Neurology and Therapy最新文献

{"title":"Disrupting Migraine Dynamics: A Narrative Review of the Consequences of Modern Anti-CGRP Monoclonal Antibody Therapies.","authors":"Dawn C Buse, Jan Versijpt, Hans-Christoph Diener","doi":"10.1007/s40120-025-00769-z","DOIUrl":"10.1007/s40120-025-00769-z","url":null,"abstract":"<p><p>This article provides an overview of a symposium held as part of the proceedings at the 10th European Academy of Neurology Congress in Helsinki, Finland, on 2 July 2024. Migraine is a common neurological disease and a leading cause of disability worldwide. Anti-calcitonin gene-related peptide (CGRP) therapies are the first to be specifically developed for migraine prevention and are recommended as a first-line option by the American Headache Society and European Headache Federation. Data on the effectiveness of anti-CGRP therapies are now available from clinical trials and real-world studies, and this article briefly reviews these data and discusses what they mean for people with migraine, and how healthcare professionals can take the conversation back to their clinics.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"1185-1196"},"PeriodicalIF":3.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Effectiveness of Fumarates Versus Sphingosine-1-Phosphate Receptor Modulators in Black Patients with Multiple Sclerosis.","authors":"Sophia Woodson, Edward J Gettings, Chu-Yueh Guo, Sylvia Klineova, Jong-Mi Lee, Rebecca S Romero, Aljoeson Walker, Nicholas Belviso, Sai L Shankar, Jason P Mendoza, Boyang Bian, James B Lewin, Kinyee Fong","doi":"10.1007/s40120-025-00774-2","DOIUrl":"10.1007/s40120-025-00774-2","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple sclerosis (MS) is a heterogeneous disease that disproportionately impacts Black people with MS (PwMS), who experience more severe disease and higher relapse rates compared with non-Black populations. Despite widespread use of fumarates and sphingosine-1-phosphate (S1P) receptor modulators as oral disease-modifying therapies (DMTs) for relapsing MS, their comparative effectiveness in Black PwMS has not been studied. This study aims to help address this gap using real-world claims data.</p><p><strong>Methods: </strong>This retrospective analysis using the Komodo Health Claims Database included Black PwMS. Patients were aged 18-64 years with ≥ 1 claim for MS diagnosis (International Classification of Diseases, Tenth Revision, Clinical Modification code G35) and ≥ 1 prescription claim for fumarates (dimethyl fumarate or diroximel fumarate) or an S1P receptor modulator (fingolimod, siponimod, ozanimod, or ponesimod) between January 2017 and April 2023. Outcomes included annualized relapse rate (ARR) and time to first relapse. Propensity score matching (2:1) and inverse probability weighting were used to balance baseline characteristics. Relapse events were identified using a claims-based algorithm.</p><p><strong>Results: </strong>The analysis included 1664 Black PwMS (1231 and 433 in fumarate and S1P treatment arms, respectively). Post-index ARRs were comparable between groups (rate ratio [RR] 1.18, p = 0.423). Kaplan-Meier analyses showed similar relapse-free proportions at 24 months (72.6% and 74.7% in fumerate and S1P populations, respectively; p = 0.152). These findings were consistent in both the propensity score-matched and inverse probability weighted populations.</p><p><strong>Conclusions: </strong>This real-world, claims-based analysis demonstrates that fumarates and S1P receptor modulators have similar effectiveness in reducing relapses among Black PwMS, with > 72% of patients in both treatment groups remaining relapse-free at 24 months. Given the underrepresentation of Black patients in MS clinical trials, these results provide valuable real-world evidence to guide treatment decisions for this population.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"1627-1639"},"PeriodicalIF":3.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of PARCOMS Composite Scales for Assessing Disease Progression and Treatment Effects in Parkinson's Disease.","authors":"Gil L'Italien, Basia Rogula, Lauren Powell, Michele Potashman, Samuel P Dickson, Nick Kozauer, Patrick O'Keefe, Ellen Korol, Madeleine Crabtree, Fernanda Nagase, Vlad Coric, Jordan Dubow, Liana S Rosenthal, Suzanne Hendrix","doi":"10.1007/s40120-025-00771-5","DOIUrl":"10.1007/s40120-025-00771-5","url":null,"abstract":"<p><strong>Introduction: </strong>Measures designed to comprehensively assess Parkinson's disease (PD) irrespective of disease stage and treatment status may be unable to capture nuances in disease progression, particularly in early-stage PD. The objective of this paper is to develop PARkinson's COMposite Scales (PARCOMS) with increased responsiveness to clinical decline using items of the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) for three discrete cohorts of patients.</p><p><strong>Methods: </strong>Patients with confirmed PD from the Parkinson's Progression Markers Initiative (PPMI) data were assigned to three cohorts based on use of dopaminergic treatment, stage of disease, and presence of motor complication. For each cohort, items from MDS-UPDRS Part I (PARCOMS-Non-Motor) and Parts II and III (PARCOMS-Motor) were selected based on responsiveness using partial least squares (PLS) regression. The responsiveness of the scales was estimated using mean-to-standard deviation ratios (MSDRs) of their change values.</p><p><strong>Results: </strong>Compared to the original MDS-UPDRS, MSDRs for PARCOMS-Motor increased 13.1% (untreated cohort, n = 430), 78.2% (treated-without-motor-complications cohort, n = 426), and 100.6% (treated-with-motor-complications cohort, n = 538). The MSDR increases observed for PARCOMS-Non-Motor were 13.9%, 6.8%, and 20.7%, respectively. Across cohorts, turning in bed and speech items were large contributors to the PARCOMS-Motor scales. Items for cognitive impairment and urinary problems were substantial contributors to PARCOMS-Non-Motor across cohorts. There was variability in the weighting of items representing different clinical concepts across cohorts for each composite, confirming heterogeneity in disease progression across disease stages.</p><p><strong>Conclusions: </strong>PD stage-specific composite measures were developed and demonstrated greater sensitivity to change than the original MDS-UPDRS, supporting the value of weighted composites tailored for disease stage.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"1609-1625"},"PeriodicalIF":3.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Treatment Outcomes in Black, Hispanic, Asian, and White People with Multiple Sclerosis Treated with Fumarates in the USA.","authors":"Sophia Woodson, Edward J Gettings, Chu-Yueh Guo, Sylvia Klineova, Jong-Mi Lee, Rebecca S Romero, Aljoeson Walker, Kinyee Fong, Jason P Mendoza, Nicholas Belviso, Boyang Bian, James B Lewin, Sai L Shankar","doi":"10.1007/s40120-025-00773-3","DOIUrl":"10.1007/s40120-025-00773-3","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple sclerosis (MS) is a heterogeneous disease affecting a diverse population. Compared with white people with MS (PwMS), Black PwMS have more severe disease and higher incidence of MS, whereas Hispanic PwMS experience earlier onset disease; however, MS is not adequately studied in these groups. We compared the effectiveness of fumarates across Black, Hispanic, Asian, and white PwMS.</p><p><strong>Methods: </strong>This retrospective analysis using the Komodo Health database included PwMS. Patients with a claim for diroximel fumarate or dimethyl fumarate were followed from disease-modifying therapy (DMT) initiation to loss of follow-up or discontinuation. Outcomes included annualized relapse rate (ARR), time to post-index first relapse, healthcare resource use (HRU), healthcare costs (HCCs), and change in absolute lymphocyte counts (ALCs). Race/ethnicity was self-reported.</p><p><strong>Results: </strong>This study included 6800 PwMS (Black, n = 1241; Hispanic, n = 777; Asian, n = 132; white, n = 4650). The average exposure duration of fumarates was 449-559 days. Black PwMS had higher baseline disease burden versus white PwMS, were less likely to have commercial insurance plans, and were more likely to reside in a state with a higher poverty rate. ARRs (12-month pre-index to post-index) were significantly reduced across groups. The Kaplan-Meier estimated proportion of relapse-free patients at 2 years was similar across groups (Black, 77.0%; Hispanic, 75.4%; Asian, 81.7%; white, 80.5%). There was a smaller decline in ALC from month 0 to month 12 in Black PwMS versus other racial/ethnic groups.</p><p><strong>Conclusion: </strong>Consistent with prior studies, these results demonstrate the effectiveness of fumarates across racial and ethnic MS subgroups. This is the largest analysis to date of the treatment effects of any individual class of DMT in Black and Hispanic PwMS. Infographic available for this article.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"1641-1656"},"PeriodicalIF":3.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacokinetics, Pharmacodynamics, and Safety of Nipocalimab in Healthy Chinese Volunteers: A Single-Dose, Phase I Study.","authors":"Haiyan Li, Juanfang Liu, Xiaohong Wang, Weilong Zhao, Lili Zhang, Xiaoye Niu, Jingyao Liu, Zhongqi Dong","doi":"10.1007/s40120-025-00763-5","DOIUrl":"10.1007/s40120-025-00763-5","url":null,"abstract":"<p><strong>Introduction: </strong>Nipocalimab is a high-affinity, fully human, immunoglobulin G (IgG) 1 monoclonal antibody that inhibits the neonatal Fc receptor. Nipocalimab is under development for the treatment of various IgG autoantibody- and alloantibody-mediated diseases. This study assessed the safety, pharmacokinetics (PK), and pharmacodynamics (PD) of a single dose of nipocalimab in healthy Chinese volunteers.</p><p><strong>Methods: </strong>In this phase I, open-label study, healthy volunteers received single doses of intravenous (IV) nipocalimab at 15, 30, or 45 mg/kg. The primary objective was to assess the PK following a single administration of nipocalimab. Secondary objectives included the PD effects of nipocalimab on change from baseline in total serum IgG levels, safety, and tolerability.</p><p><strong>Results: </strong>A total of 30 healthy Chinese volunteers (mean age 31.0 years, 93.3% men) received single doses of IV nipocalimab. Following a single infusion of nipocalimab, mean exposure increased as the dose of nipocalimab increased. Maximum serum nipocalimab concentrations increased proportionally with doses, whereas the area under the concentration-time curve increased by greater than a dose-proportional manner. Nipocalimab led to dose-dependent reductions in serum IgG levels from baseline; this decrease was sustained over a longer period of time with higher dose levels. Nipocalimab was generally well tolerated, with an acceptable safety profile, across all three doses; most of the treatment-emergent adverse events (TEAEs) were mild. Higher doses of nipocalimab were not associated with increased frequency of TEAEs.</p><p><strong>Conclusion: </strong>Our findings add to the evidence on the safety, tolerability, and PD of nipocalimab in the Chinese population, and support for the treatment of pathogenic IgG-mediated diseases in this population.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05151692.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"1439-1450"},"PeriodicalIF":3.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Safety and Efficacy of Repeated Cycles of RimabotulinumtoxinB in the Treatment of Chronic Sialorrhea: Results of the OPTIMYST Trial.","authors":"Rajesh Pahwa, Eric Molho, Mark Lew, Khashayar Dashtipour, Ramon A Gil, Fredy J Revilla, Thomas Clinch, Peibing Qin, Stuart H Isaacson","doi":"10.1007/s40120-025-00777-z","DOIUrl":"10.1007/s40120-025-00777-z","url":null,"abstract":"<p><strong>Introduction: </strong>Botulinum toxin injections into the salivary glands inhibit saliva production by reducing the release of acetylcholine at the parasympathetic nerve terminals within the salivary gland. The phase 3 study reported here assessed the safety, tolerability, and effectiveness of repeated cycles of rimabotulinumtoxinB (RIMA) injections in adults with troublesome sialorrhea.</p><p><strong>Methods: </strong>In this phase 3, open-label multicenter study, 187 adult participants with troublesome sialorrhea due to Parkinson disease (65.8%), amyotrophic lateral sclerosis (13.9%), and other etiologies (20.3%) received up to 4 cycles of RIMA treatment (3500 U every 11-15 weeks).</p><p><strong>Results: </strong>Participants (69% male, 31% female; mean age 64.1 years) had sialorrhea for a mean of 3.2 years at baseline with a mean Unstimulated Salivary Flow Rate (USFR) of 0.63 ± 0.49 g/min. During the first treatment cycle, RIMA significantly reduced the mean±standard deviation (SD) USFR from baseline to week 4 by - 0.34 ± 0.37 g/min (p < 0.0001), and efficacy was maintained through week 13 (- 0.14 ± 0.29 g/min; p < 0.0001). Reductions were maintained at subsequent injection cycles 2-4, with mean absolute USFRs at weeks 4 and 13 of each cycle similar to those of cycle 1. Most adverse events (AEs) were mild, and the most commonly reported AEs in each cycle that were considered to be treatment-related were dry mouth (≤ 15.5% participants/cycle) and dental caries (≤ 6.0% participants/cycle).</p><p><strong>Conclusion: </strong>This study demonstrates that RIMA 3500 U safely reduces saliva production over repeated treatment cycles through 1 year, thereby supporting its utility in the management of troublesome sialorrhea in adults.</p><p><strong>Clinicaltrials: </strong></p><p><strong>Gov identifier: </strong>NCT02610868.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"1553-1567"},"PeriodicalIF":3.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cenobamate for Adjunctive Treatment in Adult and Pediatric Patients with Refractory Lennox-Gastaut Syndrome: A Retrospective Chart Review.","authors":"Karen Keough, Alec Romick","doi":"10.1007/s40120-025-00779-x","DOIUrl":"10.1007/s40120-025-00779-x","url":null,"abstract":"<p><strong>Introduction: </strong>Lennox-Gastaut syndrome (LGS) is a particularly severe developmental epileptic encephalopathy (DEE) characterized by multiple types of drug-resistant, incapacitating seizures. Despite aggressive therapy including polypharmacy, surgery, implanted devices, and dietary therapy, the prognosis remains poor, with frequent ongoing seizures and risk of injury and early death. Cenobamate (CNB) is an antiseizure medication (ASM) approved for the treatment of focal seizures in adults, but real-world experience in patients with DEEs has shown promising reductions in seizure frequency.</p><p><strong>Methods: </strong>This retrospective chart review determined the effectiveness and tolerability of CNB in 36 adult and pediatric patients with LGS under the treatment of one physician.</p><p><strong>Results: </strong>Among 36 patients (69% male, median age 15.5 years) with LGS, 86% experienced a reduction in seizure frequency after the addition of CNB (median treatment duration 23 months), including ≥ 75% reduction in 22 patients (61%) and seizure freedom in 5 patients (14%). A substantial proportion of patients (75%, n = 27) successfully reduced their concomitant medications, including the lowering or discontinuation of cannabidiol in 19 patients and clobazam in 21 patients. Adverse events were reported in two-thirds of patients, reflecting the same symptoms reported in the original approval trials, with somnolence being the most common.</p><p><strong>Conclusions: </strong>This chart review provides promising evidence for the efficacy of CNB in treating LGS. Additional prospective studies will help to clarify CNB's efficacy and safety profile for patients with LGS.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"1685-1694"},"PeriodicalIF":3.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Treatment in Patients with Large Vessel Occlusion Stroke of Different Mechanisms.","authors":"Zhiyuan Feng, Ming Yang, Aoming Jin, Ning Ma, Feng Gao, Dapeng Mo, Xiaojuan Liu, Fangyuan Zhang, Xinchen Li, Yimeng Li, Qi Chu, Jing Xue, Aichun Cheng, Jinxi Lin, Hao Li, Xia Meng, Zhongrong Miao, Yongjun Wang, Jie Xu","doi":"10.1007/s40120-025-00727-9","DOIUrl":"10.1007/s40120-025-00727-9","url":null,"abstract":"<p><strong>Introduction: </strong>Acute ischemic stroke with large vessel occlusion (AIS-LVO) is mainly caused by in situ thrombosis (IST), artery-to-artery embolism (AAE), and cardioembolism (CE). The clinical characteristics and prognosis of each mechanism are unclear in a real-world scenario.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with AIS-LVO who underwent endovascular treatment (EVT) between April 2023 and August 2024. Patients were classified according to three mechanisms. This study aimed to compare the clinical characteristics, lab results, EVT procedural factors, and prognosis of patients with AIS-LVO with three different mechanisms. The modified Rankin Scale (mRS) score at 3 months was the primary outcome, which was analyzed by ordinal logistic regression.</p><p><strong>Results: </strong>Among 162 patients included, IST (n = 81) was the most common mechanism, followed by CE (n = 41) and AAE (n = 40). Patients with CE showed more severe initial symptoms and the highest rate of intracranial hemorrhage. Patients with IST were associated with more rapid progression, more posterior circulation involvement, and higher inflammatory profile. Patients with AAE experienced a longer procedural time and had a higher rate of symptomatic intracranial hemorrhage (sICH). Although patients with IST and AAE more often required stenting, no significant difference in the rate of successful recanalization was found. The rates of mRS distribution (p = 0.24), and favorable outcomes at 3 months (p = 0.36) did not differ among the three groups. However, a trend towards better outcomes in the CE group was noted. On multivariable logistic regression, age (odds ratio, 0.97, 95% confidence interval, 0.95-1.00), pre-EVT National Institutes of Health Stroke Scale (NIHSS) (odds ratio, 0.94, 95% confidence interval, 0.89-0.98), and sICH (odds ratio, 0.33, 95% confidence interval, 0.12-0.95) could independently predict a favorable shift in mRS distribution. We failed to find that the mechanism was a predictor of the outcome.</p><p><strong>Conclusions: </strong>The functional outcomes of patients with AIS-LVO were similar among different mechanisms, despite the sICH being much higher in patients with AAE. The optimal management for AIS-LVO with different mechanisms requires further research.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"1269-1283"},"PeriodicalIF":3.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Cognitive Outcomes in Multiple Sclerosis: Real-World Impact of Ozanimod on Processing Speed Using BICAMS.","authors":"Aurora Zanghì, Paola Sofia Di Filippo, Carlo Avolio, Emanuele D'Amico","doi":"10.1007/s40120-025-00736-8","DOIUrl":"10.1007/s40120-025-00736-8","url":null,"abstract":"<p><strong>Introduction: </strong>Cognitive dysfunction represents a major burden in multiple sclerosis (MS). The impact on cognitive outcomes of ozanimod in real-world settings remains to be fully elucidated.</p><p><strong>Methods: </strong>In this single-center observational study, we evaluated cognitive performance in 67 patients with MS (74.6% female) receiving ozanimod (mean treatment duration 17.7 ± 3.0 months). Cognitive assessment was performed using the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) battery, comprising Symbol Digit Modalities Test (SDMT), California Verbal Learning Test-II (CVLT-II), and Brief Visuospatial Memory Test-Revised (BVMT-R) collected at different time points.</p><p><strong>Results: </strong>Analysis suggested significant improvement in SDMT Z-scores (mean improvement 0.337, SD 0.638; Cohen's d = 0.42, p = 0.00031). Baseline SDMT Z-score emerged as the sole significant predictor of cognitive change (coefficient - 0.345, p < 0.001), accounting for 32.4% of variance. CVLT-II and BVMT-R scores remained stable across time points.</p><p><strong>Conclusions: </strong>This real-world study suggests that ozanimod treatment is associated with significant improvement in information processing speed, independent of traditional prognostic factors. These findings complement existing clinical trial data and warrant further investigation through larger, multicenter studies with extended follow-up periods to validate these cognitive benefits.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"1345-1353"},"PeriodicalIF":3.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Immune Reconstitution Therapy with Cladribine Tablets in the Management of Relapsing Multiple Sclerosis in Older Patients.","authors":"Raed Alroughani, Jihad Inshasi, Samar Farouk, Abdullah Al-Asmi, Ali Hassan, Anu Jacob, Areen T Said, Beatrice Benedetti, Dirk Deleu, Iman Al-Lawati, Miklos Szolics, Mohammad Abouelnaga, Mona Thakre, Mustafa Shakra, Pournamy Sarathchandran, Amir Boshra","doi":"10.1007/s40120-025-00767-1","DOIUrl":"10.1007/s40120-025-00767-1","url":null,"abstract":"<p><p>The pathophysiology and presentation of relapsing multiple sclerosis (RMS) differ importantly between younger and older patients. Older patients usually suffer fewer MS relapses but present with a chronically inflammatory phenotype (inflammaging) associated with accelerated age-related changes to the adaptive and innate immune systems (immunosenescence). The efficacy of most disease-modifying therapies (DMTs) appears to decline with increasing age, likely because of a shift away from focal inflammation as the main driving force for progression of MS. These observations led to suggestions that DMT may be withdrawn for an older person with very stable MS. However, this approach risks the resumption of MS disease activity. In contrast, analyses of evaluations of immune reconstitution therapy with cladribine tablets (CladT) show that this high-efficacy DMT appears to be effective and well tolerated irrespective of age. Achieving long-term freedom from MS disease activity for an older patient with MS is feasible using this approach. Switching to CladT is a rational option for reducing the dual burdens of continuous treatment (including side effects associated with continuous immunosuppression with some DMTs) and monitoring for older people with RMS. This includes possible use as an \"exit therapy\", beyond which some patients may not need pharmacological therapy for their RMS in the future.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"1169-1184"},"PeriodicalIF":3.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}