Latest News

Efficacy and effectiveness of first-line oral medications in MS

May 21, 2015

REVIEWER: Mark S. Freedman, HBSc, MSc, MD, CSPQ, FANA, FAAN, FRCPC, Professor of Medicine (Neurology), University of Ottawa, Canada

Efficacy
NNT analysis
Safety
Natalizumab discontinuation studies
NeuroSens Survey on first-line orals

The 2015 annual meeting of the American Academy of Neurology (AAN) provided new data on the initiation and optimization of disease-modifying therapy (DMT) for multiple sclerosis. Of particular interest was research on the most recent DMTs, teriflunomide and dimethyl fumarate (DMF), the two oral therapies indicated for first-line treatment. (In Canada, fingolimod is generally recommended as a second-line agent.) Phase III extension data have now been supplemented by real-world observational studies on the effectiveness of therapy in practice, including drug safety and tolerability. Read More

Suicide: the Toronto experience

May 13, 2015

Over 200 people a year commit suicide in Toronto, Canada, and a coroner’s chart review has analysed the data to determine if there are common features (Sinyor et al. Can J Psychiatry 2014;59:26-33). The sample included 2,886 cases from 1998-2010 in which the coroner ruled that the death was due to suicide. Five clusters were identified based on individual and suicide-specific factors. Read More

Raising urate levels in Parkinson’s disease: the SURE-PD study

May 13, 2015

A new study has investigated the safety and tolerability of administering inosine, a urate precursor, in patients with early untreated Parkinson’s disease with baseline levels of urate below normal median of 6 mg/dL. In the SURE-PD (Safety of Urate Elevation in PD) trial, 75 subjects (mean age 62 years) received inosine or placebo for up to 24 months (Parkinson Study Group SURE-PD Investigators et al. JAMA Neurol 2014;71:141-150). Inosine dosing was titrated to produce mildly (6.1-7.0 mg/dL) or moderately (7.1-8.0 mg/dL) elevated serum urate levels; the maximum dose of inosine was 500-1000 mg TID. Read More

Endovascular trials in ischemic stroke: an update

April 24, 2015

REPORT FROM THE 67TH AMERICAN ACADEMY OF NEUROLOGY (AAN) ANNUAL MEETING – WASHINGTON DC, APRIL 18-25, 2015 – The use of tissue plasminogen activators (tPA) in patients with ischemic stroke is limited by the narrow therapeutic time window, and poor efficacy in opening proximal occlusions of the major intracranial arteries. Intraarterial interventions, such as thrombectomy with mechanical devices, are potentially useful but studies to date have produced mixed results, in large part because of trial design and patient selection.

A series of recent studies have attempted to clarify the role of thrombectomy post-stroke, and these were summarized in an invited science session hosted by the AAN in conjunction with the American Heart Association and the American Stroke Association (AAN 2015; S54). Read More