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New guidance on use of sNfL in practice

May 27, 2024

…4 (Kuhle et al. Neurology 2019;92:e1007-e1015). The international panel recommended obtaining CSF and serum NfL at baseline. sNfL is sufficient if no lumbar puncture is planned and is less invasive than cNfL for subsequent follow-ups. NfL testing may be performed if new MRI lesions are observed; at 3-6 months after a disease activity event (relapse, Gd+ lesion); and at 3-6 month intervals after DMT initiation to evaluate treatment effectiveness….

New developments in epilepsy: focus on cenobamate

May 2, 2024

…ate were published by Smith and colleagues (Neurol Ther 2022;11:1705-1720; free full text at www.ncbi.nlm.nih.gov/pmc/articles/PMC9588096/pdf/40120_2022_Article_400.pdf). Dose reduction of concomitant ASMs was shown to increase tolerability and retention in a phase III trial of cenobamate (Rosenfeld et al. Epilepsia 2021;62:3016-3028). Treatment response rates were similar after concomitant ASM dose reduction. Moreover, 24.6% of patients were able…

Treatment initiation with a higher-efficacy DMT: update from AAN

April 25, 2024

…ension (n=465) and results at six years are now available (Pardo et al. AAN 2024;S31.003). Mean age was about 36 years; mean body-mass index was about 26 kg/m2; and mean EDSS was about 2.30. ARR was 0.05 in the continuous ofatumumab group at Year 6. There was near-complete suppression of Gd+ lesions (0.001 lesions/scan) with continuous ofatumumab. The annualized rate of new T2 lesions was also low (0.07). The teriflunomide group saw substantial im…

REPORT FROM AAN 2024 – THURSDAY, APRIL 18

April 18, 2024

…ew-onset vascular events in people with and without epilepsy (Li et al. AAN 2024;S19.010). Vascular events comprised stroke, myocardial infarction and transient ischemic attacks. Over a six-year period, vascular events occurred in 9.6% of people with epilepsy vs. 4.4% of people without epilepsy (odds ratio 2.44 for any event; OR 2.3 for TIA, 2.13 for MI; 1.91 for stroke). The higher risk of vascular events among people with epilepsy was attributab…

REPORT FROM AAN 2024 – WEDNESDAY, APRIL 17

April 17, 2024

…orily controlled with conventional therapy. Two new database analyses have compared outcomes in patients receiving cenobamate or another adjunctive therapy. The two studies indicated that treatment with cenobamate may significantly reduce morbidity and healthcare utilization in patients with focal-onset epilepsy and refractory epilepsy post-surgery. The first study (N=58,786; mean age 42 years) compared adjunctive cenobamate versus brivaracetam, c…