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Neurodegenerative Disease Management

Natalie Witek, Cynthia Comella
Tardive dyskinesia (TD) is a bothersome and - at times, disabling - movement disorder associated with exposure to dopamine receptor antagonist medications. On 11 April 2017, valbenazine became the first US FDA-approved medication indicated for the treatment of TD. Valbenazine is a vesicular monoamine transporter 2 (VMAT2) inhibitor that decreases the abnormal movements of TD. The FDA considered valbenazine a breakthrough therapy in 2014 given its underlying mechanism and its importance in addressing an unmet need, as there were no available FDA-approved medications indicated for TD...
February 6, 2019: Neurodegenerative Disease Management
Nicki Niemann, Joohi Jimenez-Shahed
Tardive dyskinesia is a common movement disorder in the population of patients taking dopamine receptor blocking agents, such as antipsychotics and certain antiemetics, which likely lead to D2-receptor upregulation and hypersensitization. Efficacious and well-tolerated treatments are now available to reduce symptoms. Deutetrabenazine, a reversible inhibitor of vesicular monoamine transporter 2, was US FDA-approved for treatment of tardive dyskinesia in 2017. Two pivotal clinical trials, Aim to Reduce Movements in Tardive Dyskinesia (ARM-TD) and Addressing Involuntary Movements in Tardive Dyskinesia (AIM-TD), provide evidence that deutetrabenazine dosed 24-48 mg/day effectively controlled involuntary movements according to rating scales...
January 31, 2019: Neurodegenerative Disease Management
Francesco Patti
Postapproval studies have an essential role in demonstrating that an intervention is effective and well tolerated during use in daily clinical practice. Numerous large observational and registry studies of tetrahydrocannabinol (THC):cannabidiol (CBD) oromucosal spray have been conducted subsequent to its approval in Europe in 2011. Collectively, these studies provide valuable insight into various aspects of THC:CBD spray during real-world use in patients with multiple sclerosis spasticity, including its long-term effectiveness and tolerability...
January 18, 2019: Neurodegenerative Disease Management
Jolana Marková
Subsequent to EMA approval of tetrahydrocannabinol (THC): cannabidiol (CBD) oromucosal spray based on results of various studies, including an enriched-design clinical trial, two newer postapproval randomized trials have confirmed its efficacy and safety for treating resistant multiple sclerosis spasticity, while simultaneously addressing specific authorities' concerns. A double-blind, placebo-controlled, Phase IV trial, conducted as part of the EMA's risk management plan, found no effect of THC:CBD spray on cognition and mood after 50 weeks of treatment...
January 18, 2019: Neurodegenerative Disease Management
Tjalf Ziemssen
Proceedings of an Almirall-sponsored satellite symposium held at the 34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis in Berlin, Germany, 10 October 2018.
January 18, 2019: Neurodegenerative Disease Management
Laura Dormer
No abstract text is available yet for this article.
January 14, 2019: Neurodegenerative Disease Management
Linda Lee, Loretta M Hillier, Stephanie K Lu, Sharon Dillon Martin, Sarah Pritchard, Jennifer Janzen, Karen Slonim
AIM: This study pilot-tested the person-centered risk assessment framework (PCRAF), a framework for managing risk among persons living with dementia (PLWD) in primary care. METHODS: Healthcare providers (N = 7) piloting the PCRAF completed a survey, rating their satisfaction with the tool, and an interview to gather their perceptions of the PCRAF. PLWD and care partners (N = 12) completed a survey, rating their satisfaction with safety planning. RESULTS: Care providers were very satisfied with the tool; however, patient or care partner inability to perceive or understand safety risks was a challenge...
January 14, 2019: Neurodegenerative Disease Management
Alby Richard, Samuel Frank
Deutetrabenazine (DTBZ) is a US FDA-approved treatment for chorea in Huntington's disease. The substitution of deuterium for hydrogen at specific positions imparts a longer half-life on DTBZ, allowing for less-frequent daily dosing. As a reversible vesicular monoamine transporter Type 2 inhibitor, DTBZ depletes monoamines at presynaptic nerve terminals. DTBZ significantly improved chorea in Huntington's disease patients compared with placebo. This effect continued in an ongoing open-label extension study in the cohort who switched from tetrabenazine to DTBZ...
January 9, 2019: Neurodegenerative Disease Management
Merrill D Benson, Noel R Dasgupta, Brett P Monia
Hereditary  transthyretin amyloidosis (ATTR) is a fatal systemic disease that results from deposition of the misfolded protein transthyretin (TTR) in tissues. Common clinical manifestations of ATTR include peripheral neuropathy, cardiomyopathy, autonomic dysfunction, diarrhea and constipation. Historically there have not been effective therapies for this devastating disease. Inotersen/Tegsedi™ (Akcea Therapeutics, MA, USA) is a second-generation antisense oligonucleotide (ASO) specific for TTR that inhibits production of TTR by the liver...
December 18, 2018: Neurodegenerative Disease Management
Werner Poewe, K Ray Chaudhuri, Lars Bergmann, Angelo Antonini
AIM: To evaluate long-term effects of levodopa-carbidopa intestinal gel on dyskinesia burden. PATIENTS & METHODS: Posthoc analysis of the GLORIA registry assessed subgroups of advanced Parkinson's disease patients with <4 and ≥4 h/day of levodopa-induced dyskinesia at baseline. RESULTS & CONCLUSIONS: Mean dyskinesia duration significantly (p < 0.0001) decreased by 3.5 h in patients with ≥4 h baseline dyskinesia; conversely, dyskinesia duration increased by 1...
December 14, 2018: Neurodegenerative Disease Management
Linda Lee, Karen Slonim, Loretta M Hillier, Stephanie K Lu, Jennifer Lee
AIMS: To understand persons with dementia (PWD) and care partners' experiences with the Primary Care Collaborative Memory Clinic (PCCMC) care model. METHODS: Interviews were conducted with a purposeful sample of PWD (n = 12) and care partners (N = 16) to identify their perspectives of care received in the clinic and suggestions for improvement. RESULTS: PWD and care partners were satisfied with care received within the PCCMC, had positive interactions with and perceived a strong sense of support from team members and felt listened to; the necessity of cognitive testing was recognized but disliked...
December 2018: Neurodegenerative Disease Management
Philippe Huot
No abstract text is available yet for this article.
December 2018: Neurodegenerative Disease Management
Viraj Bharambe, Andrew J Larner
AIM: To examine features associated with functional cognitive disorders (FCDs) compared with neurological cognitive disorders (dementia, mild cognitive impairment, transient amnesias) in consecutive patients referred to a secondary care cognitive disorders clinic. METHODS: Patients diagnosed with either neurological cognitive disorder or FCD were compared by demographic (age, gender, handedness, referral source) and clinical features (family history of dementia, clinical signs, Likert screening measure of subjective memory complaint, mini-Addenbrooke's Cognitive Examination)...
December 2018: Neurodegenerative Disease Management
Samar S Ayache, Moussa A Chalah
Multiple sclerosis (MS) is an autoimmune disease of the central nervous system, characterized by chronic inflammation, demyelination, synaptopathy and neurodegeneration. Patients may exhibit sensory, motor, cognitive, emotional and behavioral symptoms throughout their disease process. Nowadays, the challenge is to find optimal treatment for MS symptoms, especially that available pharmacological interventions are faced by modest therapeutic outcomes and numerous side effects. Thus, finding alternative strategies might be of help in this context...
December 2018: Neurodegenerative Disease Management
Hannah Brown, Simone Gabriele, Joanna White
OBJECTIVE: To assess factors used in treatment decision-making for relapsing-remitting multiple sclerosis in both the 5EU (UK/Germany/France/Italy/Spain) and the USA. METHODS: Data were abstracted from the Ipsos Healthcare Global Multiple Sclerosis Therapy Monitor (data abstracted September-December, 2015-2017) a bi-annual online chart-review study of patients with multiple sclerosis. RESULTS: Treatment choices were primarily due to efficacy for relapses while convenience factors, other than oral administration, were uncommon...
December 2018: Neurodegenerative Disease Management
Arnt V Kristen, Senda Ajroud-Driss, Isabel Conceição, Peter Gorevic, Theodoros Kyriakides, Laura Obici
Hereditary transthyretin-mediated amyloidosis is a rapidly progressive, heterogeneous disease caused by the accumulation of misfolded transthyretin protein as amyloid fibrils at multiple sites, and is characterized by peripheral sensorimotor neuropathy, autonomic neuropathy and/or cardiomyopathy. Current treatment options have limited efficacy and often do not prevent disease progression. Patisiran is a novel RNA interference therapeutic that specifically reduces production of both wild-type and mutant transthyretin protein...
November 27, 2018: Neurodegenerative Disease Management
Volker Limmroth, Iason Bartzokis, Eckhard Bonmann, Patrick Kusel, Thomas Schreiner, Markus Schürks
Adherence to long-term treatment in chronic diseases such as multiple sclerosis is challenging. Many disease-modifying drugs (DMDs) for MS need to be injected. Injection devices may improve satisfaction with the injection procedure and boost adherence. Meeting patients' needs in handling and design of autoinjectors and other supporting elements may be key to successful therapy. The BETACONNECT™ system is a platform-based approach in DMD therapy. It combines autoinjector technology with digital tools to support patient self-management and facilitate communication between patients and healthcare providers...
October 3, 2018: Neurodegenerative Disease Management
Danko Coric, Jenny A Nij Bijvank, Laurentius J van Rijn, Axel Petzold, Lisanne J Balk
In this review, a current overview is provided of how optical coherence tomography and infrared oculography can aid in assessing the visual system and CNS in multiple sclerosis (MS). Both afferent and efferent visual disorders are common in MS and visual complaints can have a tremendous impact on daily functioning. Optical coherence tomography and infrared oculography can detect and quantify visual disorders with high accuracy, but could also serve as quantitative markers for inflammation, neurodegeneration and network changes including cognitive decline in MS patients...
October 2018: Neurodegenerative Disease Management
Robert W Motl, Brian M Sandroff, Edward McAuley
AIM: This study examined the trajectory and pattern of naturally occurring change in perceived walking impairment over a 30-month period in relapsing-remitting multiple sclerosis (RRMS). PATIENTS & METHODS: Two hundred and sixty-nine persons with RRMS completed the 12-item Multiple Sclerosis Walking Scale (MSWS-12) every 6 months over a 30-month period. Data were analyzed using latent growth curve modeling and latent class growth curve modeling. RESULTS: Latent growth curve modeling demonstrated that a linear trajectory adequately described the group-level pattern of change in MSWS-12 scores over time...
October 2018: Neurodegenerative Disease Management
Yusuf A Rajabally
No abstract text is available yet for this article.
October 2018: Neurodegenerative Disease Management
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