Updates on immunosuppressant safety and malignancy risk in patients with multiple sclerosis.

Introduction: Multiple sclerosis (MS) is a chronic, immune-mediated disease of the central nervous system, characterized by relapses or progressive neurological decline. Over recent decades, high-efficacy immunosuppressive therapies have dramatically reduced relapse rates and curtailed new MRI lesion activity in MS, but also raise safety concerns regarding infections, malignancy, and other serious adverse events.

Areas Covered: This review discusses immunosuppressants in MS, from older cytotoxic agents (azathioprine, cyclophosphamide, mitoxantrone) to newer therapies (cladribine, alemtuzumab, and anti-CD20 monoclonal antibodies).

Learning as a digital hallmark of cognition in multiple sclerosis: lessons from a digital symbol digit modalities test.

Background: Multiple Sclerosis (MS) often causes cognitive impairment that significantly impacts functional independence. The Symbol Digit Modalities Test (SDMT) is the gold standard for screening and monitoring cognitive functioning in people with MS (pwMS). Electronic SDMT (eSDMT) adaptations offer potential for remote monitoring and capturing more detailed performance metrics, compared to conventional pen-and-paper administration.

Brain atrophy and associations with long-term disability and cognitive function in participants with relapsing multiple sclerosis treated with ozanimod: Results from phase 3 and open-label extension trials.

Background: In phase 3 trials, ozanimod reduced brain atrophy and improved cognitive processing speed compared with interferon β-1a (IFN) in participants with relapsing multiple sclerosis (RMS).

Objectives: To assess long-term brain volume changes and associations with clinical/cognitive outcomes during an open-label extension ([OLE] DAYBREAK [NCT02576717]).

Methods: Completers of phase 3 "parent" trials were eligible to receive ozanimod 0.

Brain health - time matters: multiple sclerosis, neuromyelitis optica spectrum disorder (NMOSD), myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) and related conditions. 2024 report.

Introduction: Multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are lifelong neuroimmunological diseases that can severely affect many aspects of people's lives. This report expands on our 2015 policy report and includes information about practice standards, emerging science, socioeconomic data analysis and disease understanding, to identify policy recommendations.

Methods: Suitable experts from healthcare, health economics, policy and patient advocacy formed the author and working groups.

Glial Fibrillary Acidic Protein as a Marker of Disease in Relapsing Multiple Sclerosis: Post Hoc Analysis of Phase 3 Ozanimod Trials.

Background: This post hoc analysis investigated relationships between baseline plasma glial fibrillary acidic protein (GFAP), a potential biomarker for multiple sclerosis (MS), and baseline characteristics and on-treatment outcomes in participants with relapsing MS (RMS) from two Phase 3 trials that randomly assigned ozanimod 0.46 mg or 0.92 mg or interferon β-1a 30 μg.

RECLAIM-A retrospective, multicenter observational study aimed at enabling the development of artificial intelligence-driven prognostic models for disease progression in multiple sclerosis.

Multiple sclerosis (MS) is characterized by a progressive worsening of disability over time. As many regulatory-cleared disease-modifying treatments aiming to slow down this progression are now available, a clear need has arisen for a personalized and data-driven approach to treatment optimization in order to more efficiently slow down disease progression and eventually, progressive disability worsening. This strongly depends on the availability of biomarkers that can detect and differentiate between the different forms of disease worsening, and on predictive models to estimate the disease trajectory for each patient under certain treatment conditions.

Changes in circulating pro-inflammatory lymphocytes and cortical excitability with extended-interval natalizumab dosing in multiple sclerosis.

Background: Natalizumab is a potent treatment for multiple sclerosis (MS). By inhibiting immune cell trafficking to the CNS it increases the risk of progressive multifocal leukoencephalopathy (PML). Extended interval dosing (EID) aims to mitigate PML risk by partly restoring immune surveillance.

Digital remote monitoring of people with multiple sclerosis.

Introduction: Multiple sclerosis (MS) is a chronic neurodegenerative disease that affects over 2.8 million people globally, leading to significant motor and non-motor symptoms. Effective disease monitoring is critical for improving patient outcomes but is often hindered by the limitations of infrequent clinical assessments.

Identifying Biomarkers for Remyelination and Recovery in Multiple Sclerosis: A Measure of Progress.

Multiple sclerosis (MS) pathology is characterized by acute and chronic inflammation, demyelination, axonal injury, and neurodegeneration. After decades of research into MS-related degeneration, recent efforts have shifted toward recovery and the prevention of further damage. A key area of focus is the remyelination process, where researchers are studying the effects of pharmacotherapy on myelin repair mechanisms.

Patient-Generated Data as Indicators of Impact of Multidisciplinary and Multi-stakeholder Health Care Systems, in the Age of Personalised Medicine.

Using the case study of the Multiple Sclerosis Care Unit Initiative launched by the European Charcot Foundation, we discuss the need to evaluate the impact of multidisciplinary and multi-stakeholder healthcare systems on patient-reported experience and outcomes for the programming and monitoring of brain and neurodegenerative diseases in Europe and beyond. The multiple sclerosis (MS) case study presented in this paper highlights the role of patient-generated data as indicators of the impact of value-based healthcare (VBHC) for all the different neurological diseases whose prodromal symptoms are the first signs of disease progression and therefore instrumental markers for preventive treatments to preserve brain health. A holistic approach to the treatment of MS plays a crucial role in the inclusion and scientific meaning of the patient's perspective in terms of patient-reported dimension and patient-generated health data (PGHD).

Transcorneal Electrical Stimulation Modulates Visual Pathway Function in Mice.

Due to its ability to modulate neuronal activity, electrical stimulation of the eye may be a promising therapy for preserving or restoring vision. To investigate how electrical currents can influence visual function, Transcorneal Electrical Stimulation (TES) was tested on both female and male C57BL/6 mice to evaluate its neuromodulatory effect from the retina to the cerebral cortex through visual evoked potential (VEP) and electroretinogram (ERG) recording. VEP or ERG was acquired before (baseline), immediately (t0), after 5 min (t5), and 10 min (t10) of sham (i.

Transcranial direct current stimulation as a potential remyelinating therapy: Visual evoked potentials recovery in cuprizone demyelination.

Aims: Non-invasive neuromodulation by transcranial direct current stimulation (tDCS), owing to its reported beneficial effects on neuronal plasticity, has been proposed as a treatment to promote functional recovery in several neurological conditions, including demyelinating diseases like multiple sclerosis. Less information is available on the effects of tDCS in major pathological mechanisms of multiple sclerosis, such as demyelination and inflammation. To learn more about the latter effects, we applied multi-session anodal tDCS in mice exposed to long-term cuprizone (CPZ) diet, known to induce chronic demyelination.

Assessing disease progression and treatment response in progressive multiple sclerosis.

Progressive multiple sclerosis poses a considerable challenge in the evaluation of disease progression and treatment response owing to its multifaceted pathophysiology. Traditional clinical measures such as the Expanded Disability Status Scale are limited in capturing the full scope of disease and treatment effects. Advanced imaging techniques, including MRI and PET scans, have emerged as valuable tools for the assessment of neurodegenerative processes, including the respective role of adaptive and innate immunity, detailed insights into brain and spinal cord atrophy, lesion dynamics and grey matter damage.

The history of the European Neurological Society (1986-2014)-10 years later.

Background And Purpose: The European Academy of Neurology (EAN) was a merger from two parent societies: the European Neurological Association (ENS, founded in 1986) and the European Federation of Neurological Societies (EFNS, founded in 1987).

Methods: This article was written by nine former presidents, three of whom were also founders of the ENS, and is based on recollections and documents. It follows up on a review of the ENS history stored in the EAN archive.

Development and validation of an electronic Symbol-Digit Modalities Test for remote monitoring of people with multiple sclerosis.

Background: Computerized cognitive tests may extend the reach of cognitive screening and monitoring to those with mobility issues or living in remote areas. Moreover, it could enable frequent and autonomous remote cognitive assessments in people with multiple sclerosis (pwMS) on account of its reduced economic and organizational costs. This may further improve our understanding of longitudinal trends and significantly improve the standard of care for pwMS living in remote areas or with mobility limitations.

A future of AI-driven personalized care for people with multiple sclerosis.

Multiple sclerosis (MS) is a devastating immune-mediated disorder of the central nervous system resulting in progressive disability accumulation. As there is no cure available yet for MS, the primary therapeutic objective is to reduce relapses and to slow down disability progression as early as possible during the disease to maintain and/or improve health-related quality of life. However, optimizing treatment for people with MS (pwMS) is complex and challenging due to the many factors involved and in particular, the high degree of clinical and sub-clinical heterogeneity in disease progression among pwMS.

Machine learning-driven diagnosis of multiple sclerosis from whole blood transcriptomics.

Multiple sclerosis (MS) is a neurological disorder characterized by immune dysregulation. It begins with a first clinical manifestation, a clinically isolated syndrome (CIS), which evolves to definite MS in case of further clinical and/or neuroradiological episodes. Here we evaluated the diagnostic value of transcriptional alterations in MS and CIS blood by machine learning (ML).