Immunotherapy of multiple sclerosis

2009 ◽  
Vol 21 (S2) ◽  
pp. 27-34 ◽  
Author(s):  
Sven G. Meuth ◽  
Stefan Bittner ◽  
Heinz Wiendl
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Evidence ◽  
Treatment Options ◽  
Phase Iii ◽  
The Past ◽  
Phase Iii Clinical Trials ◽  
New Treatment ◽  
System Disorder ◽  
Immunomodulatory Therapies ◽  
Ms Therapy

Abstract:Multiple sclerosis (MS) is regarded as a prototypic inflammatory autoimmune central nervous system disorder causing neurological disability in young adults. Recommended basic immunomodulatory therapies of MS are currently interferon beta and glatiramer acetate. Both have proven to be clinically and paraclinically effective and clinical evidence suggests that treatment should be initiated as early as possible.However, despite the fact that therapeutic options for MS have significantly been widened over the past decade there is still tremendous activity in the search for new treatment options for MS.One important development in the field is reflected by the substantial number of promising results for oral therapies. Various phase III clinical trials are currently being initiated or are already underway evaluating the efficacy of a variety of orally administered agents, including cladribine, teriflunomide, laquinimod, fingolimod and fumaric acid. It is hoped that these oral therapies for MS further broaden our armament for MS therapy.

scholarly journals Multiple Sclerosis in Children: Current and Emerging Concepts

2020 ◽  
Vol 40 (02) ◽  
pp. 192-200
Author(s):  
J. Nicholas Brenton ◽  
Ryan Kammeyer ◽  
Lauren Gluck ◽  
Teri Schreiner ◽  
Naila Makhani
Keyword(s):  
Risk Factors ◽  
Multiple Sclerosis ◽  
International Collaboration ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Future Research ◽  
Imaging Findings ◽  
The Past ◽  
New Treatment ◽  
Made In

AbstractMultiple sclerosis is being increasingly recognized and diagnosed in children. In the past several years, advances have been made in diagnosing multiple sclerosis in children, identifying new genetic and environmental risk factors, delineating underlying immunobiology, characterizing imaging findings, and implementing new treatment strategies. In this review, we discuss these advances. Future research into the determinants of multiple sclerosis in children and into new treatment options will be aided by continued international collaboration.

scholarly journals Matter of TIME: the tumor-immune microenvironment of mesothelioma and implications for checkpoint blockade efficacy

2021 ◽  
Vol 9 (9) ◽  
pp. e003032
Author(s):  
James Harber ◽  
Tamihiro Kamata ◽  
Catrin Pritchard ◽  
Dean Fennell
Keyword(s):  
Treatment Options ◽  
Immune Checkpoint Blockade ◽  
Checkpoint Blockade ◽  
Phase Iii ◽  
Immune Microenvironment ◽  
Incurable Cancer ◽  
Phase Iii Clinical Trials ◽  
Dismal Prognosis ◽  
Tumor Immune Microenvironment ◽  
Cancer Tumor

Malignant pleural mesothelioma (MPM) is an incurable cancer with a dismal prognosis and few effective treatment options. Nonetheless, recent positive phase III trial results for immune checkpoint blockade (ICB) in MPM herald a new dawn in the fight to advance effective treatments for this cancer. Tumor mutation burden (TMB) has been widely reported to predict ICB in other cancers, but MPM is considered a low-TMB tumor. Similarly, tumor programmed death-ligand 1 (PD-L1) expression has not been proven predictive in phase III clinical trials in MPM. Consequently, the precise mechanisms that determine response to immunotherapy in this cancer remain unknown. The present review therefore aimed to synthesize our current understanding of the tumor immune microenvironment in MPM and reflects on how specific cellular features might impact immunotherapy responses or lead to resistance. This approach will inform stratified approaches to therapy and advance immunotherapy combinations in MPM to improve clinical outcomes further.

Unmet Medical Needs in Metastatic Lung and Digestive Neuroendocrine Neoplasms

2018 ◽  
Vol 108 (1) ◽  
pp. 18-25 ◽  
Author(s):  
Jaume Capdevila ◽  
Lisa Bodei ◽  
Philippa Davies ◽  
Vera Gorbounova ◽  
Robert T. Jensen ◽  
...  
Keyword(s):  
Treatment Options ◽  
Phase Iii ◽  
Neuroendocrine Neoplasms ◽  
Limited Evidence ◽  
Medical Needs ◽  
Phase Iii Clinical Trials ◽  
Metastatic Setting ◽  
Metastatic Lung ◽  
Prospective Phase ◽  
Unmet Medical Needs

Unmet medical needs are not infrequent in oncology, and these needs are usually of higher magnitude in rare cancers. The field of neuroendocrine neoplasms (NENs) has evolved rapidly during the last decade, and, currently, a new WHO classification is being implemented and several treatment options are available in the metastatic setting after the results of prospective phase III clinical trials. However, several questions are still unanswered, and decisions in our daily clinical practice should be made with limited evidence. In the 2016 meeting of the advisory board of the European Neuroendocrine Tumor Society (ENETS), the main unmet medical needs in the metastatic NENs setting were deeply discussed, and several proposals to try to solve them are presented in this article, including biomarkers, imaging, and therapy.

Treatment options in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders

2021 ◽  
Vol 27 ◽  
Author(s):  
Paulus Rommer ◽  
Uwe K Zettl
Keyword(s):  
Multiple Sclerosis ◽  
Side Effects ◽  
Neuromyelitis Optica ◽  
Treatment Options ◽  
Spectrum Disorder ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Neuromyelitis Optica Spectrum Disorders ◽  
The Past ◽  
Drug Classes ◽  
Spectrum Disorders

: There are few diseases with as many therapeutic advances in recent years as in multiple sclerosis. Nine different drug classes with more than a dozen approved therapies are now available. Similarly, there have been unimaginable advances in understanding neuromyelitis optica (now neuromyelitis optica spectrum disorder [NMOSD]) over the past 15 years. Building on the knowledge gained, the first therapies have been approved in recent years. In this review, we aim to present all therapies approved for the treatment of MS or NMOSD. The different forms of application, different approval criteria and most important side effects will be presented. This work is intended for physicians who are interested in MS and NMOSD therapies and want to get a first overview and does not replace the respective guidelines of the regulatory authorities.

Solithromycin as A Potential Novel Antibiotic Against Neisseria Gonorrhoeae Resistance

2020 ◽  
Author(s):  
Muhammad Habiburrahman ◽  
Vivian  Soetikno ◽  
Wani Riselia Sirait ◽  
Missy Savira
Keyword(s):  
Clinical Trial ◽  
Neisseria Gonorrhoeae ◽  
Wide Distribution ◽  
Phase Iii ◽  
Financial Loss ◽  
Anatomic Site ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Phase Iii Clinical Trials ◽  
New Treatment

Gonorrhea is one of the most often sexually transmitted infection in the world. In 2016, WHO stated the Southeast Asia region as the fourth-highest incidence rate and prevalence of gonorrhea. One of the current problems with gonorrhea is related to its emerging resistance to first-line drugs such as cephalosporins, macrolides, and fluoroquinolones. This resistance has an impact on the difficulty of finding effective antibiotics to eradicate the infection, thus risking financial loss and infertility in sexually active age patients. This literature review will discuss solithromycin, the first fluoroketolide in phase III clinical trial, and show its potential as a new antibiotic against infection with resistant Neisseria gonorrhoeae. Literatures are searched using Pubmed and Google Scholar search engines with keywords: antibiotics, CEM-101, clinical trial, Neisseria gonorrhoeae, new treatment, pharmacology, pharmacokinetics, resistance, safety, and solithromycin. This semisynthetic antibiotic is supported by a different chemical structure from previous macrolides; improving solithromycin becomes more stable and able to bind easier with bacterial ribosomes. Pharmacologically, solithromycin provides an advantage in its high bioavailability, easy oral administration route, wide distribution, metabolism mainly in the liver, but not required dosage adjustments due to hepatic impairment, and a single dosage preparation that can increase patient compliance in healing gonorrhea infections. Also, its lower MIC50 than previous antibiotics makes it well-tolerated, therefore making this antibiotic as a potential recommendation for the management of multi-drug resistant gonorrhea in the future. Solithromycin is not inferior to the standard therapy (ceftriaxone and azithromycin), with 80% vs. 84% gonorrhea eradication rates. Per the anatomic site, the eradication rate is 92% in genital, 94% in the pharynx, and 83% in the rectum. However, special attention needs to be paid to the side effects of the gastrointestinal tract of solithromycin, as observed in phase III clinical trials at a dose of 1000 mg in the form of diarrhea (24%) and nausea (21%).

Expanding the role of perfusionists in the era of new treatment options for cardiovascular disease

Perfusion ◽  
2003 ◽  
Vol 18 (4) ◽  
pp. 253-256 ◽  
Author(s):  
Joseph J Sistino
Keyword(s):  
Cardiovascular Disease ◽  
Treatment Options ◽  
Mail Survey ◽  
Surgical Patient ◽  
The Past ◽  
The Future ◽  
The Usa ◽  
Changing Patterns ◽  
New Treatment ◽  
New Applications

Treatment for cardiovascular disease has dramatically changed the surgical patient population over the past 10 years. Advances in medical management and interventional cardiovascular procedures have delayed surgery in many adults, and the surgical pool has begun to decrease despite an aging population. This affects perfusionists in terms of new psychological and technical challenges, and has serious consequences and implications for the future of the profession. This study will review the changing patterns of diagnosis and treatment of cardiovascular disease in the USA over the past 10 years by examining the annual surgical procedure rates and correlating them with the number of practicing perfusionists and new student graduates. The purpose of this review is to project the future employment opportunities for perfusionists. The second part of the paper will look at the alternative roles perfusionists have expanded into as a result of changes in the treatment of cardiovascular disease. The results of an e-mail survey of perfusionists will be presented to identify new applications of perfusion technology.

Evidence-Based Treatments

2017 ◽  
Author(s):  
W. Curt LaFrance ◽  
Laura H. Goldstein
Keyword(s):  
Treatment Options ◽  
Controlled Trials ◽  
Limited Sample ◽  
Future Studies ◽  
Psychogenic Nonepileptic Seizures ◽  
The Past ◽  
Evidence Based Treatments ◽  
Nonepileptic Seizures ◽  
New Treatment ◽  
Functional Neurological Disorders

Psychogenic nonepileptic seizures (PNES) have been in the medical literature for centuries. However, treatments were limited, being based on uncontrolled data, until the past decade. Treatment advances published since 2010 have included pilot controlled trials using psychotherapies, psychoeducational approaches, medications, and combined pharmacological and psychotherapeutic approaches that provide new treatment options for patients with PNES. This chapter describes these controlled trials in detail. It also covers studies of treatments for other functional neurological disorders including PNES. One conclusion from this review is that future studies still need to improve on as-yet limited sample sizes and provide insights into predictors of treatment outcome so that rational decisions can be made about which treatments offer the best outcome and who is likely to best respond to which treatment.

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