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What is the optimal dosing of natalizumab?

July 25, 2012

REPORT FROM THE AMERICAN ACADEMY OF NEUROLOGY (AAN) ANNUAL MEETING, NEW ORLEANS LA, APRIL 21-28, 2012 – The initial dose-ranging study of natalizumab indicated that 1-3 mg/kg was clinically effective (Sheremata et al. Neurology 1999;52:1072-1074) and this was the dose selected by the Natalizumab MS Trial Group (O’Connor et al. Neurology 2004;62:2038-2043).

Higher doses of 3-6 mg/kg were used in phase II testing (Miller et al. N Engl J Med 2003;348:15-23; free full text at www.nejm.org/doi/pdf/10.1056/NEJMoa020696). Dosing by body weight was replaced by the one-size-fits-all 300 mg when natalizumab was initially approved in 2004 based on the dose used in the AFFIRM and SENTINEL phase III pivotal trials.

Exploring gene-environment interactions in PD

July 25, 2012

REPORT FROM THE AMERICAN ACADEMY OF NEUROLOGY (AAN) ANNUAL MEETING, NEW ORLEANS LA, APRIL 21-28, 2012 – The preliminary results of a genome-wide association study (GWAS) suggest that combined smoking and caffeine consumption may interact with single-nucleotide polymorphisms (SNP) to reduce PD risk in some individuals (Gao et al. AAN 2012; abstract PD4.003).

Need to test for celiac disease in migraineurs?

July 25, 2012

REPORT FROM THE AMERICAN ACADEMY OF NEUROLOGY (AAN) ANNUAL MEETING, NEW ORLEANS LA, APRIL 21-28, 2012 – A number of reviews of celiac disease (CD) have reported on an increased prevalence of neurological and psychiatric symptoms, such as headache disorders, cerebellar ataxia, peripheral neuropathies, vestibular dysfunction, depression and personality changes (Burk et al. Mov Disord 2009;24:2358-2362; Zelnik et al. Pediatrics 2004;113:1672-1676).

It has been suggested that gluten sensitivity is associated with neurologic symptoms, although symptoms are still evident in CD patients adhering to a gluten-free diet (Bushara KO. Gastroenterology 2005;128(4 Suppl 1):S92-97).

New AAN guidelines for migraine prophylaxis

July 11, 2012

REPORT FROM THE AMERICAN ACADEMY OF NEUROLOGY (AAN) ANNUAL MEETING, NEW ORLEANS LA, APRIL 21-28, 2012 – The AAN annual meeting coincided with the publication of new guidelines on preventive treatment of migraine by the AAN and the American Headache Society (Silberstein et al. Neurology 2012;78:1337-1345; free full text at www.neurology.org/content/78/17/1337.full.pdf+html).

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