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MS Sequencing: Part 2 – Treatment initiation

January 12, 2017

…ibed more often than orals as the first-choice agent. To date, the few head-to-head studies comparing first-line orals with the injectables, such as the CONFIRM and TENERE trials, have produced equivocal results (Fox et al. N Engl J Med 2012;367:1087-1097; Vermersch et al. Mult Scler 2014;20:705-716). This may help to explain why glatiramer acetate continues to be the most frequently prescribed injectable, despite the fact that it is the only DMT…

Sun avoidance – more harm than good?

December 16, 2016

…art available at www.statcan.gc.ca/pub/82-624-x/2013001/article/chart/11727-01-chart3-eng.htm). A high proportion (25% in summer; 40% in winter) had vitamin D insufficiency, defined as serum 25(OH)D levels < 50 nmol/L [<20 ng/mL]. Similar prevalences of vitamin D deficiency (8%) and insufficiency (32%) have been reported in the U.S. (Looker et al. NCHS Data Brief, No. 59, March 2011). These definitions of vitamin D status may underrepresent the pr…

Gum disease linked to cognitive decline in AD

December 7, 2016

…iated with dementia severity and cognitive decline in 60 subjects with mild-to-moderate Alzheimer’s disease living in the community (Raybould et al. PLoS One 2016;11:e0151081, free full text at www.ncbi.nlm.nih.gov/pmc/articles/PMC4786266/pdf/pone.0151081.pdfAbstract). Subjects were assessed at baseline and at 6 months. The primary outcome measure was change from baseline in ADAS-cog. Blood samples were obtained for C-reactive protein (CRP) inflam…

Iatrogenic Alzheimer’s – is AD transmissible?

November 9, 2016

…Cleveland, Ohio, and the Pitié-Salpêtrière Hospital in Paris, France, to re-examine their CJD tissue banks for evidence of beta-amyloid pathology. It is well-established that prion diseases are transmissible via tainted meat (BSE), cannibalism (kuru), and tissue transplants (CJD). Whether beta-amyloid seeding indicates that AD is transmissible will require further study. But it has raised the question of whether neurodegenerative conditions are pr…

MS Sequencing: Part 1 – Mechanism of action of DMTs

November 3, 2016

…to exacerbate demyelination (Plant et al. Glia 2005;49:1-14). A number of B-cell-directed therapies (e.g. ocrelizumab, ofatumumab) are now in development. Ocrelizumab is a humanized monoclonal antibody infusion agent that targets CD20+ B cells; it increases antibody-dependent cell-mediated cytotoxicity (ADCC) and reduces complement-dependent cytotoxicity (CDC) relative to rituximab (Lycke J. Ther Adv Neurol Disord 2015;8:274-293), which may lower…