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The return of cladribine in RRMS

…ies in the CLARITY trial (Giovannoni et al. N Engl J Med 2010;362:416-426; free pdf at www.nejm.org/doi/pdf/10.1056/NEJMoa0902533). The study randomized 1326 patients to one of two doses of oral cladribine (3.5 or 5.25 mg/kg cumulative dose over two years) or placebo. There were 10 neoplasms in the cladribine groups (incidence 1.1%) versus 0 in the placebo group. The neoplasms reported were five cases of benign uterine leiomyoma, three cases of ca…

Health Canada approves Ocrevus for RRMS

…dose of ocrelizumab. Ocrelizumab was excreted in breast milk in animal studies and women are advised not to breastfeed during treatment. Click on the link to download the Canadian Product Monograph: www.rochecanada.com//content/dam/roche_canada/en_CA/documents/Research/ClinicalTrialsForms/Products/ConsumerInformation/MonographsandPublicAdvisories/Ocrevus/OCREVUS_PM_E.pdf

MS Sequencing: Part 6: Safety considerations when sequencing

…fingolimod (Carpenter et al. Mult Scler 2017;23:297-299). Management is becoming more complicated as neurologists are increasingly faced with sequential treatment choices, with the risk of additive effects on immune function from a previously-used treatment. More than ever, neurologists treating MS should expect to see the unexpected. The solutions will come from real-world data of large groups of patients. The hope is that approaches based on ri…

Delays in diagnosis, treatment: MS patient survey

…news and information website visited by about 3,000 MS patients per month (www.msology.com). The survey was conducted in English and French in February-March 2017. The number of survey respondents was 387: 85% were female, 85% lived in Canada, and 10% lived in the U.S. Patients were generally older (51.7% were aged 50 years or older; 29.4% were aged 41-50 years). Duration of MS was >10 years for 51.8%; 26.8% had been living with MS for 5 years or…

Disease-modifying therapies in MS: long-term data

…O 0.197; TOWER 0.219) or hospitalization (TEMSO 0.061; TOWER 0.111) were uncommon (Maurer et al. AAN 2017; abstract P6.361). In the 5-year follow-up of the combined TEMSO/TOWER dataset, there was a low risk of worsening disability: 96.4% of patients with baseline EDSS score < 5 on teriflunomide 14 mg/day had not advanced to EDSS 6; and 97% had no sustained disability worsening (Lublin et al. AAN 2017; abstract P6.341). Two subgroup analyses from T…