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Rare cases of stroke reported with alemtuzumab


The U.S. Food and Drug Administration (FDA) has issued a black-box warning about a risk of stroke and arterial dissection in patients with multiple sclerosis who have been exposed to alemtuzumab (…).  The announcement was issued on November 29, 2018 and a black-box warning was added to the U.S. product label. The Canadian product monograph had not been updated at the time of writing. Read More


Improving QoL in patients with schizophrenia



Comment by Dr. William MacEwan

In recent years, the goals of schizophrenia management have moved beyond the traditional model of treating positive and negative symptoms to a more holistic approach that emphasizes functional recovery, psychosocial functioning and quality of life (QoL) (Juckel & Morosini. Curr Opin Psychiatry 2008;21:630-639). Indeed, over a decade ago, Naber and colleagues proposed that quality of life should be considered as important as psychopathology in managing patients with schizophrenia (Naber et al. Schizophr Res 2001;50:79-88). To be sure, achieving symptomatic remission with antipsychotic medications is the necessary first step to functional recovery (Kokaçya et al. Noro Psikiyatr Ars 2016;53:328-333), and the prevention of clinical relapses will have the greatest impact on QoL (Briggs et al. Health Qual Life Outcomes 2008;6:105-13). A caveat, however, is that clinical effectiveness alone may not necessarily translate to improvements in QoL and patient self-rated life satisfaction, as the Clinical Antipsychotic Trial of Intervention Effectiveness (CATIE) study reported (Fervaha et al. Eur Neuropsychopharmacol 2014;24:1078-1085). Read More

Early diagnosis of MS – is it a myth?


The most recent iterations of the McDonald criteria have enabled an earlier diagnosis of multiple sclerosis (Lee et al. Eur J Neurol 2018; epublished October 26, 2018). However, it is unclear if MS is being diagnosed earlier in real-world practice, or if patients are then receiving earlier treatment with a disease-modifying therapy. Read More


Effect of MS treatment on cognitive dysfunction


A newly-published set of recommendations advocates increased professional and patient awareness of MS-related cognitive symptoms and their management. The recommendations were endorsed by the U.S. National MS Society, the Consortium of Multiple Sclerosis Centers and the International MS Cognition Society (Kalb et al. Mult Scler 2018; epublished October 10, 2018). Use of the Symbol Digit Modalities Test (SDMT) or other validated test is advised early on when the patient is clinically stable, with re-assessments at least annually to detect new-onset cognitive impairment, detect disease activity and evaluate progression of cognitive impairment. Annual screening for depression is also recommended. Read More