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Excess mortality during pandemic tops 14 million

…Control (www.census.gov/library/stories/2022/03/united-states-deaths-spiked-as-covid-19-continued.html). The CDC reported that mortality increased 19% between 2019 and 2020 – from 2,854,838 deaths to 3,390,029 deaths. This represented the largest annual increase in mortality in over 100 years. In 2020, COVID-19 was the third leading cause of death (after heart disease and cancer). In 2021, almost 75% of U.S. counties recorded more deaths than birt…

Evolving picture of cognitive dysfunction in MS

…volume loss at 48 weeks was associated with significant worsening on the 9-Hole Peg Test (9HPT). Conflicting findings may be due, in part, to the imaging technique used and the cognitive domain being evaluated. A recent study reported that cortical thinning in specific areas was associated with different domains of cognitive dysfunction (Davion et al. Rev Neurol (Paris) 2022;178:326-336). Cortical thinning in the left frontal superior and right p…

6 criteria to improve PMS outcomes

…three BTK inhibitors (evobrutinib, tolebrutinib, fenebrutinib) are in late-phase testing for MS (the phase III EVOLUTION RMS, GEMINI 1 and FENtrepid trials, respectively). Survey In your opinion, which of the Yong criteria for DMT efficacy in PMS is most important? (pick 1) Ability to cross the BBB, have direct effect in CNS Reducing compartmentalized inflammation (diffuse and meningeal) Effect on microglia Reducing oxidative stress and preventin…

AAN report: long-term data for anti-CD20s, BTK inhibitors

…erienced systemic injection-related reactions; 99.5% of reactions were mild-to-moderate in severity (Kramer et al. AAN 2022; S7.011). The most common systemic symptoms were fever, headache, chills and fatigue. Six reactions were considered serious (weakness requiring hospitalization, hypersensitivity reactions). No life-threatening injection reactions were seen. Tolebrutinib: This Bruton’s tyrosine kinase (BTK) inhibitor is currently in developmen…

CLINICAL CASES IN MS – CASE 4: WORSENING SYMPTOMS IN A WOMAN WITH STABLE EDSS

…l history and no comorbidities. Kay began treatment in 2010 with interferon-beta-1a 44 mcg tiw. She was switched to DMF 240 mg BID in 2016 due to ongoing clinical and MRI activity. At that time her EDSS score was 2.5 (pyramidal 2, cerebellar 2). She remained clinically stable for three years and continued her employment. In 2019, Kay experienced a myelopathic episode that was treated with steroids. There was one Gd+ lesion on MRI brain and one Gd+…