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Use of injectable antipsychotics in bipolar I disorder

June 29, 2018

…g other oral agents. I see two really clear benefits: I feel strongly that my patients experience a mood benefit that is superior to what is seen with oral agents; and an LAI gives me an opportunity to intervene if they are getting ill due to non-compliance with other treatments. I know for certain LAIs have prevented the need for hospitalization for many of my patients because when a patient or their family becomes aware of symptom exacerbation,…

Do injectable MS drugs still have a role?

June 12, 2018

…interferons despite the other options available. In this sample, the most commonly-used interferon was intramuscular beta-interferon-1a. The greatest preference among MS patients was for an oral DMT, which was generally perceived to be more convenient than an injectable. A separate survey (n=39) examined trade-offs of benefits and risks. Given the choice of one pill a day or one injection a day, 96% of respondents preferred an oral. However, the…

Update on CGRP inhibitors in migraine

May 18, 2018

…e (Saper et al. AAN 2018; abstract S20 001). MMD was reduced from baseline -4.0, -3.9 and -4.3 days with the three doses versus -3.2 days with placebo. The response rate (>75% reduction in MMD) was 24.7%, 22.2% and 29.7% with eptinezumab versus 16.2% with placebo. A total of 56.3% (pooled) achieved a ≥50% reduction in MMD at 12 weeks compared to 37.4% with placebo. The pooled response rate was 63.1% in weeks 21-24 versus 52.3% with placebo followi…

Update on oral cladribine – Effect on lymphocytes and safety data

May 9, 2018

…roved for use in Canada in November 2017. Cladribine is a prodrug (2-chloro-2′-deoxyadenosine) that mimics the nucleoside deoxyadenosine. It enters cells via the purine nucleoside transporter (Liliemark J. Clin Pharmacokinet 1997;32:120-131), where it accumulates intracellularly due to its resistance to adenosine deaminase. Cladribine is phosphorylated by deoxycytidine kinase (DCK) to an active triphosphate deoxynucleotide, which inhibits DNA synt…

AAN 2018 DAILY REPORT

April 26, 2018

…oencephalopathy death following treatment with ocrelizumab (P5.353). The 55-year-old female had previously been treated with mitoxantrone, natalizumab, fingolimod and DMF. The post-mortem histology was suspicious for viral encephalitis, but immunostaining was negative for JC virus and HSV. Oral cladribine: Treatment guidelines recommend a normal lymphocyte count at the start of treatment with oral cladribine, and Grade 0-1 lymphopenia at the time…