Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Multiple Sklerose ; TNF-α-Antagonisten ; Lenercept ; Infliximab ; Linomid ; Deoxyspergualin ; Sulfasalazin ; Il-10 ; TGF-β2 ; IVIg ; Orale Toleranz ; Extrakorporale Photopherese ; Cladribin ; APL ; Altered peptide ligands ; Keywords Multiple sclerosis ; TNF α-antagonist ; Linomide ; Deoxyspergualine ; Sulfasalazine ; IL-10 ; TGF-β2 ; IVIg ; Oral tolerance ; Extracorporeal photopheresis ; Cladribine ; APL ; Altered peptide ligands
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Recent immunobiological findings together with advances in biotechnology, ameliorations in clinical trial design, and MRI developments have led to a variety of therapeutical approaches in multiple sclerosis (MS). However, in contrast to successfully introduced new treatments, a number of therapeutical failures exist as well: despite impressive data from animal models, convincing concepts, and promising phase I/II studies, some investigated drugs and strategies showed no positive effects in clinical trials, or trials had to be terminated because of unexpected side effects. This article provides an overview of clinical studies that have failed or been abandoned for other reasons. Tumor necrosis factor (TNF) α-antagonists which have led to negative effects in two studies (Lenercept, Infliximab) are discussed in detail. These results raise critical questions concerning the hypothetical pathogenesis of MS lesions and the value of MRI in the assessment of clinically relevant therapeutic drug effects. In addition to a description of the immunobiological background, studies on the immunosuppressive agents linomide, deoxyspergualin, sulfasalazine and cladribine, trials for the cytokines interleukin-10 and TGF-β2, the studies on remyelination by intravenous immunoglobulins (IVIg), oral tolerance, and extracorporeal photopheresis are discussed.
    Notes: Zusammenfassung Neue immunbiologische Erkenntnisse haben zusammen mit Fortschritten in der Biotechnologie, Verbesserungen im Design von Medikamentenstudien und Entwicklung der Kernspintomographie zu einer Vielfalt prüfbarer Therapieansätze bei der multiplen Sklerose geführt. Neben erfolgreichen immunmodulatorischen Therapien gibt es jedoch einige Fehlschläge: Trotz eindrucksvoller tierexperimenteller Daten, überzeugender Konzepte oder gar Erfolg versprechender Phase-I/II-Studien erbrachten die untersuchten Medikamente letztendlich keine positive Wirkung oder zeigten unerwartete schwere Nebenwirkungen. Dieser Artikel gibt eine aktuelle Zusammenstellung von Therapiestudien, die fehlgeschlagen sind oder aus anderen Gründen abgebrochen wurden. Im Zentrum steht die Blockierung des TNF-α, die in 2 Studien (Lenercept, Infliximab) sogar zu negativen Effekten geführt hatte. Diese Resultate werfen kritische Fragen bezüglich Läsionspathogenese und Wertigkeit der Kernspintomographie in der Beurteilung klinischer Therapieeffekte auf. Außerdem werden die Studien für die immunsuppressiven Agenzien Linomid, Deoxyspergualin, Sulfasalazin und Cladribin, für die Zytokine Interleukin-10 und TGF-β2, die Studien zur Remyelinisierung durch intravenöse Immunglobuline (IVIg), zur oralen Toleranzinduktion und zur extrakorporalen Photopherese diskutiert.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 2
    ISSN: 1432-1459
    Keywords: Key words Multiple sclerosis ; Treatment trial ; Power calculations
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Phase III definitive treatment trials of new multiple sclerosis (MS) therapies now routinely incorporate an annual magnetic resonance imaging protocol, with change in T2-weighted brain lesion load providing an important outcome measure. To date the accepted strategy has been to perform a core imaging protocol on all patients in such studies. The aim of this study was to provide power calculations based on this MRI endpoint. Serial MRI data from 128 patients with either relapsing remitting (RR) or secondary progressive (SP) MS were used to calculate sample size requirements using a repeated measures analysis of variance design. We provide sample size calculations based on various follow-up intervals and effect sizes. Sample sizes for the SPMS cohort were substantially larger than for the RRMS group, reflecting the greater variance in lesion load changes between patients in the SPMS group. With a follow-up of 3 years, we estimate that only 12 and 33 patients per arm are needed to show stabilisation of MRI lesion load in the RRMS and SPMS groups, respectively. Our results suggest that ongoing phase III treatment trials are more than adequately powered to detect even subtle treatment effects, and indicate that incorporating measurements from longer follow-up durations increases power substantially. We conclude that an annual imaging protocol provides a robust and powerful tool for assessing effects on the radiological appearance of the disease process.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 3
    ISSN: 1432-1459
    Keywords: Key words Multiple sclerosis ; Haemopoietic stem cell transplantation ; Consensus guidelines
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Recent reports suggest the possible beneficial effects of haemopoietic stem cell transplantation (HSCT) in autoimmune diseases such as multiple sclerosis (MS). The definition of the risk/benefit ratio for such a treatment is perceived as a major issue for the neurological community worldwide. The First Consensus Conference on Bone Marrow Transplantation in Patients with Multiple Sclerosis was held in Milan, Italy on 21 February 1998. Participants from 16 European, North American, and South American countries discussed the guidelines form performing HSCT in MS. This conference was organized in order to : (a) define criteria for patient selection; (b) define transplantation procedures to maximize efficacy of the treatment and minimize its toxicity; (c) standardize patient outcome evaluation; and (d) establish an international working group to evaluate the efficacy and safety of HSCT in MS and to study the immunological changes related to HSCT in MS patients. During the meeting in Milan agreement was reached on: (a) the preparation and distribution of a consensus report on HSCT in MS and (b) the design of an open trial for an initial assessment of the safety and efficacy of HSCT in MS. The consensus reached during the meeting and the design of the clinical trial are summarized in this contribution.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 4
    ISSN: 1435-1102
    Keywords: Keywords: Multiple Sclerosis; gender-specific coping differences; neurological impairment; depression.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Based on the study of 48 patients and their partners by means of semi-structured interviews, we evaluated how the ability to cope (Coping Index) with a chronic somatic disease (e.g. Multiple Sclerosis) is affected by gender, the degree of disability (assessed by the Kurtzke EDSS) and associated depression (measured by the BDI). An associated depression in a sick wife induces depressive symptoms in the healthy husband; whereas healthy wives are not affected by the depression of their sick husbands. The process of coping according to gender shows that male coping, whether as patients or partners, is influenced neither by the degree of disability nor by associated depression (their own or their partner's). Women as patients or partners are influenced in their coping process by the degree of impairment (negatively for their own, positively with increasing disability of their partner). Their ability to cope is negatively affected by an associated depression (their own or their partner's). The evaluation of the MS patient should include the partner to devise individualised treatment approaches.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...