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Sequencing MS therapies: 2 studies

 

Report from the 1st Congress of the European Academy of Neurology, Berlin, Germany, June 20-23, 2015 – Few studies have examined the feasibility of switching MS patients from one higher-efficacy therapy to another. In the TOFINGO and ENIGM (Enquête Nationale sur l’Introduction du Fingolimod en Relais au Natalizumab) prospective studies, disease reactivation was generally well controlled after switching from natalizumab to fingolimod, most notably when the washout period did not exceed 12 weeks (Kappos et al. Neurology 2015; epublished May 29, 2015; Cohen et al. JAMA Neurol 2014;71:436-441).

The MSBase study group has recommended a maximum 8-week washout period (Jokubaitis et al. Neurology 2014;82:1204-1211). Read More

Does psoriasis improve MS outcomes?

 

Report from the 1st Congress of the European Academy of Neurology, Berlin, Germany, June 20-23, 2015 – There is an implied association between psoriasis and multiple sclerosis, as evidenced by an increased incidence of psoriasis in MS patients, and the efficacy of psoriasis treatments such as fumarates in MS. The relationship between psoriasis and MS was explored further in a retrospective database analysis from a single MS centre in Israel (Miron et al. EAN 2015; F2168). Read More

Beyond remission: redefining the goal of schizophrenia management

 

REVIEWER: Marc-André Roy, MD, Associate Professor of Psychiatry and Neurosciences, Université Laval, Québec City, Canada


Remission vs. functional recovery
Continuum of treatment goals

An important goal of schizophrenia management is to reduce the frequency, severity and duration of psychotic episodes (Hasan et al. World J Biol Psychiatry 2012;13: 318-378; Lehman et al. APA, NGC-3572, 2008). Indeed, it has been shown that about 70-80% of first-episode patients do achieve a remission of psychotic symptoms within the first year of treatment (Lieberman et al. Arch Gen Psychiatry 1993;50:369-376). Among patients receiving maintenance antipsychotic therapy, a systematic review estimated that the one-year recurrence rate was only 3%, compared to a 90% risk of relapse at two years in those who discontinued medication (Zipursky et al. Schizophr Res 2014;152:408-414).    Read More

Natalizumab in progressive MS: Phase II results

 

A number of preliminary studies have investigated the possible effects of natalizumab in progressive MS. The latest is the open-label phase IIb NAPMS trial that examined the effect of treatment on osteopontin, an inflammatory marker, and CSF neurofilament (NfL) light chain, a marker of axonal damage  (Romme Christensen et al. Neurology 2014;82:1499-1507). Read More

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