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91.
Sormani MP Bruzzi P Beckmann K Kappos L Miller DH Polman C Pozzilli C Thompson AJ Wagner K Filippi M 《Journal of neurology》2005,252(12):1455-1458
Whereas the effect of interferons (IFNs) on magnetic resonance imaging (MRI) outcome measures in patients with multiple sclerosis (MS) has been convincingly shown, little work has been done to define the between-patient heterogeneity of treatment response. Our aim was to assess the distribution of the effect of IFNbeta-1b in terms of reduction of active T2 lesions in patients with MS. Using a fixed and a random effects model, we investigated the distribution of active T2 lesions reduction over a three-year follow up in response to treatment with 250 mcg IFNbeta-1b every other day in 695 patients with a complete MRI data-set of the 718 (97 %) enrolled in the European, multicenter, randomised, double-blind, placebo-controlled trial of secondary progressive MS. The two statistical models consistently showed that the between-patient response to IFNbeta-1b, in terms of reduction of active T2 lesions, is highly heterogeneous. Whereas treated patients have a high probability (more than 65%) of showing an active T2 lesion reduction equal to or greater than 60%, there is also a 7% probability for treated patients not to show any reduction of MRI-detected disease activity during the course of the trial or even to have an increase of T2 active lesions. This study might be regarded as a first step toward the definition of markers potentially useful to identify IFNbeta treatment responders and non-responders with regard to T2 lesion activity. 相似文献
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Confavreux C Vukusic S Arbizu T Brochet B Clanet M Edan G Kappos L Suissa S 《Revue neurologique》2005,161(6-7):644-6; author reply 646-7
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There are presently many magnetic resonance (MR) measures that can aid the assessment of damage to the brain. The conventional measures include T2 lesion volume, T1 enhanced lesion volume, and brain atrophy. Newer methodologies include magnetization transfer measures and proton spectroscopy. These methods have the potential for improving the specificity of MR with respect to the underlying pathology. MR spectroscopy offers the ability to quantitate the component of axonal loss in multiple sclerosis. MR techniques can be implemented to assess the effectiveness of treatment algorithms. 相似文献
96.
Hematopoietic stem cell transplantation for multiple sclerosis. A retrospective multicenter study 总被引:15,自引:0,他引:15
Fassas A Passweg JR Anagnostopoulos A Kazis A Kozak T Havrdova E Carreras E Graus F Kashyap A Openshaw H Schipperus M Deconinck E Mancardi G Marmont A Hansz J Rabusin M Zuazu Nagore FJ Besalduch J Dentamaro T Fouillard L Hertenstein B La Nasa G Musso M Papineschi F Rowe JM Saccardi R Steck A Kappos L Gratwohl A Tyndall A Samijn J Samign J;Autoimmune Disease Working Party of the EBMT 《Journal of neurology》2002,249(8):1088-1097
Rationale Phase I/II studies of autologous hematopoietic stem cell transplantation (HSCT) for multiple sclerosis (MS) were initiated, based on results of experimental transplantation in animal models of multiple sclerosis and clinical observations
in patients treated concomitantly for malignant disease. Patients Eighty-five patients with progressive MS were treated with autologous HSCT in 20 centers and reported to the autoimmune disease working party of the European Group
for Blood and Marrow Transplantation (EBMT). 52 (61 %) were female, median age was 39 [20-58] years. The median interval from
diagnosis to transplant was 7 [1-26] years. Patients suffered from severe disease with a median EDSS score of 6.5 [4.5-8.5].
Active disease prior to transplant was documented in 79 of 82 evaluable cases. Results The stem cell source was bone marrow in 6 and peripheral blood in 79, and stem cells were mobilized into peripheral blood
using either cyclophosphamide combined with growth factors or growth factors alone. Three patients experienced transient neurological
complications during the mobilization phase. The high dose regimen included combination chemotherapy, with or without anti-lymphocyte
antibodies or, with or without, total body irradiation. The stem cell transplants were purged of lymphocytes in 52 patients.
Median follow-up was 16 [3-59] months. There were 7 deaths, 5 due to toxicity and infectious complications, 2 with neurological
deterioration. The risk of death of any cause at 3 years was 10 (±7)% (95 % confidence interval). Neurological deterioration
during transplant was observed in 22 patients; this was transient in most but was associated with MS progression in 6 patients.
Neurological improvement by ≥ 1 point in the EDSS score was seen in 18 (21 %) patients. Confirmed progression-free survival
was 74 (±12)% at 3 years being 66 (±23)% in patients with primary progressive MS but higher in patients with secondary progressive
or relapsing-remitting MS, 78 (±13)%; p = 0.59. The probability of confirmed disease progression was 20 (±11)%. MRI data were
available in 78 patients before transplant showing disease activity (gadolinium enhancing, new or enlarging lesions) in 33
%. Posttransplant MRI showed activity at any time in 5/61 (8 %) evaluable cases. Conclusion Autologous HSCT suggest positive early results in the management of progressive MS and is feasible. These multicentre data
suggest an association with significant mortality risks especially in some patient groups and are being utilised in the planning
of future trials to reduce transplant related mortality.
Received: 21 August 2001 Received in revised form: 4 February 2002 Accepted: 6 February 2002 相似文献
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de Sitter Alexandra Verhoeven Tom Burggraaff Jessica Liu Yaou Simoes Jorge Ruggieri Serena Palotai Miklos Brouwer Iman Versteeg Adriaan Wottschel Viktor Ropele Stefan Rocca Mara A. Gasperini Claudio Gallo Antonio Yiannakas Marios C. Rovira Alex Enzinger Christian Filippi Massimo De Stefano Nicola Kappos Ludwig Frederiksen Jette L. Uitdehaag Bernard M. J. Barkhof Frederik Guttmann Charles R. G. Vrenken Hugo 《Journal of neurology》2020,267(12):3541-3554
Journal of Neurology - Deep grey matter (DGM) atrophy in multiple sclerosis (MS) and its relation to cognitive and clinical decline requires accurate measurements. MS pathology may deteriorate the... 相似文献
100.
H Klepzig M Aumüller J Kreuzer C Baldamus E Krause A D Kappos M Kaltenbach 《Zeitschrift für Kardiologie》1985,74(2):130-131
We report on a 54-year-old patient with chronic renal failure, in whom complete AV block occurred after aortic valve replacement. During hemofiltration an external demand pacemaker sensed spikes induced by the employed machine. This caused an asystole. Fixed rate pacing re-established regular ventricular contractions. 相似文献