October 03, 2013
On September 17, the European Commission, the European equivalent of the US Food and Drug Administration (FDA), approved the release of alemtuzumab (Lemtrada™.)
Alemtuzumab is an intravenous monoclonal antibody that selectively reduces circulating T lymphocytes, which are thought to be involved in inflammation in multiple sclerosis (MS). This reduction is followed by repopulation of T and B cells over time. It is administered on five consecutive days in the first year of therapy, followed by three consecutive days 12 months later.
Swedish Neuroscience Institute was involved in Care-MS II, one of the pivotal Phase III studies in which MS patients who had relapsed on other therapies were randomized to either alemtuzumab or interferon beta-1a. The drug was found to be significantly ...
October 02, 2013
By now, the new school year is in full swing. And while it might have started with newly made memories of a great summer, it may also bring new challenges—a new classroom, a new teacher, a new setting. All parents want the same thing for their children—to be safe, healthy, happy and successful. But the latter can be more challenging in the educational setting for children with hearing loss of any level. So, as a parent, how do you ensure that your child with hearing loss succeeds in the classroom?
- Understand the impact of hearing loss on learning, and how to manipulate the classroom on your child’s behalf. Hearing loss, even a minimal degree, can have a significant impact on learning. Request preferential seating for your child. Sitting closer to the teacher will help improve the signal-to-noise ratio (or how loud the teacher’s voice is relative to background noises). This will help make listening and learning...
July 18, 2013
The American Academy of Neurology (AAN) recently published their Top Five Recommendations in the Choosing Wisely Campaign in promoting high value neurological care. This was done in collaboration with the American Board of Internal Medicine Foundation and Consumer Reports to reduce ineffective and costly care.
One of the AAN’s recommendations was to stop prescribing interferon-beta and glatiramer acetate to people who have progressive, non-relapsing forms of multiple sclerosis (MS).
The AAN made clear that the recommendations were intended to promote discussion between patients and their providers about the value of these therapies, not to completely stop the use of specific treatments.
The recommendation to stop prescribing
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June 05, 2013
Teriflunomide (Aubagio) is a once daily oral disease modifying therapy approved for treating patients with relapsing forms of multiple sclerosis (MS). One of the limitations of its use is its black box warning for potential fetal harm due to birth defects noted in rats and rabbits. Women who are of childbearing age who are not using reliable birth control are advised to not use teriflunomide.
At the Consortium of Multiple Sclerosis Centers annual meeting on May 30, I presented a poster describing 81 pregnancies in female patients and 20 pregnancies in partners of male patients in nine teriflunom...
March 19, 2013
A small pilot study from the University of Southern California suggests a pulse adrenocorticotropic hormone (ACTH) therapy could be effective in patients with breakthrough multiple sclerosis attacks while on beta-interferon. “Breakthrough” attacks that occur after starting a disease modifying therapy (DMT).
The study compared the safety and benefits of monthly pulse ACTH to monthly methylprednisone (MP) pulse in patients on beta-interferon. Over 15 months, researchers found that those treated with ACTH had fewer relapses and fewer psychiatric side effects. ACTH gel is currently used to treat MS relapses, but researchers note it may be able to alter the body’s immune responses beyond producing steroids.
As I discussed with the Medscape reporter, Megan Brooks, l...
May 31, 2011
Multiple sclerosis is unique among neurological diseases in that there are currently eight treatments for this one condition that have received approval by the U.S. Food and Drug Administration (FDA). Five of these drugs require subcutaneous or intramuscular injection, two are administered intravenously, and fingolimod, the newest agent on the block, is given orally. None are considered curative, but these disease-modifying therapies (DMT) have led to a reduction in relapse rates and the progression of disability.
Despite this progress, each of the drugs comes with side effects, including flu-like symptoms with the interferons, lipoatrophy with glatiramer, progressive multifocal leukodystrophy (PML) with natalizumab, and congestive heart failure or leukemia with mitoxantrone. As the first oral agent for MS, fingolimod created great expectations prior to FDA approval. Its popularity, however, has been surprisingly limited, presumably due to the potential for unknown long-term risks. The occur re...