Disability outcomes in the N-MOmentum trial of inebilizumab in neuromyelitis optica spectrum disorder

OBJECTIVE: To assess treatment effects on Expanded Disability Status Scale (EDSS) score worsening and modified Rankin Scale (mRS) scores in the N-MOmentum trial of inebilizumab, a humanized anti-CD19 monoclonal antibody, in participants with neuromyelitis optica spectrum disorder (NMOSD). METHODS: Adults (N = 230) with aquaporin-4 immunoglobulin G-seropositive NMOSD or -seronegative neuromyelitis optica and an EDSS score ≤8 were randomized (3:1) to receive inebilizumab 300 mg or placebo on days 1 and 15. The randomized controlled period (RCP) was 28 weeks or until adjudicated attack, with an option to enter the inebilizumab open-label period. Three-month EDSS-confirmed disability progression (CDP) was assessed using a Cox proportional hazard model. The effect of baseline subgroups on disability was assessed by interaction tests. mRS scores from the RCP were analyzed by the Wilcoxon-Mann-Whitney odds approach. RESULTS: Compared with placebo, inebilizumab reduced the risk of 3-month CDP (hazard ratio [HR]: 0.375; 95% CI: 0.148-0.952; p = 0.0390). Baseline disability, prestudy attack frequency, and disease duration did not affect the treatment effect observed with inebilizumab (HRs: 0.213-0.503; interaction tests: all p > 0.05, indicating no effect of baseline covariates on outcome). Mean EDSS scores improved with longer-term treatment. Inebilizumab-treated participants were more likely to have a favorable mRS outcome at the end of the RCP (OR: 1.663; 95% CI: 1.195-2.385; p = 0.0023). CONCLUSIONS: Disability outcomes were more favorable with inebilizumab vs placebo in participants with NMOSD

Música e Identidade: relatos de autobiografias musicais em pacientes com esclerose múltipla Music and identity: musical autobiographies in multiple sclerosis patients

Autobiografias musicais constituem um recurso terapêutico eloqüente a respeito de como os indivíduos definem a si mesmos, auxiliando a (re)construção da identidade e contribuindo para a melhoria da qualidade de vida de portadores de Esclerose Múltipla. Oito pacientes adultos sob acompanhamento no Centro de Investigação em Esclerose Múltipla (CIEM) - UFMG, selecionaram entre 10 a 15 músicas significativas em sua vida, a respeito das quais discorreram em entrevista aberta. Os dados foram analisados qualitativamente segundo categorias criadas pelo musicoterapeuta norueguês Even RUDD (1998), que visam revelar como o indivíduo expressa suas identidades pessoal, social, temporal e transpessoal. Submetidos a tratamento quantitativo, os dados indicaram que, através da sua história musical, os pacientes aumentaram a percepção dos sentimentos e sensações corporais, expressaram-se de maneiras alternativas e ativaram memórias afetivas, contextualizando-as e adquirindo um senso de continuidade da vida.<br>Musical autobiographies consist a powerful therapeutic tool through which individuals define themselves, helping in the (re)construction of their identities and in enhancing quality of life of Multiple Sclerosis patients. Eight adult patients under treatment in the Research Centre for Multiple Sclerosis (CIEM) - UFMG, selected 10 to 15 significant pieces of music in their lives, after which they narrated in open interview. The data collected were submitted to the music therapist Even RUDD (1998) categories, which reveal how the person expresses his personal, social, temporal and transpersonal identities. The quantitative treatment indicate that, through their musical history, patients could better the perception of their feelings and body awareness, they could express themselves through alternative ways and activated affective memories, contextualizing them and achieving a sense of continuity of life