Disease-Modifying Drugs and Family Planning in People with Multiple Sclerosis: A Consensus Narrative Review from the Gulf Region

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High-efficacy therapies for relapsing-remitting multiple sclerosis: implications for adherence. An expert opinion from the United Arab Emirates

The number of disease-modifying treatments (DMDs) for relapsing-remitting multiple sclerosis has increased. DMDs differ not only in their efficacy and safety/tolerability, but also in the treatment burden of, associated with their initiation, route/frequency of administration, maintenance treatment and monitoring. High-efficacy DMDs bring the prospect of improved suppression of relapses and progression of disability, but may have serious safety issues, and burdensome long-term monitoring. Studies of patient preferences in this area have focused on side effects, efficacy and route of administration. Adherence to DMDs is often suboptimal in relapsing-remitting multiple sclerosis and there is a need to understand more about how the complex therapeutic and administration profiles of newer DMDs interact with these barriers to support optimal adherence to therapy

Expert consensus from the Arabian Gulf on selecting disease-modifying treatment for people with multiple sclerosis according to disease activity.

AbstractRecent research has expanded our understanding of the natural history and clinical course of multiple sclerosis (MS) in the Arabian Gulf region. In addition, the number of available therapi..

Of all the Nerve... (Audio)

Dysphagia; Dyarthria; Left facial numbnessA 46-year old male with difficulty swallowing and right facial droop. Previous history significant for cancer, bipolar disease, pseudopseudohypoparathyroidism and a personal history of polysubstance abuse along with a 34-year history of heavy smoking.VA: 20/50 OD, 20/200 OS; Color plates: 14/15 OD, 0/15 OSCT; MRIMalignant epithelial cells with fibrosis and inflammation of the peripheral nerves.Surgery; Antineoplastic agents1. Krendel DA, Ditter SM, Frankel MR, Ross WK, Biopsy proven cerebral vasculitis associated with cocaine abuse. Neurology, 40, 1092, 1990. 2. Ballantyne AJ, McCarten AB, Ibanez IL, The extension of cancer of the head and neck through peripheral nerves, AmerJ Surg, 106, 651, 1963. 3. Clouston PD, Sharpe DM, Corbett AJ, Kos S, Kennedy PJ, Perineural spread of cutaneous head and neck cancer - its orbital and central neurologic complications, Arch Neurol, 47, 73, 1 990. 4. ten Hove MW, Glaser JS, Schatz JS, Occult perineural tumor infiltration of the trigeminal nerve, J Neuro-Ophthalmol, 17(3), 170, 1997. 5. Trobe JD, Hood CI, Parsons JT, Quisling RG, Intracranial extension of squamous carcinoma along trigeminal nerve, Arch Ophthalmol, 100(4), 608, 1982. 6. Sullivan LM, Smee R, Leptomeningeal carcinomatosis from perineural invasion of lip squamous cell carcinoma, Australasian Radiology, 50, 262, 2006. 7. Nogajski JH, Brewer J, Storey CE, Perineural spread of facial squamous cell carcinoma, J Clin Neurosci, 13, 400, 2006

Of all the Nerve

Dysphagia; Dysarthria; Left facial numbnessA 46-year old male with difficulty swallowing and right facial droop. Previous history significant for cancer, bipolar disease, pseudopseudohypoparathyroidism and a personal history of polysubstance abuse along with a 34-year history of heavy smoking.VA: 20/50 OD, 20/200 OS; Color plates: 14/15 OD, 0/15 OSCT; MRIMalignant epithelial cells with fibrosis and inflammation of the peripheral nerves.Surgery; Antineoplastic agents1. Krendel DA, Ditter SM, Frankel MR, Ross WK, Biopsy proven cerebral vasculitis associated with cocaine abuse. Neurology, 40, 1092, 1990. 2. Ballantyne AJ, McCarten AB, Ibanez IL, The extension of cancer of the head and neck through peripheral nerves, AmerJ Surg, 106, 651, 1963. 3. Clouston PD, Sharpe DM, Corbett AJ, Kos S, Kennedy PJ, Perineural spread of cutaneous head and neck cancer - its orbital and central neurologic complications, Arch Neurol, 47, 73, 1 990. 4. ten Hove MW, Glaser JS, Schatz JS, Occult perineural tumor infiltration of the trigeminal nerve, J Neuro-Ophthalmol, 17(3), 170, 1997. 5. Trobe JD, Hood CI, Parsons JT, Quisling RG, Intracranial extension of squamous carcinoma along trigeminal nerve, Arch Ophthalmol, 100(4), 608, 1982. 6. Sullivan LM, Smee R, Leptomeningeal carcinomatosis from perineural invasion of lip squamous cell carcinoma, Australasian Radiology, 50, 262, 2006. 7. Nogajski JH, Brewer J, Storey CE, Perineural spread of facial squamous cell carcinoma, J Clin Neurosci, 13, 400, 2006

Of all the Nerve... (PowerPoint)

Dysphagia; Dyarthria; Left facial numbnessA 46-year old male with difficulty swallowing and right facial droop. Previous history significant for cancer, bipolar disease, pseudopseudohypoparathyroidism and a personal history of polysubstance abuse along with a 34-year history of heavy smoking.VA: 20/50 OD, 20/200 OS; Color plates: 14/15 OD, 0/15 OSCT; MRIMalignant epithelial cells with fibrosis and inflammation of the peripheral nerves.Surgery; Antineoplastic agents1. Krendel DA, Ditter SM, Frankel MR, Ross WK, Biopsy proven cerebral vasculitis associated with cocaine abuse. Neurology, 40, 1092, 1990. 2. Ballantyne AJ, McCarten AB, Ibanez IL, The extension of cancer of the head and neck through peripheral nerves, AmerJ Surg, 106, 651, 1963. 3. Clouston PD, Sharpe DM, Corbett AJ, Kos S, Kennedy PJ, Perineural spread of cutaneous head and neck cancer - its orbital and central neurologic complications, Arch Neurol, 47, 73, 1 990. 4. ten Hove MW, Glaser JS, Schatz JS, Occult perineural tumor infiltration of the trigeminal nerve, J Neuro-Ophthalmol, 17(3), 170, 1997. 5. Trobe JD, Hood CI, Parsons JT, Quisling RG, Intracranial extension of squamous carcinoma along trigeminal nerve, Arch Ophthalmol, 100(4), 608, 1982. 6. Sullivan LM, Smee R, Leptomeningeal carcinomatosis from perineural invasion of lip squamous cell carcinoma, Australasian Radiology, 50, 262, 2006. 7. Nogajski JH, Brewer J, Storey CE, Perineural spread of facial squamous cell carcinoma, J Clin Neurosci, 13, 400, 2006

Expert opinion on clinical experience with subcutaneous interferon beta‐1a in multiple sclerosis patients with different disease activity profiles

AbstractLatest diagnostic criteria have increased the speed and accuracy of multiple sclerosis diagnosis. Early diagnosis of multiple sclerosis and early treatment initiation help in achieving better clinical outcomes. Accordingly, recent clinical studies include patients with less severe multiple sclerosis as compared to older studies, and in this milder multiple sclerosis population, many patients do not progress over 2 years. Interferon beta‐1a has been used for the treatment of relapsing multiple sclerosis for more than 20 years and has been assessed in multiple clinical trials of varying lengths. Clinical trials of subcutaneous interferon beta‐1a show efficacy in terms of relapse rate, magnetic resonance imaging outcomes, and long‐term disability measures in relapsing multiple sclerosis patients with different disease activity profiles. This article discusses multiple sclerosis experts' opinions on the level of disease activity of the patient populations used in the clinical trials of subcutaneous interferon beta‐1a and on the effectiveness of subcutaneous interferon beta‐1a in these patient populations. Based on experts' opinions, it can be concluded that patients with mild or moderate disease activity have a high potential of benefiting from high‐dose subcutaneous interferon beta‐1a