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Multiple Sclerosis

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564 papers 25 to 100 followers
By Alexandros Tsichlakis Medical representative
Robert Zivadinov, Jennie Medin, Nasreen Khan, Jonathan R Korn, Niels Bergsland, Michael G Dwyer, Tanuja Chitnis, Robert T Naismith, Enrique Alvarez, Peter Kinkel, Stanley Cohan, Samuel F Hunter, Diego Silva, Bianca Weinstock-Guttman
BACKGROUND AND PURPOSE: Evidence is needed to understand the effect of fingolimod on slowing down brain atrophy progression in multiple sclerosis (MS) patients in clinical practice. We investigated the effect of fingolimod on brain atrophy in MS patients with active disease (clinically and/or magnetic resonance imaging [MRI]) versus no evidence of active disease (NEAD). METHODS: MS and clinical outcome and MRI in the United States (MS-MRIUS) is a multicenter, retrospective study that included 590 relapsing-remitting MS patients, who initiated fingolimod, and were followed for a median of 16 months...
May 11, 2018: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
L Ferre', F Clarelli, G Sferruzza, M A Rocca, E Mascia, M Radaelli, F Sangalli, G Dalla Costa, L Moiola, M Aboulwafa, F Martinelli Boneschi, G Comi, M Filippi, V Martinelli, F Esposito
BACKGROUND: Several studies have shown an association between 25-hydroxyvitamin D (25[OH]D) levels and multiple sclerosis (MS) susceptibility and/or level of disease activity in patients treated with first line drugs. AIMS: To investigate whether baseline 25[OH]D values could influence disease activity also during treatment with the second-line drug fingolimod (FTY). PATIENTS AND METHODS: We enrolled 176 MS patients who started FTY at the San Raffaele Hospital (OSR) MS center with available 25[OH]D measurement at the time of treatment start...
May 13, 2018: Neurological Sciences
Konstantina G Yiannopoulou, Dimitra Papadimitriou, Aikaterini I Anastasiou, Marina Siakantaris
A 47-year-old Caucasian female with relapsing- remitting Multiple Sclerosis, received alemtuzumab after a serious relapse. She had ceased receiving any treatment during the previous year. 23 days after alemtuzumab infusion she developed severe early neutropenia, which resulted in septic shock by Staphylococcus aureus and death. This is the first report of alemtuzumab infusion-related death due to early neutropenia in non-immunocompromised MS patients. We suggest that the long existing safety guidelines for alemtuzumab infusion in B-cell chronic lymphocytic leukemia might be also beneficial in the MS setting...
April 28, 2018: Multiple Sclerosis and related Disorders
Andrea Huwiler, Uwe Zangemeister-Wittke
The immunomodulatory drug fingolimod (FTY720, GilenyaR ) was approved for oral treatment of relapsing-remitting multiple sclerosis, due to its impressive efficacy and good tolerability. Pharmacologically, it acts as an unselective agonist of sphingosine 1-phosphate receptors (S1PR) and as a selective functional antagonist of the S1P1 subtype by induction of receptor downregulation. Since S1P1 is crucial for the regulation of lymphocyte trafficking, its downregulation causes redistribution of the immune cells to secondary lymphoid tissues, resulting in the depletion from the circulation and hence immunosuppression...
May 2018: Pharmacology & Therapeutics
Ralf Gold, Eugen Schlegel, Birte Elias-Hamp, Christian Albert, Stephan Schmidt, Björn Tackenberg, James Xiao, Tom Schaak, Hans Christian Salmen
Background: Gastrointestinal (GI) events are common adverse events (AEs) associated with delayed-release dimethyl fumarate (DMF), an approved treatment for relapsing-remitting multiple sclerosis (RRMS). The objective of the TOLERATE study was to evaluate GI tolerability and GI mitigation via symptomatic therapies in patients initiating DMF in a real-world clinical setting in Germany. Methods: TOLERATE was a multicentre, open-label, single-arm study performed at 25 German sites...
2018: Therapeutic Advances in Neurological Disorders
Erin E Longbrake, Daniel Kantor, Siddharama Pawate, Michael J Bradshaw, Gloria von Geldern, Salim Chahin, Anne H Cross, Becky J Parks, Marc Rice, Samia J Khoury, Bassem Yamout, Maya Zeineddine, Shira Russell-Giller, Ana Caminero-Rodriguez, Keith Edwards, Ellen Lathi, Danita VanderKodde, William Meador, Regina Berkovich, Lily Ge, Tamar E Bacon, Ilya Kister
Background: Fingolimod is a daily oral medication used to treat relapsing multiple sclerosis (MS). Clinicians often adopt less frequent dosing for patients with profound drug-induced lymphopenia or other adverse events. Data on the effectiveness of alternate dose fingolimod are limited. Methods: We conducted a multicenter, retrospective, observational study at 14 sites and identified 170 patients with MS taking alternate doses of fingolimod for ≥1 month. Clinical and radiologic outcomes were collected and compared during daily and alternate fingolimod dosing...
April 2018: Neurology. Clinical Practice
Chiara Gerardi, Vittorio Bertele', Silvia Rossi, Silvio Garattini, Rita Banzi
OBJECTIVE: To review the evidence supporting the European Union marketing authorization of drugs for multiple sclerosis (MS) and assess how far postmarketing research addresses information gaps at the time of approval. METHODS: Through its database, we identified drugs approved by the European Medicines Agency and gathered data on pivotal trials from the European Public Assessment Reports and corresponding publications. We searched Medline, Embase, Cochrane Library, and trial registries for postmarketing randomized controlled trials testing the drugs identified in any form of the disease...
April 25, 2018: Neurology
Konstantin Huhn, Antonios Bayas, Sebastian Doerck, Benedikt Frank, Kathrin Gerbershagen, Kerstin Hellwig, Boris Kallmann, Christoph Kleinschnitz, Ingo Kleiter, De-Hyung Lee, Volker Limmroth, Mathias Mäurer, Sven Meuth, Peter Rieckmann, Tobias Ruck, Ralf Gold, Ralf A Linker
BACKGROUND: Relapsing-remitting multiple sclerosis (RRMS) requires efficient immunomodulatory treatment to reach "no evidence of disease activity" status at best. Alemtuzumab and fingolimod have proved to be efficient options in RRMS with active disease course. Yet, side effects and break-through disease may limit long-time treatment and necessitate switch of medication. Data on efficacy and safety of alemtuzumab following fingolimod treatment are limited, but useful for clinical practice...
April 25, 2018: Journal of Neurology
D Biotti, J Ciron
Today, first-line treatments for multiple sclerosis include injectable immunomodulators - some of which have been on the market for nearly 25 years - as well as teriflunomide and dimethyl fumarate, which are more recent, but have opened the way for oral treatments. These drugs are considered similar in effectiveness, and their safety and side-effect profiles are generally reassuring. These treatments have been associated with a reduction in radiological and clinical disease activity, and a positive effect on patient quality of life, especially when introduced early in the disease process...
April 24, 2018: Revue Neurologique
Maria Teresa Giordana, Paola Cavalla, Antonio Uccelli, Alice Laroni, Fabio Bandini, Marco Vercellino, Gianluigi Mancardi
We present the neuropathological description of an autoptic case of fatal rebound of disease activity after fingolimod discontinuation in a multiple sclerosis patient. MRI prior to the fatal outcome showed several large tumefactive demyelinating lesions. These lesions were characterized by prominent astrocytic gliosis, with a remarkable preponderance of large hypertrophic reactive astrocytes showing intense expression of sphingosine-1-phosphate receptor 1. Prominent astrocytic gliosis was also diffusely observed in the normal-appearing white matter...
April 1, 2018: Multiple Sclerosis: Clinical and Laboratory Research
Peter Harmel, Frieder Schlunk, Lutz Harms
BACKGROUND: Rebound phenomena after discontinuation of different treatments for relapsing-remitting multiple sclerosis (RRMS) have previously been described. Systematic database research in PubMed did not show any report with relapse directly associated with dimethyl fumarate (DMF) cessation. CASE PRESENTATION: Here, we report on a 38-year-old Caucasian male patient suffering from a relatively mild course of RRMS who developed a fulminant clinical rebound 2 months after discontinuation of DMF therapy...
April 1, 2018: Multiple Sclerosis: Clinical and Laboratory Research
Amit Bar-Or, Richard A Grove, Daren J Austin, Jerry M Tolson, Susan A VanMeter, Eric W Lewis, Frederick J Derosier, Monica C Lopez, Sarah T Kavanagh, Aaron E Miller, Per S Sorensen
OBJECTIVE: To assess dose-response effects of the anti-CD20 monoclonal antibody ofatumumab on efficacy and safety outcomes in a phase 2b double-blind study of relapsing forms of multiple sclerosis (RMS). METHODS: Patients (n = 232) were randomized to ofatumumab 3, 30, or 60 mg every 12 weeks, ofatumumab 60 mg every 4 weeks, or placebo for a 24-week treatment period, with a primary endpoint of cumulative number of new gadolinium-enhancing lesions (per brain MRI) at week 12...
April 25, 2018: Neurology
Serena Ruggieri, Alessandra Logoteta, Gabriella Martini, Alessandro Bozzao, Laura De Giglio
No abstract text is available yet for this article.
April 2, 2018: JAMA Neurology
Jeffrey I Greenstein
BACKGROUND: Opportunistic infections have occurred during dimethyl fumarate (DMF) therapy. OBJECTIVE: Diffuse skin dermatophytosis which occurred during DMF therapy in the setting of lymphopenia is described. METHODS AND RESULTS: The clinical course, the lymphocyte subset profile, and dermatologic evaluations were reviewed. In both instances, there was no other cause of lymphopenia or immune suppression, and it is likely that the tinea infections are associated with DMF therapy...
April 1, 2018: Multiple Sclerosis: Clinical and Laboratory Research
Dalia L Rotstein, Aditya Bharatha, Daniel Selchen
We report the case of an MS patient with aseptic temporal lobe encephalitis while on treatment with fingolimod. This 49-year-old woman developed headache and decreasing level of consciousness after 3.5 years of fingolimod therapy. Imaging, CSF studies, and rapid clinical response to acyclovir suggested a viral etiology, although CSF cultures and viral PCR were negative. This case illustrates the potential for severe manifestations of infectious illnesses on fingolimod, which may have a predilection for the CNS and also include herpes virus infections, cryptococcus, and PML...
April 16, 2018: Multiple Sclerosis and related Disorders
Simon Faissner, Ralf Gold
No abstract text is available yet for this article.
February 1, 2018: Multiple Sclerosis: Clinical and Laboratory Research
Simon Faissner, Ralf Gold
Multiple sclerosis treatment faces tremendous changes as a result of the approval of new medications. The new medications have differing safety considerations and risks after long-term treatment, which are important for treating physicians to optimize and individualize multiple sclerosis care. Since the approval of the first multiple sclerosis capsule, fingolimod, the armamentarium of multiple sclerosis therapy has grown with the orally available medications dimethyl fumarate and teriflunomide. Fingolimod is mainly associated with cardiac side effects, dimethyl fumarate with bowel symptoms...
March 2018: CNS Drugs
Alexander Rae-Grant, Gregory S Day, Ruth Ann Marrie, Alejandro Rabinstein, Bruce A C Cree, Gary S Gronseth, Michael Haboubi, June Halper, Jonathan P Hosey, David E Jones, Robert Lisak, Daniel Pelletier, Sonja Potrebic, Cynthia Sitcov, Rick Sommers, Julie Stachowiak, Thomas S D Getchius, Shannon A Merillat, Tamara Pringsheim
OBJECTIVE: To review evidence on starting, switching, and stopping disease-modifying therapies (DMTs) for multiple sclerosis (MS) in clinically isolated syndrome (CIS), relapsing-remitting MS (RRMS), and progressive MS forms. METHODS: Relevant, peer-reviewed research articles, systematic reviews, and abstracts were identified (MEDLINE, CENTRAL, EMBASE searched from inception to November 2016). Studies were rated using the therapeutic classification scheme. Prior published Cochrane reviews were also used...
April 24, 2018: Neurology
Kevin Rostásy, Barbara Bajer-Kornek
PURPOSE OF REVIEW: Neuroimmunological diseases encompass a wide spectrum of diseases in children. Apart from the discovery of autoantibodies affecting primarily grey matter structures and the improved clinical characterization of rare entities such as N-methyl D-aspartate receptor-R- encephalitis, important strides have also been made in autoimmune-mediated white matter diseases, including paediatric multiple sclerosis (pedMS) and other acute demyelinating syndromes (ADS) often associated with antibodies (abs) against myelin-oligodendrocyte-glycoprotein (MOG)...
June 2018: Current Opinion in Neurology
Robert Zivadinov, Nasreen Khan, Jonathan R Korn, Ellen Lathi, Jason Silversteen, Jonathan Calkwood, Scott Kolodny, Diego Silva, Jennie Medin, Bianca Weinstock-Guttman
OBJECTIVE: The impact of multiple sclerosis (MS) center type on outcomes has not been investigated. This study aimed to evaluate baseline characteristics and clinical and magnetic resonance imaging (MRI) outcomes in patients with MS receiving fingolimod over 16 months' follow-up at private or academic centers in the USA. METHODS: Clinical and MRI data collected in clinical practice from patients initiating fingolimod were stratified by center type and retrospectively analyzed...
April 12, 2018: Current Medical Research and Opinion
2018-04-21 21:27:58
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