1,721,130 research outputs found
The differential diagnosis of multiple sclerosis: classification and clinical features of relapsing and progressive neurological syndromes.
No full textReview of interferon beta-1b in the treatment of early and relapsing multiple sclerosis.
No full textThe transition from relapsing-remitting MS to irreversible disability: clinical evaluation.
No full textInterdisciplinary approach to opportunistic infections: staphylococcal meningitis in a patient with multiple sclerosis on treatment with dimethyl fumarate
No full textDear Editor,
Multiple Sclerosis (MS) is a chronic infammatory disease
of the central nervous system (CNS) representing a relevant
cause of disability in young adults. In the last 20 years, new
and emerging disease-modifying drugs (DMD) have been
introduced in clinical practice revolutionizing the natural
history of the disease [1]. However, immunomodulatory and
immunosuppressive treatments for MS are associated with
an increased risk of severe infections, which ranges from
0.2% to 2.6% [2
Efficacy and Safety of Oral Therapies for Relapsing-Remitting Multiple Sclerosis
No full textDisease-modifying therapies have now become standard treatment for multiple sclerosis. These include five oral therapies for relapsing-remitting multiple sclerosis, namely fingolimod, dimethyl fumarate, teriflunomide, cladribine, and siponimod, although there is some discrepancy on the relative efficacy and safety of these agents. To gain further insight on these oral agents in relapsing-remitting multiple sclerosis, we performed a narrative review of fingolimod, dimethyl fumarate, teriflunomide, cladribine, and siponimod. We limited the analysis to randomized clinical studies in which a comparator was used (i.e., placebo or other disease-modifying therapy). As relapsing-remitting multiple sclerosis is a chronic disease and treatment is lifelong, long-term outcomes were an additional focus. A total of 37 studies met inclusion criteria: 15 for fingolimod, 8 for dimethyl fumarate, 7 for teriflunomide, 4 for cladribine, and 3 for siponimod. All drugs showed some functional and magnetic resonance imaging benefit in nearly all clinical studies. The reduction in annual relapse rate was similar for fingolimod, dimethyl fumarate, and cladribine, and somewhat greater than for teriflunomide; there is limited information on the annual relapse rate for siponimod. For all drugs, the benefits reported at short follow-up times are broadly consistent with those seen at longer follow-up times. For fingolimod and dimethyl fumarate, there was a definite trend towards a progressively lower annual relapse rate with continuing treatment. The safety profile of all five drugs was considered to be acceptable, even after extended treatment. While these results should be treated with caution, they highlight that future head-to-head studies are needed to better understand the long-term benefits of disease-modifying therapies. Such information will be of value when considering the risk-benefit profile of these oral therapies
The impact of neutralizing antibodies on the risk of disease worsening in interferon β-treated relapsing multiple sclerosis: a 5 year post-marketing study.
No full textThe impact of neutralizing antibodies (NAbs)
on interferon b (IFNb) efficacy in MS patients is still an
object of controversy. To evaluate the clinical response to
IFNb during NAb-positive (NAb?) and NAb-negative
(NAb-) statuses on a large population of relapsing
remitting (RR) MS patients were followed up to 5 years.
Sera from 567 RR MS patients treated with IFNb for
2–5 years were collected every 6–12 months and evaluated
for NAb presence by a cytopathic effect assay. The relapse
rate and expanded disability status scale (EDSS) score
were assessed at baseline and every 6 months for each
patient. A NAb? status was defined after two consecutive
positive titers of NAbs[/= 20 neutralizing units (NU)/mL.
Multivariate models were used to analyze the relapse rate,
the time to first relapse, the time to confirmed EDSS score
4 during NAb? and NAb- statuses. A propensity score
(PS) matching analysis was performed to assess the
robustness of the multivariate models. Fourteen percent of
patients became NAb? during the follow-up. A significant
increase of the relapse rate (IRR = 1.38; p = 0.0247) and
decrease of the time to 1st relapse (IRR = 1.51;
p = 0.0111) were found during NAb? periods. The PS
matching analysis, in a selected cohort of patients, demonstrated
a negative trend of NAbs on the time to reach the
milestone EDSS 4 (IRR = 2.94; p = 0.0879). This longterm
post-marketing observational study further confirms
that the occurrence of NAbs significantly affects the risk of
disease worsening in IFNb- treated RRM
CORRELATIONS BETWEEN NEUTRALIZING ANTIBODIES PRODUCTION AND CLINICAL OUTCOMES: ANALYSIS IN A POPULATION- BASED SURVEILLANCE ITALIAN STUDY OF INTERFERON BETA TREATMENT IN MULTIPLE SCLEROSIS PATIENTS
No full textLong-term comparative analysis of no evidence of disease activity (NEDA-3) status between multiple sclerosis patients treated with natalizumab and fingolimod for up to 4 years
Full text linkComparative effectiveness of natalizumab and fingolimod over a follow-up longer than 2 years has been not addressed yet
The role of exercise parameters on small extracellular vesicles and microRNAs cargo in preventing neurodegenerative diseases
No full textPhysical activity (PA), which includes exercise, can reduce the risk of developing
various non-communicable diseases, including neurodegenerative diseases
(NDs), and mitigate their adverse effects. However, the mechanisms underlying
this ability are not yet fully understood. Among several possible mechanisms
proposed, such as the stimulation of brain-derived neurotrophic factor (BDNF),
endothelial nitric oxide synthase (eNOS), insulin-like growth factor-1 (IGF-1),
vascular endothelial growth factor (VEGF), and nerve growth factor (NGF), the
possible involvement of particular vesicular structures enclosed in lipid
membranes known as extracellular vesicles (EVs) has recently been
investigated. These EVs would appear to exert a paracrine and systemic action
through their ability to carry various molecules, particularly so-called microRNAs
(miRNAs), performing a function as mediators of intercellular communication.
Interestingly, EVs and miRNAs are differentially expressed following PA, but
evidence on how different exercise parameters may differentially affect EVs
and the miRNAs they carry is still scarce. In this review we summarized the
current human findings on the effects of PA and different exercise parameters
exerted on EVs and their cargo, focusing on miRNAs molecules, and discussing
how this may represent one of the biological mechanisms through which exercise
contributes to preventing and slowing NDs
- …
