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Franco, Carolina Azze; Elias, Isaac; Mendonça, Andreia Costa Rabelo; Carvalho, L. F. D.; Diniz, Denise Sisterolli; Tur, C; Tintoré, Mar; Oliveira, Enedina Maria Lobato de; Bichuetti, Denis Bernardi

doi:10.1177/1352458517731285

Cited by 36 publications

(3 citation statements)

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“…Case reports have reported similar findings with subcutaneous cladribine [66]. No treatment effect on cNFL was seen with monthly methylprednisolone, intrathecal mesenchymal stem cells, intrathecal and intravenous rituximab, intraventricular rituximab, dimethyl fumarate and intrathecal methotrexate [67][68][69][70][71][72].…”

Section: Nfl As a Biomarker Of Treatment Effectmentioning

confidence: 92%

Neurofilaments in progressive multiple sclerosis: a systematic review

2020

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Background Neurofilament proteins have been extensively studied in relapsing-remitting multiple sclerosis, where they are promising biomarkers of disease activity and treatment response. Their role in progressive multiple sclerosis, where there is a particularly urgent need for improved biomarkers, is less clear. The objectives of this systematic review are to summarise the literature on neurofilament light and heavy in progressive multiple sclerosis, addressing key questions. Methods A systematic search of PubMed, Embase, Web of Science and Scopus identified 355 potential sources. 76 relevant sources were qualitatively reviewed using QUADAS-2 criteria, and 17 were identified as at low risk of bias. We summarise the findings from all relevant sources, and separately from the 17 high-quality studies. Results Differences in neurofilament light between relapsing-remitting and progressive multiple sclerosis appear to be explained by differences in covariates. Neurofilament light is consistently associated with current inflammatory activity and future brain atrophy in progressive multiple sclerosis, and is consistently shown to be a marker of treatment response with immunosuppressive disease-modifying therapies. Associations with current or future disability are inconsistent, and there is no evidence of NFL being a responsive marker of purportedly neuroprotective treatments. Evidence on neurofilament heavy is more limited and inconsistent. Conclusions Neurofilament light has shown consistent utility as a biomarker of neuroinflammation, future brain atrophy and immunosuppressive treatment response at a group level. Neither neurofilament light or heavy has shown a consistent treatment response to neuroprotective disease-modifying therapies, which will require further data from successful randomised controlled trials.

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Section: Nfl As a Biomarker Of Treatment Effectmentioning

confidence: 92%

Neurofilaments in progressive multiple sclerosis: a systematic review

2020

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“…Most of the studies have only accounted for relapses in the first year postpartum. However, two studies extended the observation period and found prolonged beneficial effects on ARR ( 67 , 68 ). Real-world evidence showed that breastfeeding did not substantially modify the risk of disability over time ( 69 ), but prospective studies with a longer observational time are still required.…”

Section: Current Research Gapsmentioning

confidence: 99%

The protective role of breastfeeding in multiple sclerosis: Latest evidence and practical considerations

2023

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The immunoprotective role of pregnancy in multiple sclerosis (MS) has been known for decades. Conversely, there has been rich debate on the topic of breastfeeding and disease activity in MS. In clinical practice, women are often offered to restart their disease-modifying drug (DMD) soon after delivery to maintain their relapse risk protection. Limited available information about peri-partum DMD safety can discourage women to choose breastfeeding, despite the World Health Organization's recommendation to breastfeed children for the first 6 months of life exclusively. New evidence is emerging about the protective role of exclusive breastfeeding on relapse rate. Research studies shed light on the hormonal and immunological mechanisms driving the risk of relapses during pregnancy and postpartum. Finally, case reports, real-world data, and clinical trials are increasing our knowledge of the safety of DMDs for the fetus and infant. While some DMDs must be avoided, others may be considered in highly active pregnant or lactating women with MS. This mini-review conveys recent evidence regarding the protective role of exclusive breastfeeding in MS and offers clinicians practical considerations for a patient-tailored approach.

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“…MC1R, MC3R, and MC5R subtypes are found on macrophages, B lymphocytes, and T lymphocytes and mediate the anti-inflammatory and immunomodulatory properties of MCR agonists. 7,[9][10][11] RCI inhibits B lymphocyte proliferation and immunoglobulin production 12 and inhibits inflammatory cytokine production from macrophages 13 and T lymphocytes 14 in vitro.…”

Section: Introductionmentioning

confidence: 99%

Real-World Treatment Patterns and Outcomes from an Electronic Medical Records Database for Patients with Rheumatoid Arthritis Treated with Repository Corticotropin Injection

Hayes

Panaccio

Houston

et al. 2021

OARRR

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Purpose: Repository corticotropin injection (RCI; Acthar ® Gel) is a naturally sourced mixture of adrenocorticotropic hormone analogs and other pituitary peptides that exerts antiinflammatory and immunomodulatory properties via melanocortin receptors. RCI is approved as a short-term adjunctive therapy for rheumatoid arthritis (RA) and is typically used in patients with refractory RA. The objective of this study was to describe real-world outcomes of RA patients treated with RCI by retrospective analysis of an electronic medical records (EMR) database. Patients and Methods: EMR data were obtained from the United Rheumatology-Normal Integrated Community Evidence (UR-NICE TM ) data repository for patients who used RCI for the treatment of RA. Demographics, comorbidities, disease history, medications, and laboratory evaluations 365 days prior to and 365 days after initiation of RCI were examined. Results: The patient cohort was predominantly White females with a mean age of 60 years and high RA activity prior to RCI therapy. Clinical measures of disease severity indicated that patients had high RA activity before starting RCI therapy. Clinical Disease Activity Index (CDAI) scores were significantly reduced 365 days post-initiation of RCI. Swollen and tender joint counts and patient-reported outcomes, including Routine Assessment of Patient Index Data 3 (RAPID3), Physician Global Assessment, and patient assessment of pain severity were also significantly lower. The number of patients taking conventional synthetic (cs) disease-modifying antirheumatic drugs (DMARDs), biologic (b) DMARDs, nonsteroidal anti-inflammatory drugs (NSAIDS), and opioids decreased, as did the number of drugs tried within each class for csDMARDs, bDMARDs, NSAIDs, and glucocorticoids. Conclusions: These findings suggest that RCI significantly improves clinical outcomes of RA and decreases the need for concomitant medications for up to 1 year following initiation of therapy. The study provides valuable insights into the use of RCI and management of these difficult-to-treat RA patients during routine clinical practice.

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ePosters

Cited by 36 publications

References 0 publications

Neurofilaments in progressive multiple sclerosis: a systematic review

Neurofilaments in progressive multiple sclerosis: a systematic review

The protective role of breastfeeding in multiple sclerosis: Latest evidence and practical considerations

Real-World Treatment Patterns and Outcomes from an Electronic Medical Records Database for Patients with Rheumatoid Arthritis Treated with Repository Corticotropin Injection

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