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AAN 2023 HIGHLIGHTS – MONDAY, APRIL 24

April 24, 2023

…in patients with RMS and PMS (Gross et al. AAN 2023;P1.010). Samples were obtained at baseline and after 3-12 months. Age-adjusted NfL and GFAP levels were comparable in RMS and PMS patients at baseline. Following ocrelizumab initiation, NfL levels decreased 27.6% (from 6.8 to 4.9) in RMS patients but were unchanged in PMS patients. GFAP levels were unchanged in RMS patients but increased (from 52.4 to 60.8) in PMS patients. The results suggest t…

Putting biomarkers into practice

March 8, 2023

…al NfL measures in individual patients (see RCV tool at BMJ 2020;368:m149: www.bmj.com/content/368/bmj.m149/rr-8). Serum NfL was obtained every three months in 58 MS patients over one year. In comparing patients with and without MRI lesions, median RCV was 57 and 92, respectively. An RCV using a cut-off of >76 was predictive of new MRI lesions (sensitivity 60%, specificity 75%). A 10-unit increase in RCV was associated with a 30% increase in the o…

Putting shared decision-making into practice

February 16, 2023

…patients in arriving at a decision that reflects their preferences. A core component is evidence-based information about each of the treatment options, including any uncertainty about the data or their interpretation (Ubbink 2022). It is also important to include a method to clarify the patient’s values so that the patient’s preferences are addressed and he/she does not come to regret the decision (Witteman et al. Med Decision Making 2021;41:801-8…

CLINICAL CASES IN MS – AN OLDER PATIENT WITH STABLE DISEASE

February 9, 2023

…scontinuing treatment if Janet wanted to stop, and 3% said it would depend on the lymphocyte count. Only 3% would stop treatment because the risks of treatment outweigh the benefits in patients aged >55 years. Question 5: What are your criteria for treatment discontinuation? The most common criteria were age >55 years and stable disease >5 years (50% of respondents). Another 14% said either age >60 years or stable disease >5 years would be suffici…

MS Awards 2022 – Oddities and Observations

December 9, 2022

…o come: what if the healthcare system were adequately funded? Ogden et al. Free download at www.canada.ca/content/dam/phac-aspc/documents/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2022-48/issue-7-8-july-august-2022/ccdrv48i78a01-eng.pdf). Persistence Prize This year saw the 27-year follow-up of the Copolymer-1 trial (Ford et al. Mult Scler 2022;28:1729-1743); median duration of drug exposure was 9.8 years….