Neurology

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“Therapeutic inertia” is a term coined over a decade ago to describe the 90% of clinicians who failed to intensify antihypertensive therapy in patients with high blood pressure (Antrade et al. Am J Manag Care 2004l;10(7 Pt 2):481-486). The concept was first applied to multiple sclerosis treatment decision-making three years ago and has become something of a cottage industry ever since, with about a dozen papers and abstracts to date on the topic. Read More

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MS highlights from EAN 2019

 

SPECIAL REPORT

The following summarizes some of the key data on multiple sclerosis presented at the European Academy of Neurology meeting, held 29 June – 2 July, in Oslo, Norway. Read More

HSCT vs. drug in RRMS: head-to-head study

 

A new head-to-head trial has reported that nonmyeloablative hematopoietic stem-cell transplantation is superior to disease-modifying drugs (DMD) with respect to time to disease progression in patients with highly-active relapsing-remitting multiple sclerosis (Burt et al. JAMA 2019;321:165-174). Read More

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FDA approves migraine drug for cluster headaches

 

Galcanezumab, a calcitonin gene-related peptide (CGRP) antagonist, is the first agent to receive FDA approval for the treatment of cluster headaches. The product was accorded a priority review in March and a ruling had been expected later this year. Galcanezumab is marketed as Emgality in the U.S. and received approval for the prevention of migraine last year. It is the third CGRP-targeted monoclonal antibody for migraine prophylaxis after erenumab (Aimovig) and fremanezumab (Ajovy). Aimovig, which uniquely targets the CGRP receptor, has also received approval by Health Canada for migraine prevention. Read More

Switching therapies in MS – what is the evidence?

 

SPECIAL REPORT

It is now generally accepted that patients with relapsing-remitting multiple sclerosis will require more than one disease-modifying therapy (DMT) during their clinical course. Although a proportion of patients appear to be clinically stable on a platform therapy (beta-interferons and glatiramer acetate), it has been difficult to demonstrate the long-term benefits of this approach. A recent analysis of patients who initiated a DMT in the period 1995-2002 and received treatment for 13 years found no difference in time to onset of secondary-progressive MS (SPMS) between treated patients and untreated natural history cohorts (Coret et al. Mult Scler J Exp Transl Clin 2018;4:2055217318783347). Read More