Fiadeiro Sequeira, Ary Severino Lopes de Sousa, Carlos Miguel Cheganças Capela, Rui Manuel Gomes Pedrosa, Manuel Alexandre Dos Santos Manita
OBJECTIVES: The aim of this study was to evaluate postmarketing fingolimod safety and effectiveness in a real-world clinical population. METHODS: This was a retrospective, single-center study with active multiple sclerosis patients treated with fingolimod with at least 12 months of follow-up. Demographic and clinical and imaging characteristics, including annualized relapse rate (ARR), Expanded Disability Status Score, previous treatment, adverse events, treatment duration, and reason for discontinuation, were analyzed...
July 2018: Clinical Neuropharmacology
Tobias Sejbaek, Mads Nybo, Thor Petersen, Zsolt Illes
BACKGROUND: Dimethyl fumarate (DMF) has been registered for the treatment of relapsing-remitting multiple sclerosis (RRMS). Differences in tolerability between multiple sclerosis clinics in patients treated with DMF has not been examined. AIM: We examined real-world tolerability to DMF, and also compared adherence data between two MS clinics. METHODS: Adverse events (AE), discontinuation rates, and causes of discontinuation were investigated...
June 2, 2018: Multiple Sclerosis and related Disorders
Kathleen Mary Noon, Stephen Maxwell Montgomery, Nicholas Edward Adlard, Michel Anton Kroes
OBJECTIVES: Specific economic model types often become de facto standard for health technology appraisal over time. Markov and discrete event simulation (DES) models were compared to investigate the impact of innovative modeling on the cost-effectiveness of disease-modifying therapies (DMTs) in relapsing-remitting multiple sclerosis (RRMS). Fingolimod was compared to dimethyl fumarate (DMF; in highly active [HA] RRMS), alemtuzumab (in HA RRMS) and natalizumab (in rapidly evolving severe RRMS)...
July 5, 2018: Journal of Medical Economics
Alexandra Tremblay, Céline Jobin, Mélanie Demers, Emmanuelle Dagenais, Sridar Narayanan, David Araújo, Arnold L Douglas, Elaine Roger, Laury Chamelian, Pierre Duquette, Isabelle Rouleau
OBJECTIVES: Although multiple sclerosis (MS) has long been considered to primarily affect white matter, it is now recognized that cognitive deficits in MS are also related to neocortical, thalamic and hippocampal damage. However, the association between damage to these structures and memory deficits in MS is unclear. This study examines whether MS patients with cognitive impairment have a reduction of hippocampal and/or thalamic volumes compared to cognitively intact patients, and whether these volume reductions correlate with various aspects of memory function...
June 8, 2018: Brain and Cognition
J Frau, M P Sormani, A Signori, S Realmuto, D Baroncini, P Annovazzi, E Signoriello, G Maniscalco, S La Gioia, C Cordioli, B Frigeni, S Rasia, G Fenu, R Grasso, A Sartori, R Lanzillo, M L Stromillo, S Rossi, B Forci, E Cocco
OBJECTIVE: There is debate as to whether the apparent rebound after fingolimod discontinuation is related to the discontinuation itself, or if it is due to the natural course of highly active multiple sclerosis (MS). We aimed to survey the prevalence of severe reactivation and rebound after discontinuation of fingolimod in a cohort of Italian patients with MS. METHODS: Patients with relapsing-remitting MS (RRMS) who were treated with fingolimod for at least 6 months and who stopped treatment for reasons that were unrelated to inefficacy were included in the analysis...
May 31, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Luca Prosperini, Matteo Lucchini, Shalom Haggiag, Paolo Bellantonio, Assunta Bianco, Maria Chiara Buscarinu, Fabio Buttari, Diego Centonze, Antonio Cortese, Laura De Giglio, Roberta Fantozzi, Elisabetta Ferraro, Arianna Fornasiero, Ada Francia, Simonetta Galgani, Claudio Gasperini, Girolama Alessandra Marfia, Enrico Millefiorini, Viviana Nociti, Simona Pontecorvo, Carlo Pozzilli, Serena Ruggieri, Marco Salvetti, Eleonora Sgarlata, Massimiliano Mirabella
OBJECTIVE: To directly compare fingolimod (FNG) and dimethyl fumarate (DMF) on no evident disease activity (NEDA) status in patients with relapsing-remitting multiple sclerosis (RRMS) from 7 multiple sclerosis outpatient clinics in Central Italy. METHODS: We analyzed data of patients with RRMS who started an oral agent, namely DMF or FNG, either as first treatment (naives) or after switching from self-injectable drugs (switchers). We performed a propensity score (PS)-based nearest-neighbor matching within a caliper of 0...
July 10, 2018: Neurology
Antonio Riccardo Buonomo, Emanuela Zappulo, Giulio Viceconte, Riccardo Scotto, Guglielmo Borgia, Ivan Gentile
Alemtuzumab is a monoclonal anti CD-52 antibody recently approved for use in relapsing-remitting multiple sclerosis(MS). Given that the targeted antigen is primarily expressed on B and T lymphocytes, the administration of this biological drug is associated with rapid but protracted peripheral lymphopenia. Areas covered: The impact on infective risk of this immune impairment is still to be fully understood. In this review, we attempt to summarize all the available literature concerning opportunistic infections occurring in patients with MS receiving alemtuzumab...
July 2018: Expert Opinion on Drug Safety
Nadia Pariani, Mark Willis, Ilaria Muller, Sarah Healy, Taha Nasser, Anne McGowan, Greta Lyons, Joanne Jones, Krishna Chatterjee, Colin Dayan, Neil Robertson, Alasdair Coles, Carla Moran
Context: Alemtuzumab, a highly effective treatment for multiple sclerosis (MS), predisposes to Graves' disease (GD) with a reportedly indolent course. Objective: To determine the type, frequency and course of thyroid dysfunction (TD) in a cohort of alemtuzumab-treated MS patients in the UK. Design: Case records of alemtuzumab-treated patients who developed TD were reviewed. Results: 41.1% (102/248; 80F, 22M) of patients developed TD, principally GD (71...
June 6, 2018: Journal of Clinical Endocrinology and Metabolism
L J W Canham, A Manara, J Fawcett, M Rolinski, A Mortimer, K E A Inglis, D A Cottrell
We report the case of a patient who died from the rare complication of Listeriosis in the immediate phase following alemtuzumab administration one month after discontinuing dimethyl fumarate (DMF). There is considerable overlap with typical post-infusion symptoms therefore high surveillance and low threshold for empirical or possible prophylactic antibiotic therapy is advocated.
May 18, 2018: Multiple Sclerosis and related Disorders
2018-06-13 18:11:07
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