Effectiveness of long-term infliximab use and impact of treatment adherence on disease control in refractory, non-infectious pediatric uveitis

Abstract Background Refractory non-infectious uveitis is a serious condition that leads to ocular complications and vision loss and requires effective systemic treatment to control disease. The effectiveness of long-term infliximab [IFX] in refractory non-infectious childhood uveitis and the impact of treatment adherence on disease control were evaluated. Methods Retrospective, single-center study between December 2002 and April 2016 of 27 children with refractory non-infectious uveitis [17 with juvenile idiopathic arthritis, JIA] treated with long-term IFX [9+ months]. Disease activity was assessed prior to and while on IFX using the Standardization of Uveitis Nomenclature [SUN]. Number of visits per year with active uveitis was analyzed by repeated measures logistic regression analysis from 2 years prior to IFX initiation or from onset of uveitis until most recent visit on IFX. Incomplete treatment adherence was assessed for each visit and defined as any deviance in corticosteroid use, prescribed infusion frequency, and/or follow-up examination frequency. Results Primary outcomes were sustained uveitic and systemic disease control prior to and during IFX treatment and the impact of incomplete adherence on uveitic disease control while on IFX. Secondary outcomes included corticosteroid and glaucoma medication requirement, ocular complications and need for surgical intervention. Mean age at IFX initiation was 10.4 ± 4.5 years; initial mean dose was 6.6 ± 2.2 mg/kg [and given at weeks 0, 2, 4 and q4 weeks thereafter for 93%]. Median duration on IFX was 35 [range 9–128] months. Prior to IFX, 14/27 patients had failed adalimumab ± methotrexate [MTX]; 21/27 failed MTX. IFX led to uveitis control in 89% and arthritis control in 76% (13/17). The odds ratio of having controlled disease after IFX was 4.1 (2.6, 6.4) compared to pre-treatment visits. Topical corticosteroids and glaucoma medications were statistically decreased (p = 0.007 right eye [OD], 0.003 left eye [OS] and p = 0.001 OD, p = 0.028 OS respectively). Incomplete adherence to treatment showed 10.3 times greater odds (7.1, 15.0) of having disease activity than full adherence. Conclusions This study adds significantly to the IFX literature by documenting outstanding uveitis control with long-term IFX treatment in non-infectious pediatric uveitis patients. Higher dosage and shorter interval were utilized without adverse effects. Importantly, this is the first study, to our knowledge, to document the significant impact of treatment adherence on uveitis control.

Download Full-text

Covid-19 In Man: A Very Dangerous Affair.

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530321666210101123801 ◽

2021 ◽

Vol 21 ◽

Author(s):

Giuseppe Lisco ◽

Vito A. Giagulli ◽

Giovanni De Pergola ◽

Anna De Tullio ◽

Edoardo Guastamacchia ◽

...

Keyword(s):

Poor Prognosis ◽

Metabolic Diseases ◽

Systemic Disease ◽

Public Health Issue ◽

Immune System Dysfunction ◽

Data Support ◽

Systemic Spread ◽

The Impact

Background: The novel pandemic of Coronavirus disease 2019 (COVID-19) has becoming a public health issue since March 2020 considering that more than 30 million people were found to be infected worldwide. Particularly, recent evidences suggested that men may be considered as at higher risk of poor prognosis or death once the infection occurred and concerns surfaced in regard of the risk of a possible testicular injury due to SARS-CoV-2 infection. Results: Several data support the existence of a bivalent role of testosterone (T) in driving poor prognosis in patients with COVID-19. On one hand, this is attributable to the fact that T may facilitate SARS-CoV-2 entry in human cells by means of an enhanced expression of transmembrane serine-protease 2 (TMPRSS2) and angiotensin-converting enzyme 2 (ACE2). At the same time, younger man with normal testicular function compared to women of similar age are prone to develop a blunted immune response against SARS-CoV-2, being exposed to less viral clearance and more viral shedding and systemic spread of the disease. Conversely, low levels of serum T observed in hypogonadal men predispose them to a greater background systemic inflammation, cardiovascular and metabolic diseases, and immune system dysfunction, hence driving harmful consequences once SARS-CoV-2 infection occurred. Finally, SARS-CoV-2, as a systemic disease, may also affect testicles with possible concerns for current and future testicular efficiency. Preliminary data suggested that SARS-CoV-2 genome is not normally found in gonads and gametes, therefore sex transmission could be excluded as a possible way to spread the COVID-19. Conclusion: Most data support a role of T as a bivalent risk factor for poor prognosis (high/normal in younger; lower in elderly) in COVID-19. However, the impact of medical treatment aimed to modify T homeostasis for improving the prognosis of affected patients is unknown in this clinical setting. In addition, testicular damage may be a harmful consequence of the infection even in case it occurred asymptomatically but no long-term evidences are currently available to confirm and quantify this phenomenon. Different authors excluded the presence of SARS-CoV-2 in sperm and oocytes, thus limiting worries about both a potential sexual and gamete-to-embryos transmission of COVID-19. Despite these evidence, long-term and well-designed studies are needed to clarify these issues.

Download Full-text

P181 Long-term improvement in axial spondyloarthritis clinical outcomes following 2-weeks of intensive education and rehabilitation: results from the Bath residential rehabilitation programme

Rheumatology ◽

10.1093/rheumatology/keab247.176 ◽

2021 ◽

Vol 60 (Supplement_1) ◽

Author(s):

Rosie Barnett ◽

Anita McGrogan ◽

Matthew Young ◽

Charlotte Cavill ◽

Mandy Freeth ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Disease Activity ◽

Axial Spondyloarthritis ◽

Rehabilitation Programme ◽

Spinal Mobility ◽

The Impact

Abstract Background/Aims Axial spondyloarthritis (axSpA) is a chronic rheumatic condition, characterised by inflammatory back pain - often associated with impaired function and mobility, sleep disturbance, fatigue, and reduced quality of life. Despite the vast advances in pharmacological treatments for axSpA over the last few decades, physical activity and rehabilitation remain vital for effective disease management. At the Royal National Hospital for Rheumatic Diseases in Bath (RNHRD), the 2-week inpatient axSpA rehabilitation programme has been integral to axSpA care since the 1970’s. Prior research has demonstrated significant short-term improvements in spinal mobility (BASMI), function (BASFI) and disease activity (BASDAI) following course attendance. However, the long-term outcomes are yet to be evaluated in this unique cohort. Methods Since the early 1990’s, clinical measures of spinal mobility, function and disease activity have been routinely collected at the RNHRD at all clinical appointments through administration of the BASMI, BASFI and BASDAI, respectively. Dates of attending the axSpA course and standard clinical and treatment follow-up data were also collected. Multiple linear regression models were used to investigate the impact of course attendance on final reported BASMI, BASDAI and BASFI scores (final score=most recent). Length of follow-up was defined as time between first and last recorded BASMI. Results Of the 203 patients within the Bath SPARC200 cohort, 77.8% (158/203) had attended at least one rehabilitation course throughout follow-up. 70.0% (140/203) of patients were male. The mean duration of follow-up was 13.5 years (range 0-35 years); 28.1% (57/203) of individuals with 20+ years of follow-up. Course attendance (yes versus no) significantly reduced final BASMI score by 0.84 (p = 0.001, 95%CI -1.31 to -0.37) and final BASDAI score by 0.74 (p = 0.018, 95%CI -1.34 to -0.13). Although course attendance reduced final BASFI by 0.45 (95%CI -1.17 to 0.28), this relationship did not reach significance (p = 0.225). Whilst minimally clinically important difference (MCID) is, to our knowledge, yet to be defined for BASMI, MCIDs were achieved long-term for both BASDAI and BASFI - defined by van der Heijde and colleagues in 2016 as 0.7 and 0.4 for BASDAI and BASFI, respectively. Conclusion These results provide novel evidence to support the integral role of education, physical activity and rehabilitation in the management of axSpA. Future work should investigate additional outcomes of critical importance to patients and clinicians, such as fatigue, quality of life and work productivity. Furthermore, a greater understanding of the factors that confound these outcomes may provide insights into those patients who may most benefit from attending a 2-week rehabilitation course. In addition to facilitating identification of those patients who may require additional clinical support. Disclosure R. Barnett: None. A. McGrogan: None. M. Young: None. C. Cavill: None. M. Freeth: None. R. Sengupta: Honoraria; Biogen, Celgene, AbbVie, Novartis, MSD. Grants/research support; Novartis, UCB.

Download Full-text

Laryngeal complaints and videolaryngoscopic laryngeal alterations in rheumatoid arthritis patients and its association with disease activity and duration

Journal of Otolaryngology-ENT Research ◽

10.15406/joentr.2019.11.00438 ◽

2019 ◽

Vol 11 (5) ◽

pp. 216-223

Author(s):

Mohamed Baraka ◽

Hossam ElDessouky ◽

Alaa Abdel Azeez Labeeb ◽

Eman Ezzat ◽

Asmaa ElDessouky

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Disease Duration ◽

Systemic Disease ◽

Vocal Folds ◽

Moderate Activity ◽

University Hospitals ◽

Self Assessment ◽

Perceptual Assessment ◽

The Impact

Background: Rheumatoid arthritis (RA) is an autoimmune systemic disease with a wide clinical presentation. The laryngeal manifestations are often masked by the articular disability often experienced in the early and late stages of the disease. Objective: Association between different laryngeal complaints and videolaryngoscopic laryngeal alterations in patients with RA, and disease activity and duration. Patients and methods: A retrospective study was conducted on 79 patients with RA. All subjects were recruited from the out-patient clinic of physical medicine, rehabilitation, and rheumatology in Al-Menoufia University Hospitals during the period from March 2015 to March 2017. All patients were subjected to both phoniatric and rheumatological assessment. Results: Patients with phonasthenic symptoms and globus pharynges had significantly (p=0.01, 0.008 respectively) higher disease duration than patients without. No significant association found between rheumatoid arthritis duration and different videolaryngoscopic laryngeal alterations, patient’s self-assessment of the impact of laryngeal complaints on their lives, and auditory perceptual assessment (APA) of patient’s voice characters. As regards rheumatoid disease's activity no significant correlation has been established (p>0.05) with different laryngeal complaints except for patients in remission who had higher prevalence of intermittent dysphonia than patients with low activities. Rheumatoid disease's activity had no significant association with different laryngeal findings except those with moderate activity; they had significantly higher prevalence of vocal folds nodules than patients with high activity and patients in remission. Conclusion: A significant association between the disease's duration and presence of laryngeal complaints, dysphonia, and its persistence has been established. Also, patients with phonasthenic symptoms and globus pharynges had significantly higher disease duration than patients without. Rheumatoid diseases activity had significant association with different laryngeal complaints in patients with remission that had higher prevalence of intermittent dysphonia than patients with low activities. No significant association between the disease activity and different laryngeal findings that has been found except for patients with DAS-28>3.2, they had significantly higher prevalence of rheumatoid nodules.

Download Full-text

Measurement properties of the minimal disease activity criteria for psoriatic arthritis

RMD Open ◽

10.1136/rmdopen-2019-001002 ◽

2019 ◽

Vol 5 (2) ◽

pp. e001002 ◽

Cited By ~ 2

Author(s):

Laura C Coates ◽

Vibeke Strand ◽

Hilary Wilson ◽

Dennis Revicki ◽

Brad Stolshek ◽

...

Keyword(s):

Psoriatic Arthritis ◽

Disease Activity ◽

Clinical Status ◽

Measurement Properties ◽

Minimal Disease Activity ◽

Minimal Disease ◽

Additional Support ◽

Randomised Controlled ◽

The Impact

ObjectiveTo comprehensively assess evidence on the measurement properties of the minimal disease activity (MDA) criteria, a composite measure of the state of disease activity in psoriatic arthritis (PsA).MethodsA targeted literature review was conducted to identify studies that informed the validity and/or ability of the MDA to detect change among patients known to have experienced a change in clinical status. The search was conducted using MEDLINE and Embase databases (published as of October 2017). Pertinent articles provided by investigators and identified from select conference proceedings were also evaluated.ResultsA total of 20 publications met the inclusion criteria. The MDA criteria were consistently associated with other indicators of disease activity/severity. The ability of the MDA criteria to detect change was supported in randomised controlled trials (n=10), with a greater percentage of patients randomised to active treatments achieving MDA relative to patients in comparator arms. Long-term observational studies (n=2) provided additional support for the ability of the MDA to detect within-subject change in the real-world settings.ConclusionEvidence supports the MDA as a valid measure of disease activity in PsA that can detect between-group and within-subject change. The MDA is a comprehensive measure and clinically meaningful endpoint to assess the impact of interventions on PsA disease activity.

Download Full-text

Reevaluation of Acromegalic Patients in Long-Term Remission according to Newly Proposed Consensus Criteria for Control of Disease

International Journal of Endocrinology ◽

10.1155/2014/581594 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 7

Author(s):

Elisa Verrua ◽

Emanuele Ferrante ◽

Marcello Filopanti ◽

Elena Malchiodi ◽

Elisa Sala ◽

...

Keyword(s):

Disease Control ◽

Significant Decline ◽

Intensive Monitoring ◽

Gh Secretion ◽

Igf I ◽

Group A ◽

Group B ◽

The Impact

Acromegaly guidelines updated in 2010 revisited criteria of disease control: if applied, it is likely that a percentage of patients previously considered as cured might present postglucose GH nadir levels not adequately suppressed, with potential implications on management. This study explored GH secretion, as well as hormonal, clinical, neuroradiological, metabolic, and comorbid profile in a cohort of 40 acromegalic patients considered cured on the basis of the previous guidelines after a mean follow-up period of 17.2 years from remission, in order to assess the impact of the current criteria. At the last follow-up visit, in the presence of normal IGF-I concentrations, postglucose GH nadir was over 0.4 μg/L in 11 patients (Group A) and below 0.4 μg/L in 29 patients (Group B); moreover, Group A showed higher basal GH levels than Group B, whereas a significant decline of both GH and postglucose GH nadir levels during the follow-up was observed in Group B only. No differences in other evaluated parameters were found. These results seem to suggest that acromegalic patients considered cured on the basis of previous guidelines do not need a more intensive monitoring than patients who met the current criteria of disease control, supporting instead that the cut-off of 0.4 mcg/L might be too low for the currently used GH assay.

Download Full-text

Individually Optimal Choices can be Collectively Disastrous in COVID-19 Disease Control

10.21203/rs.3.rs-143573/v1 ◽

2021 ◽

Author(s):

Madison Stoddard ◽

Debra Van Egeren ◽

Kaitlyn Johnson ◽

Smriti Rao ◽

Josh Furgeson ◽

...

Keyword(s):

Public Health ◽

Disease Control ◽

Control Measures ◽

Disease Spread ◽

Complete Suppression ◽

Natural Immunity ◽

Endemic Disease ◽

Health Measures ◽

The Impact

Abstract Background: The word ‘pandemic’ conjures dystopian images of bodies stacked in the streets and societies on the brink of collapse. Despite this frightening picture, denialism and noncompliance with public health measures are common in the historical record, for example during the 1918 Influenza pandemic or the 2015 Ebola epidemic. The unique characteristics of SARS-CoV-2—its high basic reproduction number (R0), time-limited natural immunity and considerable potential for asymptomatic spread—exacerbate the public health repercussions of noncompliance with interventions (such as vaccines and masks) to limit disease transmission. Our work explores the rationality and impact of noncompliance with COVID-19 disease control measures. Methods: In this work, we used game theory to explore when noncompliance confers a perceived benefit to individuals. We then used epidemiological modeling to predict the impact of noncompliance on control of COVID-19, demonstrating that the presence of a noncompliant subpopulation prevents suppression of disease spread. Results: Our modeling demonstrating that noncompliance is a Nash equilibrium under a broad set of conditions, and that the existence of a noncompliant population can result in extensive endemic disease in the long-term after a return to pre-pandemic social and economic activity. Endemic disease poses a threat for both compliant and noncompliant individuals; all community members are protected if complete suppression is achieved, which is only possible with a high degree of compliance. For interventions that are highly effective at preventing disease spread, however, the consequences of noncompliance are borne disproportionately by noncompliant individuals. Conclusions: In sum, our work demonstrates the limits of free-market approaches to compliance with disease control measures during a pandemic. The act of noncompliance with disease intervention measures creates a negative externality, rendering COVID-19 disease control ineffective in the short term and making complete suppression impossible in the long term. Our work underscores the importance of developing effective strategies for prophylaxis through public health measures aimed at complete suppression and the need to focus on compliance at a population level.

Download Full-text

Adenoid cystic carcinoma of trachea: long-term disease control after endoscopic surgery and radiotherapy

Future Oncology ◽

10.2217/fon-2018-0685 ◽

2019 ◽

Author(s):

Corrado Spatola ◽

Alessandra Tocco ◽

Dario Marletta ◽

Roberto Milazzotto ◽

Francesco Marletta ◽

...

Keyword(s):

Disease Control ◽

Adenoid Cystic Carcinoma ◽

Intensity Modulated Radiotherapy ◽

Neck Region ◽

Intensity Modulated ◽

Adenoid Cystic ◽

The Impact

Aim: Adenoid cystic carcinoma is a rare tumor of head and neck region and its development in the thoracic region is even less frequent. This implies the absence of guidelines for therapeutic management and a consequent case-by-case approach. The role of radiotherapy is not yet clearly defined, but intensity-modulated radiotherapy allows for improved organ-at-risk sparing. Materials & methods: We have collected the cases of four patients treated at our institutions by the means of intensity-modulated radiotherapy, after endoscopic resection. Results & conclusion: Patients treated achieved long-term disease control of about 5 years, with a minimal acute toxicity. Longer follow-up is needed to drain conclusion on the impact of this treatment on overall survival.

Download Full-text

Automated image analysis of hand radiographs reveals widened joint spaces in patients with long-term control of acromegaly: relation to disease activity and symptoms

Acta Endocrinologica ◽

10.1530/eje-11-0795 ◽

2012 ◽

Vol 166 (3) ◽

pp. 407-413 ◽

Cited By ~ 11

Author(s):

N R Biermasz ◽

R van 't Klooster ◽

M J E Wassenaar ◽

S H Malm ◽

K M J A Claessen ◽

...

Keyword(s):

Image Analysis ◽

Disease Activity ◽

Disease Control ◽

Joint Space ◽

Cross Sectional Study ◽

Automated Image Analysis ◽

Cross Sectional ◽

Hand Joints ◽

Hand Radiographs

ObjectiveArthropathy is an invalidating complication of acromegaly. Although acromegalic arthropathy shares features with primary osteoarthritis, joint spaces are widened rather than narrowed in patients with long-term cure of acromegaly. The late effects of acromegaly on hand joints have not been characterized. Therefore, the objective of the current study was to assess joint space widths (JSWs) of hand joints in patients with long-term control of acromegaly and to identify factors associated with JSW.MethodsA cross-sectional study was carried out in 89 patients (age 58±12 years, 49% women) with long-term controlled acromegaly and 471 controls without hand symptoms (age 46±12 years, 42% women). Radiological JSWs of individual hand joints were measured by automated image analysis.ResultsPatients had wider mean joint spaces than controls: metacarpo-phalangeal (MCP) joints were ∼24%, proximal interphalangeal joints ∼21%, and distal interphalangeal joints were ∼20% wider (patients vs controls; P<0.001 for all joints). Mean JSW exceeded the 95th percentile of the values obtained in controls in 64% of patients. Higher IGF1 and GH concentrations at diagnosis were associated with larger JSWs (adjusted β for pretreatment GH in tertiles: 0.09 (95% confidence interval (CI) 0.03–1.84) and for IGF1 in tertiles: 0.14 (95% CI 0.05–0.23) at the MCP joints in acromegalic patients. In male patients, but not in female patients, increased JSWs were associated with more self-reported pain (P=0.02).ConclusionsUsing a new semi-automated image analysis of hand radiographs, acromegalic patients with long-term disease control appeared to have increased joint spaces of all hand joints. JSWs were positively related to disease activity at diagnosis, but not to duration of follow-up, suggesting irreversible cartilage hypertrophy. Irreversible cartilage hypertrophy may partly explain persisting hand complaints despite long-term disease control.

Download Full-text

Fruit in Diets for Diabetes (P08-086-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz044.p08-086-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

John Monro ◽

Suman Mishra

Keyword(s):

Repeated Measures ◽

Group Intervention ◽

Metabolic Effects ◽

Partial Substitution ◽

Glycemic Response ◽

Clinical Biomarkers ◽

Long Term Study ◽

The Impact

Abstract Objectives Determine the effect on glycemic response of equi-carbohydrate partial exchange of fruit for cereal, identify mechanisms of its effectiveness, and establish the metabolic safety of long-term fruit consumption in individuals at risk of type 2 diabetes. Methods Randomised repeated measures human intervention studies were conducted with healthy participants ingesting 40 g available carbohydrate meals of wheaten starch biscuit (WB), WB plus kiwifruit (WB + KF), and WB plus the same sugars in the same quantity as consumed in the kiwifruit (WB + KFS). Postprandial glycemic responses were measured. Associated in vitro studies aimed to identify mechanisms of glycemic response reduction by fruit. Physicochemical and rheological properties of fruit digested under simulated gastro-intestinal conditions, and the impact of the fruit remnants on physical and enzymatic processes of digestion were determined. In a follow-up parallel group intervention study, prediabetic (HBA1c > 4%) participants consumed 2 kiwifruit per day for 12 weeks, to establish the metabolic safety of long term kiwifruit consumption through clinical biomarkers. Results Partial substitution by kiwifruit (WB + KF) significantly (P < 0.05) and substantially (−35%) reduced glycemic response peak height compared with unsubstituted WB. Also, substitution by kiwifruit (WB + KF) caused significantly (P < 0.001) lower (−20%) peak glycaemic response than substitution with the kiwifruit sugars alone (WB + KFS), indicating the glycemia reducing effect of the fruit was due to more than fructose substitution of digestible starch. The mechanistic studies showed several gut-level factors by which kiwifruit could reduce glycemic impact; high gastric acidification and buffering capacity, swelling and dispersion of the fruit cell walls (dietary fiber) leading to rheological changes retarding digestion, glucose diffusion and intraluminal mixing, all involved in transport of digestion products to the gut wall for absorption. The long term study could not detect adverse metabolic effects. Conclusions Including fruit in the diet in a carbohydrate exchange format may suppress glycemic response through a number of mechanisms and without metabolic risk. Funding Sources New Zealand National Science Challenge.

Download Full-text

Inclusion of brain volume loss in a revised measure of ‘no evidence of disease activity’ (NEDA-4) in relapsing–remitting multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458515616701 ◽

2016 ◽

Vol 22 (10) ◽

pp. 1297-1305 ◽

Cited By ~ 140

Author(s):

Ludwig Kappos ◽

Nicola De Stefano ◽

Mark S Freedman ◽

Bruce AC Cree ◽

Ernst-Wilhelm Radue ◽

...

Keyword(s):

Multiple Sclerosis ◽

Disease Activity ◽

Brain Volume ◽

Objective Measure ◽

Volume Loss ◽

Brain Volume Loss ◽

Relapsing Remitting ◽

Relapsing Remitting Multiple Sclerosis ◽

The Impact

Background: ‘No evidence of disease activity’ (NEDA), defined as absence of magnetic resonance imaging activity (T2 and/or gadolinium-enhanced T1 lesions), relapses and disability progression (‘NEDA-3’), is used as a comprehensive measure of treatment response in relapsing multiple sclerosis (RMS), but is weighted towards inflammatory activity. Accelerated brain volume loss (BVL) occurs in RMS and is an objective measure of disease worsening and progression. Objective: To assess the contribution of individual components of NEDA-3 and the impact of adding BVL to NEDA-3 (‘NEDA-4’) Methods: We analysed data pooled from two placebo-controlled phase 3 fingolimod trials in RMS and assessed NEDA-4 using different annual BVL mean rate thresholds (0.2%–1.2%). Results: At 2 years, 31.0% (217/700) of patients receiving fingolimod 0.5 mg achieved NEDA-3 versus 9.9% (71/715) on placebo (odds ratio (OR) 4.07; p < 0.0001). Adding BVL (threshold of 0.4%), the respective proportions of patients achieving NEDA-4 were 19.7% (139/706) and 5.3% (38/721; OR 4.41; p < 0.0001). NEDA-4 status favoured fingolimod across all BVL thresholds tested (OR 4.01–4.41; p < 0.0001). Conclusion: NEDA-4 has the potential to capture the impact of therapies on both inflammation and neurodegeneration, and deserves further evaluation across different compounds and in long-term studies.

Download Full-text