Neurology and Therapy最新文献

{"title":"The Difficult Journey of a Child with Dravet Syndrome: Perspectives from a Parent and the Neuropaediatrician.","authors":"Romain Reboux, Silvia Napuri","doi":"10.1007/s40120-025-00826-7","DOIUrl":"https://doi.org/10.1007/s40120-025-00826-7","url":null,"abstract":"<p><p>Dravet syndrome (DS) is a rare and severe form of epilepsy, characterised by recurrent seizures that begin during the first year of life, leading to motor, cognitive and behavioural impairments. This article provides the perspectives of a parent of a child with DS ('Ethan') and the treating neuropaediatrician. Ethan's seizures began when he was 9 months old, and were a mixture of focal seizures and status epilepticus. Numerous treatments were tried, including standard anti-seizure medications (such as levetiracetam, clobazam and fenfluramine), other medications (cannabidiol) and nonpharmacological approaches (ketogenic diet), with little success. When Ethan was 3 years old, a prolonged episode of status epilepticus precipitated by coronavirus disease 2019 (COVID-19) led to brain damage. Rehabilitation allowed Ethan to regain some of his previous functioning and, at the age of 38 months, combination therapy with clobazam, sodium valproate and stiripentol was begun and has successfully controlled Ethan's seizures. Ethan's father describes the stress that the diagnosis of DS, interactions with the healthcare system, and the search for effective treatment imposed on the family. Since Ethan's seizures have been better controlled, the family has been able to lead a more normal life, and is now focused on supporting Ethan and looking to the future. Ethan's neuropaediatrician outlines the approach she takes to the diagnosis and management of DS, including the importance of the clinician-parent relationship in imparting the diagnosis and making initial and ongoing treatment decisions. The preferred first-line treatment is sodium valproate, which is followed by sodium valproate-clobazam-stiripentol combination therapy, topiramate or a ketogenic diet as second-line options. In children > 2 years, cannabidiol and fenfluramine can also be considered. The aim of maintenance treatment (which will invariably be polytherapy) is to reduce the number of seizures, particularly status epilepticus, given the significant impact of this seizure type on patients and caregivers.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microglial Polarization and Therapeutic Strategies in Post-stroke Neuroinflammation.","authors":"Travis Yui Hei Chan, Brian De Yu Ma, Timothy Keith Hung, Jenny Sum Yee Wong, Benjamin Wai Yue Lo","doi":"10.1007/s40120-025-00825-8","DOIUrl":"https://doi.org/10.1007/s40120-025-00825-8","url":null,"abstract":"<p><p>Stroke remains a leading cause of global disability, perpetuated by maladaptive neuroinflammation that drives secondary injury and impairs recovery. An early reparative (M2) state rapidly transitions into a dominant destructive (M1) phenotype within days, worsening tissue damage through the release of cytokines [tumor necrosis factor alpha (TNFα), interleukin-6 (IL-6)], blood-brain barrier disruption, and amplified peripheral immune cell infiltration. Emerging pharmacological interventions, such as the free radical scavenger edaravone, the neurotrophic factor cerebrolysin, and the excitotoxicity modulator citicoline, demonstrate promising neuroprotective potential when strategically timed. Additionally, novel non-pharmacological approaches, including repetitive transcranial magnetic stimulation, stem cell therapy, and nanoparticle-based drug delivery, offer innovative pathways for targeting neuroinflammation. However, translational challenges persist, including narrow therapeutic windows, biomarker heterogeneity, and preclinical-to-clinical gaps. Future progress necessitates precision medicine paradigms integrating spatiotemporal drug delivery, biomarker-guided intervention timing, and synergistic combinatorial regimens targeting acute injury and chronic repair phases. By bridging mechanistic insights with clinical applications, this review delineates neuroinflammatory modulation as a pivotal frontier for redefining stroke recovery while outlining essential research trajectories to overcome existing barriers. Systematic search of electronic databases including PubMed, Web of Science, Embase, and Cochrane (1996-2025) was performed, with eligible studies assessed using PRISMA guidelines. Findings on neuroinflammation, mechanism, or interventions in ischemic stroke were narratively synthesized through thematic analysis. This review summarizes current insights into post-stroke neuroinflammatory mechanisms, with a focus on the dual role of microglial polarization.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Post-Alteplase Long-Term Unfavorable Outcome in Atrial Fibrillation Patients Presented with Embolic Stroke in the Middle East and North Africa Regions: A Multi-center, Longitudinal Study.","authors":"Mohamed G Zeinhom, Mohamed Fouad Elsayed Khalil, Ahmad Galal Elmesallami, Tamer Shaaban Zedan, Karam Dahy Hamdan Hassaneen, Hossam Mohamed Refat, Ahmed Ahmed Mohamed Kamal Ebied, Shady S Georgy, Ahmed Zaki Omar Akl, Mohamed Ismaiel, Salah Ibrahim Ahmed, Hesham Farouk Eissa, Asmaa Ibrahem Desouky Mostafa Ibrahem, Youssry Salah Shafiq Kerolos, Mohamed Elshafei, Amir Ahmed Elsaeed Egila, Enji Hamdy Elsawy Khalil, Emad Labib Abdelhamid Mahmoud, Sherihan Rezk Ahmed","doi":"10.1007/s40120-025-00814-x","DOIUrl":"https://doi.org/10.1007/s40120-025-00814-x","url":null,"abstract":"<p><strong>Introduction: </strong>Embolic stroke is connected to a higher risk of hemorrhagic transformation (HT), functional disability, and mortality. There is a gap of knowledge regarding the predictors of long-term post-alteplase functional outcomes, especially in patients with atrial fibrillation (AF), which limits delivering adequate care and support to stroke survivors. We aimed to assess the predictors of long-term post-thrombolysis unfavorable functional outcomes in patients with atrial fibrillation who presented with first-ever embolic stroke in the Middle East and North Africa (MENA).</p><p><strong>Methods: </strong>Our prospective cohort study was conducted between May 2021 and May 2025 and included patients with AF who presented with first-ever embolic stroke and received thrombolytic therapy, and who were recruited from Kafr Elsheikh University Hospital, Kafr Elsheikh General Hospital, Al-Sahel Teaching Hospital, NMC Royal Hospital, and Al-Obour Hospital in the period from May 2021 to May 2023. Our longitudinal study included two groups; the unfavorable outcomes group, and the favorable outcomes group.</p><p><strong>Results: </strong>A total of 580 patients completed the 2-year follow-up period. National institute of health stroke scale (NIHSS) at the time of admission [odds ratio (OR), 2.06; 95% CI, 1.86-4.39; P = 0.03], sustained atrial fibrillation (OR, 1.98; 95% CI, 1.42-3.80; P = 0.03), heart failure (OR, 1.79; 95% CI, 1.23-2.96; P = 0.03), HAS-BLED score (OR, 1.64; 95% CI, 1.41-3.65; P = 0.03), CHA₂DS₂VASc score (OR, 1.72; 95% CI, 1.72-3.53; P = 0.04), post-thrombolysis intracranial hemorrhage (OR, 2.89; 95% CI, 1.74-3.63; P = 0.02), and recurrent symptomatic stroke (OR, 1.98; 95% CI, 1.22-3.73; P = 0.04) were predictors of long-term post-thrombolysis unfavorable outcomes.</p><p><strong>Conclusion: </strong>Higher baseline NIHSS, heart failure, post-thrombolysis intracranial haemorrhage, and recurrent symptomatic stroke were independent predictors of long-term post-thrombolysis unfavorable functional outcome in embolic stroke patients. Novelly, higher HAS-BLED and CHA2DS2-VASc scores were independent predictors of long-term post-thrombolysis unfavorable functional outcome in Arabian patients. Moreover, sustained AF was an independent predictor of long-term post-thrombolysis unfavorable functional outcome.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World 24-Month Outcomes of Ofatumumab in Relapsing Multiple Sclerosis: Efficacy, Safety, and the Impact of Frailty.","authors":"Gina Ferrazzano, Roberta Fantozzi, Shalom Haggiag, Doriana Landi, Francesca Napoli, Maria Chiara Buscarinu, Leonardo Malimpensa, Assunta Bianco, Giovanna Borriello, Elena Barbuti, Fabiana Marinelli, Fabrizia Monteleone, Francesca Marchione, Nicola Falcone, Marta Altieri, Giorgio Leodori, Daniele Belvisi, Fabio Buttari, Valeria Pozzilli, Alessandra Cicia, Antonio Cortese, Francesco Sica, Anna Chiara Landi, Elisabetta Ferraro, Carlo Pozzilli, Massimiliano Mirabella, Carla Tortorella, Girolama Alessandra Marfia, Diego Centonze, Marco Salvetti, Antonella Conte","doi":"10.1007/s40120-025-00818-7","DOIUrl":"https://doi.org/10.1007/s40120-025-00818-7","url":null,"abstract":"<p><strong>Introduction: </strong>Ofatumumab (OFA) is a highly effective therapeutic option for multiple sclerosis (MS), but real-world data on its efficacy and safety remain limited. We evaluated the real-world efficacy and safety of OFA in patients with MS and explored the predictive value of frailty.</p><p><strong>Methods: </strong>We retrospectively collected clinical and MRI data from 12 MS centers in Central Italy, including patients who initiated OFA between April 2022 and January 2024. We assessed annualized relapse rate (ARR), clinical relapses, radiological activity, and safety. Frailty, defined as increased vulnerability due to age-related health deficits, was measured using a frailty index (FI). The study was approved by the local Ethics Committee (No. 6357).</p><p><strong>Results: </strong>A total of 242 patients with MS were included (66.8% female and 33.2% male; mean age: 38.9 ± 10.3 years; disease duration: 7.7 ± 7.6 years). Of these, 95 (39.2%) were treatment-naïve, and 147 (60.8%) had switched from another therapy, mostly a first switch. The mean follow-up was 15.4 ± 5.4 months; all patients completed 12-month follow-up, and 103 completed 24 months. ARR dropped from 0.9 to 0.02 (p < 0.001). Only 4 patients (1.6%) had a clinical relapse, all within 6 months (mean time: 3.0 ± 1.8 months). Expanded Disability Status Scale (EDSS) scores remained stable (p > 0.05). MRI activity occurred in 10 patients (4.1%) at 6 months and 3 (1.2%) at 12 months; none at 24 months. Adverse events included flu-like symptoms (34.3%), injection site reactions (8.2%), and infections (18.5%). Among 239 patients assessed for frailty (mean FI: 0.06 ± 0.08), 187 were relatively fit (FI ≤ 0.10), 30 least fit, and 22 frail. FI predicted 24-month confirmed disability progression (p = 0.0068), with significant variation by frailty level (p = 0.0009).</p><p><strong>Conclusion: </strong>This real-world study suggests that OFA is effective and safe for MS, offering rapid disease control. Lower frailty levels suggest preferential use in patients with lower baseline disability. Further large-scale, long-term studies are needed.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Preferences of Neurologists in Generalized Myasthenia Gravis: A Conjoint Analysis Study.","authors":"Luis Querol, Rocío Gómez-Ballesteros, Gerardo Gutiérrez-Gutiérrez, Adrián Ares, Ramón Villaverde, Virginia Reyes, Thaís Armangué, Elisa Salas, Paola Díaz-Abós, Pablo Rebollo, Mònica Sarmiento, Neus Canal, Jorge Maurino, Elena Cortés-Vicente","doi":"10.1007/s40120-025-00821-y","DOIUrl":"https://doi.org/10.1007/s40120-025-00821-y","url":null,"abstract":"<p><strong>Introduction: </strong>Generalized myasthenia gravis (gMG) is a chronic autoimmune neuromuscular disorder for which treatment decision-making is increasingly complex due to the emergence of biologic targeted therapies. This study aimed to evaluate neurologists' treatment preferences in acetylcholine receptor seropositive gMG using conjoint analysis to simulate real-world clinical decision-making.</p><p><strong>Methods: </strong>We conducted a cross-sectional, web-based study among neurologists involved in the management of gMG in collaboration with the Spanish Society of Neurology. Participants were presented with eight hypothetical treatment scenarios comprising five key attributes: intensity of improvement, onset of action, duration of effect, adverse events, and route/frequency of administration. Utility values and importance of each attribute were estimated using ordinary least squares regression. Demographic, professional, and behavioral characteristics were assessed to explore variability in preference patterns.</p><p><strong>Results: </strong>A total of 149 neurologists participated in the study. The mean age was 39.0 (SD 9.4) years, and 54.4% were male. Participants had a mean of 9.9 years (8.4) of experience treating patients with MG. The most valued treatment attribute was intensity of improvement (mean relative importance: 38.6%), followed by onset of action (21.5%) and duration of effect (17.4%). At the individual level, route and frequency of administration accounted for up to 21.9% of decision weight in some participants. Preferences were consistent across neuromuscular specialists and general neurologists but differed based on empathy and conscientiousness. Model fit was robust (Pearson's R = 1.000, p < 0.001).</p><p><strong>Conclusions: </strong>Neurologists treating gMG placed the highest value on rapid and clinically meaningful symptom improvement, consistent with the therapeutic goals of emerging targeted therapies. However, substantial heterogeneity in preferences, especially regarding administration burden, emphasizes the need for individualized approaches and shared decision-making.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Testing the Clinical Dementia Rating Sum of Boxes as an Outcome for Dementia with Lewy Bodies Clinical Trials.","authors":"James E Galvin, Andres Salcedo","doi":"10.1007/s40120-025-00822-x","DOIUrl":"https://doi.org/10.1007/s40120-025-00822-x","url":null,"abstract":"<p><strong>Introduction: </strong>Dementia with Lewy bodies (DLB), a common cause of dementia, has no FDA-approved therapies, and clinical trials to date have had limited ability to demonstrate efficacy. The lack of validated DLB-specific clinical trial outcomes may hinder these efforts. Here, we test whether the Clinical Dementia Rating (CDR) and other commonly used clinical evaluation tools for Alzheimer's disease (AD) and Parkinson's disease (PD) could potentially be used as outcome measures in future DLB clinical trials.</p><p><strong>Methods: </strong>A retrospective, cross-sectional chart review of 600 patients (359 AD, 241 DLB) who completed a comprehensive clinical, cognitive, functional, and behavioral evaluation over a 10-year period was carried out. Performance of the CDR, its sum of boxes (CDR-SB), and other AD and PD evaluation measures were assessed for stage-wide performance from mild cognitive impairment (CDR 0.5) to moderate-severe dementia (CDR 2).</p><p><strong>Results: </strong>The CDR and CDR-SB characterize important differences between AD and DLB across different cross-sectional stages of disease severity, with the greatest differences seen at the CDR 0.5 stage. DLB showed greater deficits in commonly used AD functional and behavioral measures at the CDR 0.5 stage, while more DLB-specific measures showed significant differences from AD across the entire disease spectrum. The patient version of the Quick Dementia Rating System showed greater stage-wide impairment in DLB than AD, supporting its use as a patient-reported outcome. The Montreal Cognitive Assessment showed greater stage-wide impairment in AD than in DLB patients, suggesting lack of sensitivity as an outcome measure for DLB clinical trials.</p><p><strong>Conclusion: </strong>Improved study design and selection of appropriate outcome measures in DLB clinical trials can facilitate demonstration of efficacy. While the CDR-SB could work on a DLB clinical trial, the field would be most advanced by the development of a DLB-specific global rating instrument.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Brief Mindfulness Intervention on Emotions, Sleep and Quality of Life in Patients with Newly Diagnosed Amyotrophic Lateral Sclerosis: A Prospective Study.","authors":"Xin Huang, Guanghao Hou, Hui Li, Yuchen Zhu, Tielun Yin, Na Zhang, Hong Liu, Yanjing Yang, Linna Bai, Wenxia Ban, Jiaying Zhang, Ruixue Zhang, Dongsheng Fan, Shan Ye","doi":"10.1007/s40120-025-00816-9","DOIUrl":"https://doi.org/10.1007/s40120-025-00816-9","url":null,"abstract":"<p><strong>Introduction: </strong>Amyotrophic lateral sclerosis (ALS) is a devastating progressive neurodegenerative disorder causing significant suffering and mental health problems for patients. Many patients with ALS have a severe psychological reaction to the serious diagnosis when they are first diagnosed. This study aims to investigate the impact of a brief mindfulness intervention on emotions, sleep, and quality of life (QOL) in patients with ALS who have recently been diagnosed.</p><p><strong>Methods: </strong>This prospective intervention study enrolled patients who had been newly diagnosed with ALS. Participants received cognitive training and audio-led mindfulness exercises involving breathing awareness and body scan sessions for 10 days. The effectiveness of the intervention was evaluated by several scales.</p><p><strong>Results: </strong>Ninety-one patients (aged 54.15 [10.10] years, 52 male/39 female [57.10%/42.90%]) were finally enrolled in the analysis. The Chinese Version Perceived Stress Scale (CPSS) (t = 2.05, P = 0.04) and Epworth Sleepiness Scale (ESS) (Z = -2.03, P = 0.04) scores significantly decreased, and the 40-item Amyotrophic Lateral Sclerosis Assessment Questionnaire (ALSAQ40) significantly increased (Z = -2.93, P < 0.01) following the brief mindfulness intervention. The Patient Health Questionnaire-9 (PHQ-9) (Z = -2.97, P < 0.01) and the 17-Item Hamilton Rating Scale for Depression (HAMD-17) (Z = -3.43, P < 0.01) were significantly reduced in patients with ALS diagnosed with depression. QOL was significantly improved in other patients with ALS (Z = -2.51, P = 0.01).</p><p><strong>Conclusion: </strong>Our study indicated that a brief mindfulness intervention could be a potential way to reduce depression and improve daytime sleepiness, while also improving the QOL for newly diagnosed patients with ALS.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Multidimensional Analgesia via Asymmetric Dual-Target Deep Brain Stimulation of the Periaqueductal Gray and Ventral Posterior Thalamus in Central Post-stroke Pain.","authors":"Shiming Wan, Kanglin Liu, Jiaxi Zhao, Jing Xu, Xin Chen, Haifeng Shu, Sixun Yu","doi":"10.1007/s40120-025-00819-6","DOIUrl":"https://doi.org/10.1007/s40120-025-00819-6","url":null,"abstract":"<p><p>Central post-stroke pain (CPSP) is an intractable neuropathic pain syndrome. Dual-target deep brain stimulation (DBS), which integrates sensory thalamic modulation and endogenous analgesic pathways, has emerged as a potential intervention; however, clinical evidence remains scarce. We report a 54-year-old woman who developed right-sided limb paresthesia progressing to persistent right hemibody pain following a left thalamic hemorrhage. Asymmetric DBS electrodes were implanted in the right periaqueductal gray (R-PAG) and left ventral posterior thalamus (L-VP). Longitudinal assessments utilized standardized scales-including the Visual Analog Scale (VAS), Douleur Neuropathique 4 (DN4) and Hamilton Depression Scale (HAMD). These evaluations demonstrated sustained improvements in pain intensity (VAS: 7 → 1), neuropathic symptoms (DN4: 4 → 1) and depressive symptoms (HAMD: 22 → 8) at the 12-month follow-up. Pain and transient numbness were mitigated by applying cyclic stimulation (5-min on/off intervals). This case highlights the potential of asymmetric dual-target DBS targeting both the PAG and VP to achieve multidimensional analgesia in CPSP and provides insights for optimizing patient selection and treatment strategies, including choices of targets, stimulation parameters and modalities. These findings enhance understanding of neural pathways in chronic pain modulation, specifically the interplay between sensory and emotional processing, and suggest a potential role for asymmetric DBS in treating neuropathic pain.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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}