Long-term treatment of multiple sclerosis with glatiramer acetate: Natural history of the subtypes of anti-glatiramer acetate antibodies and their correlation with clinical efficacy

2010 ◽  
Vol 220 (1-2) ◽  
pp. 125-130 ◽  
Author(s):  
Dimitros Karussis ◽  
Dvora Teitelbaum ◽  
Camille Sicsic ◽  
Talma Brenner
Keyword(s):  
Multiple Sclerosis ◽  
Natural History ◽  
Glatiramer Acetate ◽  
Clinical Efficacy ◽  
Term Treatment ◽  
Long Term Treatment ◽  
History Of

Glatiramer acetate antibodies, gene expression and disease activity in multiple sclerosis

2011 ◽  
Vol 18 (3) ◽  
pp. 305-313 ◽  
Author(s):  
F Sellebjerg ◽  
CJ Hedegaard ◽  
M Krakauer ◽  
D Hesse ◽  
H Lund ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Transcription Factors ◽  
Disease Activity ◽  
Glatiramer Acetate ◽  
Immunological Response ◽  
Term Treatment ◽  
Pcr Analysis ◽  
Enhanced Mri ◽  
Long Term Treatment

Background: Glatiramer acetate (GA) treatment suppresses disease activity in multiple sclerosis (MS). The immunological response to treatment may differ in patients who are stable on GA therapy and patients with breakthrough disease activity, but the results of previous studies are inconsistent. Objectives: We studied the immunological response to GA and its relationship with disease activity. Methods: Anti-GA antibodies in plasma and the expression of genes encoding cytokines and T-cell-polarizing transcription factors in blood cells were analysed by flow cytometric bead array and polymerase chain reaction (PCR) analysis in 39 untreated and 29 GA-treated relapsing–remitting MS patients. Definition of breakthrough disease was based on the occurrence of relapses, disability progression, or gadolinium (Gd)-enhanced MRI. Results: The expression of T helper type 1 (Th1) and Th17 cytokines and transcription factors was reduced during long-term treatment, but there was no relationship between the expression of cytokines and transcription factors and anti-GA antibodies. High expression of mRNA encoding GATA3 and lymphotoxin-β (LT-β) was associated with low disease activity in Gd-enhanced MRI studies. None of the variables studied were associated with clinical disease activity. GA treatment resulted in the development of IgG and IgG4 anti-GA antibodies during the first months of treatment, persisting during long-term treatment. Conclusions: The observed relationship between the expression of mRNA encoding GATA3 and LT-β expression and MRI disease activity deserves further analysis in future studies. The development of anti-GA antibodies was observed in all patients treated with GA, but this was not related with measures of cellular immunity, clinical or MRI disease activity.

Benefit of Endermology on Indurations and Panniculitis/Lipoatrophy During Relapsing–Remitting Multiple Sclerosis Long-Term Treatment with Glatiramer Acetate

2014 ◽  
Vol 31 (8) ◽  
pp. 904-914 ◽  
Author(s):  
Carmen Márquez-Rebollo ◽  
Luisa Vergara-Carrasco ◽  
Rosa Díaz-Navarro ◽  
Delia Rubio-Fernández ◽  
Pablo Francoli-Martínez ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Glatiramer Acetate ◽  
Term Treatment ◽  
Long Term Treatment ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis

Improving Survival in Lymphangioleio­myomatosis: A 16-Year Observational Study in a Large Cohort of Patients

Respiration ◽  
2021 ◽  
pp. 1-11
Author(s):  
Sergio Harari ◽  
Olga Torre ◽  
Davide Elia ◽  
Antonella Caminati ◽  
Giuseppe Pelosi ◽  
...  
Keyword(s):  
Natural History ◽  
Cumulative Incidence ◽  
Pulmonary Function Tests ◽  
Diagnostic Techniques ◽  
Term Treatment ◽  
Large Cohort ◽  
Clinical Aspects ◽  
Long Term Treatment ◽  
History Of

<b><i>Background:</i></b> Over the last 2 decades, great progress has been made in the understanding of the clinical aspects and pathogenesis of lymphangioleiomyomatosis (LAM), leading to publication of guidelines and approval of an effective therapy. <b><i>Objectives:</i></b> Aim of our study was to describe how the management and the natural history of this rare disease have changed after the publication of the ERS and American Thoracic Society/Japanese Respiratory Society guidelines and the introduction of sirolimus. <b><i>Methods:</i></b> We examined 162 LAM patients followed at our center between 2001 and 2017, reporting clinical characteristics and diagnostic approach. Response to sirolimus in patients undergoing long-term treatment and mortality risk, estimated in terms of cumulative incidence taking into account organ transplantation as a competing cause of the event, were evaluated. The difference in the cumulative incidence between the patients admitted to the observation before 2011 and after 2011, year of the publication of the MILES trial for the efficacy of sirolimus, has also been estimated. <b><i>Results:</i></b> Sixty-one patients had a histological diagnosis (22 from 2010 onward). 101 patients received a radiological diagnosis according to the guidelines criteria. Pulmonary function tests remained stable over a 3-year treatment period in patients who received sirolimus for over 12 months. The cumulative incidence of mortality after 10 years in the whole population was 25.5%. The cumulative incidence of mortality after 5 years was significantly lower in patients who entered the study since 2011 (after publication of the MILES trial) than in patients who entered the study before. <b><i>Conclusions:</i></b> We provide the data supporting the long-term efficacy of sirolimus therapy in a large cohort of patients with functional impairment and other manifestations of the disease. Our results also suggest that the advent of sirolimus and the publication of international guidelines changed the natural history of the disease lowering the mortality and reducing the need of invasive diagnostic techniques.

Thyroid autoimmunity and dysfunction in multiple sclerosis patients during long-term treatment with interferon beta or glatiramer acetate: an Italian multicenter study

2014 ◽  
Vol 20 (9) ◽  
pp. 1265-1268 ◽  
Author(s):  
Giovanni Frisullo ◽  
Massimiliano Calabrese ◽  
Carla Tortorella ◽  
Damiano Paolicelli ◽  
Paolo Ragonese ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Glatiramer Acetate ◽  
Interferon Beta ◽  
Thyroid Autoimmunity ◽  
Term Treatment ◽  
First Year ◽  
Close Monitoring ◽  
Long Term Treatment ◽  
Multiple Sclerosis Patients

Few long-term follow-up data are available on thyroid dysfunction (TD) in multiple sclerosis (MS) patients treated with glatiramer acetate (GA) or with interferon-beta (IFNb). In a cohort of 787 relapsing–remitting MS (RRMS) patients whom were followed up for 8 years, we observed an increased prevalence of TD and thyroid autoimmunity (TA) within the first year of IFNb treatment, regardless of the dose or frequency of administration, while no change was observed with GA treatment. The increased prevalence of TD and TA within the first year of IFNb treatment suggested the need for close monitoring of thyroid function and autoimmunity, though only during the first year of IFNb treatment.

scholarly journals Homocysteine (Hcy) Follow-Up Study

2007 ◽  
Vol 30 (1) ◽  
pp. 21 ◽  
Author(s):  
Arnon Blum ◽  
Ihsan Hijazi ◽  
Michal Mashiach Eizenberg ◽  
Nava Blum
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Natural History ◽  
Beta Blockers ◽  
Term Treatment ◽  
Channel Blockers ◽  
Long Term Treatment ◽  
History Of

Background: Hyperhomocysteinemia confers an increased risk of coronary artery disease, stroke, and deep vein thrombosis, and is a strong predictor of mortality among patients with ischemic heart disease. Purpose: To determne the long term clinical outcome of patients with risk factors to atherosclerosis with high concentrations of homocysteine (Hcy). Methods: 89 patients with one or more risk factors for atherosclerosis, whose plasma total Hcy concentrations were measured, were followed for 5 years. Patients were interviewed and underwent a clinical examination in the outpatient clinic. Their medical records were reviewed in the last 5 years including smoking habits, medications, other diseases (hypertension, diabetes mellitus, hyperlipidemia) and their management. SPSS was used to describe and explore possible relationships between Hcy concentration, other diseases, medications and the clinical long term outcome. Results: All men with normal Hcy concentrations (10.76±1.71µmol/L) survived during the 5 years’ follow up, while 5 of the men with high Hcy concentrations (21.27±5.37µmol/L), died (17%) (P< 0.05). In women Hcy concentration did not affect survival. No association was found between diabetes mellitus, hypercholesterolemia, hypertension and Hcy. Long term treatment with Beta Blockers, ACE inhibitors, Calcium Channel blockers, and especially with Aspirin prevented death and changed the natural history of patients with high Hcy concentrations (P < 0.05). Conclusions – Hyperhomocysteinemia may have an effect on survival in men. Long term treatment with Beta Blockers, ACE inhibitors, Calcium Channel Blockers, and especially with Aspirin – prevented death and changed the natural history of patients with high Hcy concentrations.

Clinical Efficacy of Dhatryadi Ghanavati in Shvitra (Vitiligo)

2017 ◽  
Vol 1 (4) ◽  
Author(s):  
Manjiri Walinjkar ◽  
P.D. Londhe ◽  
S. R. Makhare ◽  
Anil Avhad
Keyword(s):  
Clinical Efficacy ◽  
Skin Disorder ◽  
Total Population ◽  
Social Stigma ◽  
Term Treatment ◽  
Effective Therapy ◽  
Long Term Treatment ◽  
Percentage Area ◽  
Effective Remedy

Background: Shvitra (vitiligo) is a kind of skin disorder comprising of white coloured skin patches which is considered as a social stigma. Worldwide prevalence of Vitiligo is observed as 1% of the total population. Due to the chronic nature, long term treatment, lack of uniform effective therapy and unpredictable course the disease is usually very demoralizing for patients. Aim: To study the efficacy of ‘Dhatryadi Ghanavati’ in the management of Shvitra. Materials and Methods: Total 50 patients of Shvitra from OPD and IPD unit of Dr. M.N. Agashe Hospital, Satara were selected and provided with Dhatryadi Ghanavati 1gm B.D. for the duration of 3 months. Results: 100% relief was observed in Daha and Kandu followed by 83.33% relief was observed in Rukshata. 34.51% improvement was seen in number of patches, 34.82% in size of patches and 34.29% in percentage area involved. Color of the patches was improved by 69.01% whereas 44% improvement was seen in hair discoloration. Conclusion: The compound formulation ‘Dhatryadi Ghanavati’ was found as an effective remedy for ‘Shvitra’. The parameters like number of patches, size of patches, percentage area involved and colour of patches showed statistically highly significant results.

scholarly journals Long term dual antiplatelet therapy after myocardial infarction: retrospective analysis in an outpatient population

2021 ◽  
Author(s):  
Gennaro Ratti ◽  
Antonio Maglione ◽  
Emilia Biglietto ◽  
Cinzia Monda ◽  
Ciro Elettrico ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Term Treatment ◽  
Multivessel Disease ◽  
Coronary Syndrome ◽  
Anticoagulant Drugs ◽  
Long Term Treatment ◽  
Risk Condition ◽  
History Of

Long term treatment with ticagrelor 60 mg and low-dose aspirin are indicated after acute coronary syndrome (ACS). We retrospectively reviewed aggregate data of 187 patients (155 M and 38 F) (mean age 63.8±9 years) in follow up after ACS with at least one high risk condition (Multivessel disease, diabetes, GFR<60 mL/min, history of prior myocardial infarction, age >65 years) treated with ticagrelor 60 mg twice daily (after 90 mg twice daily for 12 months). The results were compared with findings (characteristics of the patients at baseline, outcomes, bleeding) of PEGASUS-TIMI 54 trial and Eu Label. The highrisk groups were represented as follows: multivessel disease 105 pts (82%), diabetes 63 pts (33%), GFR< 60 mL/min 27 pts (14%), history of prior MI 33 pts (17%), >65 year aged 85 pts (45%). Treatment was withdrawn in 7 patients: 3 cases showed atrial fibrillation and were placed on oral anticoagulant drugs, one developed intracranial bleeding, in three patients a temporary withdrawal was due to surgery (1 colon polyposis and 2 cases of bladder papilloma). Chest pain without myocardial infarction occurred in 16 patients (revascularization was required in 9 patients). Dyspnea was present in 15 patients, but was not a cause for discontinuation of therapy. Long term treatment with ticagrelor 60 mg twice daily plus aspirin 100 mg/day showed a favourable benefit/risk profile after ACS.  In this study all patients had been given ticagrelor 90 mg twice daily for 12 months and the 60 mg twice daily dosage was started immediately thereafter, unlike PEGASUS-TIMI 54 trial in which it was prescribed within a period ranging from 1 day to 1 year after discontinuation of the 90 mg dose. This makes our results more consistent with current clinical practice. However, a careful outpatient follow-up and constant counseling are mandatory to check out compliance to therapy and adverse side effects.

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