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The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on multiple sclerosis or other clinical topics then use Trip today.
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Cladribine (Mavenclad) - for the treatment of adult patients with highly active relapsing multiplesclerosis (MS) Cost-effectiveness of cladribine (Mavenclad®) for the treatment of adult patients with highly active relapsing multiplesclerosis (MS) as defined by clinical or imaging features The NCPE has issued a recommendation regarding the cost-effectiveness of cladribine (Mavenclad®). Following assessment of the applicant’s submission, the NCPE recommends that cladribine (Mavenclad® (...) who has a responsibility for commissioning or providing healthcare, public health or social care services. National Centre for Pharmacoeconomics July 20182 Summary In December 2017, Merck Serono Europe Ltd submitted a dossier of clinical, safety and economic evidence in support of cladribine (Mavenclad®) for the treatment of adult patients with highly active relapsing multiplesclerosis (MS) as defined by clinical or imaging features. This includes both relapsing remitting MS (RRMS) and secondary
Ocrelizumab (Ocrevus) for the treatment of adult patients with relapsing forms of multiplesclerosis (RMS) Cost-effectiveness of ocrelizumab (Ocrevus®) for the treatment of adult patients with relapsing-remitting multiplesclerosis (RRMS) The NCPE has issued a recommendation regarding the cost-effectiveness of Ocrelizumab (Ocrevus) for the treatment of relapsing – remitting multiplesclerosis (RRMS). Following assessment of the applicant’s submission, the NCPE recommends that ocrelizumab (...) , safe and value for money treatments for patients. Our advice is for consideration by anyone who has a responsibility for commissioning or providing healthcare, public health or social care services. National Centre for Pharmacoeconomics August 20182 Summary Roche Products Ireland Ltd submitted an economic dossier on the cost-effectiveness of ocrelizumab (Ocrevus®) for the treatment of adult patients with relapsing-remitting multiplesclerosis (RRMS) on the 16 th March 2018. Ocrelizumab
Ocrelizumab (Ocrevus) for the treatment of adult patients with early primary progressive multiplesclerosis (PPMS) Cost-effectiveness of ocrelizumab (Ocrevus®) for the treatment of adult patients with early primary progressive multiplesclerosis (PPMS) The NCPE has issued a recommendation regarding the cost-effectiveness of ocrelizumab (Ocrevus®) for the treatment of adult patients with early primary progressive multiplesclerosis (PPMS). Following assessment of the applicant’s submission (...) primary progressive multiplesclerosis (PPMS) in terms of disease duration and level of disability, and with imaging features characteristic of inflammatory activity. Ocrelizumab is a humanised monoclonal antibody that selectively targets CD20 a cell surface antigen expressed on B cells but not on lymphoid stem cells or plasma cells. It was granted regulatory approval from the European Medicines Agency (EMA) on the 8 th January 2018. The formulation is ocrelizumab 300mg concentrate for solution
MultiplesclerosisMultiplesclerosis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Multiplesclerosis Last reviewed: February 2019 Last updated: February 2019 Summary Demyelinating central nervous system condition clinically defined by two episodes of neurological dysfunction (brain, spinal cord, or optic nerves) that are separated in space and time. Classically presents in white women, aged between 20 to 40 years (...) , but lends greater specificity when present with brain lesions. Treatment of the condition can be divided into three parts: treatment of the acute attack; prevention of future attacks by reducing triggers and use of disease-modifying therapies; and symptomatic treatments of neurological difficulties such as spasticity, pain, fatigue, and bladder dysfunction. Definition Multiplesclerosis (MS) is defined as an inflammatory demyelinating disease characterised by the presence of episodic neurological
Urgent Clinical Commissioning Policy Statement: Natalizumab-induced Progressive Multifocal Leukoencephalopathy in relation to Immune Reconstitution Inflammatory Syndrome in MultipleSclerosis NHS England » Urgent Clinical Commissioning Policy Statement: Natalizumab-induced Progressive Multifocal Leukoencephalopathy in relation to Immune Reconstitution Inflammatory Syndrome in MultipleSclerosis (all ages) Search Search Menu Urgent Clinical Commissioning Policy Statement: Natalizumab-induced (...) Progressive Multifocal Leukoencephalopathy in relation to Immune Reconstitution Inflammatory Syndrome in MultipleSclerosis (all ages) Document first published: 14 March 2018 Page updated: 14 March 2018 Topic: , Publication type: This clinical commissioning policy statement is an interim commissioning position pending the formation of a Clinical Policy. Document PDF 74 KB 5 pages
Extract from Cannabis sativa (spasticity due to multiplesclerosis) - Benefit assessment according to §35a Social Code Book V (expiry of the decision) Extract 1 Translation of the executive summary of the dossier assessment Extrakt aus Cannabis sativa (Spastik aufgrund von multipler Sklerose) – Nutzenbewertung gemäß § 35a SGB V (Ablauf Befristung) (Version 1.0; Status: 26 July 2018). Please note: This document was translated by an external translator and is provided as a service by IQWiG (...) to English-language readers. However, solely the German original text is absolutely authoritative and legally binding. IQWiG Reports – Commission No. A18-27 Extract from Cannabis sativa (spasticity due to multiplesclerosis) – Benefit assessment according to §35a Social Code Book V 1 (expiry of the decision) Extract of dossier assessment A18-27 Version 1.0 Extract from Cannabis sativa (spasticity due to multiplesclerosis) 26 July 2018 Institute for Quality and Efficiency in Health Care (IQWiG) - i
MultiplesclerosisMultiplesclerosis - NICE CKS Share Multiplesclerosis: Summary Multiplesclerosis (MS) is a presumed autoimmune inflammatory condition of the central nervous system (CNS) resulting in areas of demyelination (damage to white matter), gliosis (subsequent scarring), and secondary neuronal damage (cell loss) throughout the CNS. Typically, MS first develops in young adults and is the most common non-traumatic cause of significant neurological disability in people younger than 40 (...) published by the National Institute for Health and Care Excellence (NICE) Multiplesclerosis: management of multiplesclerosis in primary and secondary care [ ]. This CKS topic covers the diagnosis and referral of people with suspected multiplesclerosis, and appropriate treatment of symptoms and complications that may come under the remit of primary care. This CKS topic does not cover the details of secondary care treatments, including disease modifying therapies. The target audience for this CKS topic
Fourteen sequence variants that associate with multiplesclerosis discovered by meta-analysis informed by genetic correlations. A meta-analysis of publicly available summary statistics on multiplesclerosis combined with three Nordic multiplesclerosis cohorts (21,079 cases, 371,198 controls) revealed seven sequence variants associating with multiplesclerosis, not reported previously. Using polygenic risk scores based on public summary statistics of variants outside the major (...) histocompatibility complex region we quantified genetic overlap between common autoimmune diseases in Icelanders and identified disease clusters characterized by autoantibody presence/absence. As multiplesclerosis-polygenic risk scores captures the risk of primary biliary cirrhosis and vice versa (P = 1.6 × 10-7, 4.3 × 10-9) we used primary biliary cirrhosis as a proxy-phenotype for multiplesclerosis, the idea being that variants conferring risk of primary biliary cirrhosis have a prior probability
Respiratory muscle training for multiplesclerosis. Multiplesclerosis (MS) is a chronic disease of the central nervous system, affecting approximately 2.5 million people worldwide. People with MS may experience limitations in muscular strength and endurance - including the respiratory muscles, affecting functional performance and exercise capacity. Respiratory muscle weakness can also lead to diminished performance on coughing, which may result in (aspiration) pneumonia or even acute (...) ventilatory failure, complications that frequently cause death in MS. Training of the respiratory muscles might improve respiratory function and cough efficacy.To assess the effects of respiratory muscle training versus any other type of training or no training for respiratory muscle function, pulmonary function and clinical outcomes in people with MS.We searched the Trials Register of the Cochrane MultipleSclerosis and Rare Diseases of the Central Nervous System Group (3 February 2017), which contains
PRAC recommends further restrictions for multiplesclerosis medicine Zinbryta due to risk of serious liver damage PRAC recommends further restrictions for multiplesclerosis medicine Zinbryta due to risk of serious liver damage | European Medicines Agency Search Search Menu PRAC recommends further restrictions for multiplesclerosis medicine Zinbryta due to risk of serious liver damage Press release 27/10/2017 Zinbryta to be used only in a restricted patient group, with strict liver monitoring (...) EMA's ( ) is recommending further restrictions on the use of the multiplesclerosis medicine Zinbryta (daclizumab) following a review of the medicine's effects on the liver. The review found that unpredictable and potentially fatal immune-mediated liver injury can occur during treatment with Zinbryta and for up to 6 months after stopping treatment. In , 1.7% of patients receiving Zinbryta had a serious liver reaction. In order to reduce the risks, doctors should now only prescribe Zinbryta
Antineutrophil Cytoplasmic Antibody andÂ MultipleSclerosis 29854982 2019 02 26 2468-0249 3 3 2018 May Kidney international reports Kidney Int Rep Antineutrophil Cytoplasmic Antibody and MultipleSclerosis. 732-737 10.1016/j.ekir.2017.11.013 George Jason C JC Department of Nephrology, Geisinger Medical Center, Danville, Pennsylvania, USA. Mohan Prince P Department of Nephrology, Geisinger Medical Center, Danville, Pennsylvania, USA. Ho Kevin K Department of Nephrology, Geisinger Medical Center
Alemtuzumab versus interferon beta 1a for relapsing-remitting multiplesclerosis. Alemtuzumab is a humanised monoclonal antibody that alters the circulating lymphocyte pool, causing prolonged lymphopenia, thus remoulding the immune repertoire that accompanies homeostatic lymphocyte reconstitution. It has been proved more effective than interferon (IFN) 1a for the treatment of relapsing-remitting multiplesclerosis (RRMS).To compare the efficacy, tolerability and safety of alemtuzumab versus (...) interferon beta 1a in the treatment of people with RRMS to prevent disease activity.We searched the Cochrane MultipleSclerosis and Rare Diseases of the CNS Group Trials Register (1 February 2017) which, among other sources, contains records from CENTRAL, MEDLINE, Embase, CINAHL, LILACS, PEDRO and the trial registry databases Clinical Trials.gov and WHO International Clinical Trials Registry Platform for all prospectively registered and ongoing trials.All double-blind, randomised, controlled trials
Comorbidity in multiplesclerosis is associated with diagnostic delays and increased mortality To investigate the effect of chronic comorbidity on the time of diagnosis of multiplesclerosis (MS) and on mortality in MS.We conducted a population-based, nationwide cohort study including all incident MS cases in Denmark with first MS symptom between 1980 and 2005. To investigate the time of diagnosis, we compared individuals with and without chronic comorbidity using multinomial logistic
Clemastine fumarate as a remyelinating therapy for multiplesclerosis (ReBUILD): a randomised, controlled, double-blind, crossover trial. Multiplesclerosis is a degenerative inflammatory disease of the CNS characterised by immune-mediated destruction of myelin and progressive neuroaxonal loss. Myelin in the CNS is a specialised extension of the oligodendrocyte plasma membrane and clemastine fumarate can stimulate differentiation of oligodendrocyte precursor cells in vitro, in animal models (...) , and in human cells. We aimed to analyse the efficacy and safety of clemastine fumarate as a treatment for patients with multiple sclerosis.We did this single-centre, 150-day, double-blind, randomised, placebo-controlled, crossover trial (ReBUILD) in patients with relapsing multiplesclerosis with chronic demyelinating optic neuropathy on stable immunomodulatory therapy. Patients who fulfilled international panel criteria for diagnosis with disease duration of less than 15 years were eligible. Patients were
2017LancetControlled trial quality: predicted high
Clinical and cost-effectiveness of beta interferon and glatiramer acetate for treating multiplesclerosis: systematic review and economic evaluation Clinical and cost-effectiveness of beta interferon and glatiramer acetate for treating multiplesclerosis: systematic review and economic evaluation Clinical and cost-effectiveness of beta interferon and glatiramer acetate for treating multiplesclerosis: systematic review and economic evaluation Melendez-Torres G, Auguste P, Armoiry X, Maheswaran (...) -effectiveness of beta interferon and glatiramer acetate for treating multiplesclerosis: systematic review and economic evaluation. Health Technology Assessment 2017; 21(52) Authors' objectives To undertake (1) systematic reviews of the clinical effectiveness and cost-effectiveness of IFN-β and GA in relapsing–remitting multiplesclerosis (RRMS), secondary progressive multiplesclerosis (SPMS) and clinically isolated syndrome (CIS) compared with best supportive care (BSC) and each other, investigating
Are cannabinoids effective in multiplesclerosis? Multiple beneficial effects have been proposed lately for cannabinoids in different clinical situations. Among them, it has been postulated they would control symptoms of multiplesclerosis. However, there is no consensus about their real clinical role. To answer this question, we searched in Epistemonikos database, which is maintained by screening multiple databases. We identified 25 systematic reviews including 35 studies overall, of which 26 (...) were randomized trials. We extracted data, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. We concluded cannabinoids in multiplesclerosis do not reduce spasticity or pain, and are probably associated to frequent adverse effects.