The Dose-Response Relationship between Opioid Agonist Therapy and Alterations in Pain Pathways in Patients with Opioid Use Disorders: A Cross-Sectional Study
ConclusionThe present trial demonstrates the clear effects of opioid agonist therapy on the somatosensory system. Both central sensitization and descending pain modulation are negatively affected by high doses of opioids and our data elucidate a moderate dose-response relationship for these phenomena. (Source: CNS Drugs)
Source: CNS Drugs - February 29, 2024 Category: Neurology Source Type: research
Real-World Retrospective Analysis of Alemtuzumab Outcomes in Relapsing-Remitting Multiple Sclerosis: The LEMCAM Study
ConclusionsThis study shows that alemtuzumab reduced the relapse rate and disability worsening in real-world clinical practice, with many patients achieving and sustaining NEDA-3 over time. The safety profile of alemtuzumab was consistent with previous findings, and no new or unexpected safety signals were observed. As this was an observational and retrospective study, the main limitation of not having all variables comprehensively available for all patients should be considered when interpreting results. (Source: CNS Drugs)
Source: CNS Drugs - February 28, 2024 Category: Neurology Source Type: research
SAFE-ROCK: A Phase I Trial of an Oral Application of the ROCK Inhibitor Fasudil to Assess Bioavailability, Safety, and Tolerability in Healthy Participants
ConclusionsOral fasudil was generally well tolerated in the studied population, and no safety concerns were identified. However, systemic bioavailability of oral hydroxyfasudil corresponded to 69%, and dose adjustments need to considered. The results presented here lay grounds for future trials of fasudil in chronic diseases, which require an oral long-term application. This trial was registered with EudraCT (no. 2019-001805-26). (Source: CNS Drugs)
Source: CNS Drugs - February 28, 2024 Category: Neurology Source Type: research
Andexanet Alfa: What We Have Learned from Clinical Trials and Real-World Data
AbstractAndexanet alfa is a specific reversal agent for factor Xa inhibitors with immediate reversal of their anticoagulant effect. Andexanet alfa is currently approved for use in patients treated with rivaroxaban and apixaban who have life-threatening or uncontrolled bleeding. New data from both controlled clinical trials and real-world experience are continuously being published, providing greater insight into the clinical characteristics of the drug, such as efficacy and safety. It is worth considering that andexanet alfa could be of benefit in a variety of different clinical scenarios where patients receiving treatment...
Source: CNS Drugs - February 23, 2024 Category: Neurology Source Type: research
Unmet Needs in Psychodermatology: A Narrative Review
In conclusion, increasing resources for dermatologist education on psychotropic agent use, development of new drugs targeting stress-induced skin conditions, and research on the psychocutaneous applications of current medications may greatly improve the quality and access of psychodermatology care. (Source: CNS Drugs)
Source: CNS Drugs - February 22, 2024 Category: Neurology Source Type: research
Benzodiazepines for the Treatment of Seizure Clusters
AbstractPatients with epilepsy may experience seizure clusters, which are described by the US Food and Drug Administration (FDA) as intermittent, stereotypic episodes of frequent seizure activity that are distinct from a patient ’s usual seizure pattern. Untreated seizure clusters may increase the risk for status epilepticus, as well as decrease quality of life and increase burden on patients and care partners. Benzodiazepine therapies are the mainstay for acute treatment of seizure clusters and are often administered by nonmedical care partners outside a healthcare facility. Three rescue therapies are currently FDA-appr...
Source: CNS Drugs - February 15, 2024 Category: Neurology Source Type: research
Targeting Pannexin-1 Channels: Addressing the ‘Gap’ in Chronic Pain
AbstractChronic pain complicates many diseases and is notoriously difficult to treat. In search of new therapeutic targets, pannexin-1 (Panx1) channels have sparked intense interest as a key mechanism involved in a variety of chronic pain conditions. Panx1 channels are transmembrane proteins that release ions and small molecules, such as adenosine triphosphate (ATP). They are expressed along important nodes of the pain pathway, modulating activity of diverse cell types implicated in the development and progression of chronic pain caused by injury or pathology. This review highlights advances that have unlocked the core str...
Source: CNS Drugs - February 14, 2024 Category: Neurology Source Type: research
The Efficacy and Safety of Different Targeted Drugs for the Treatment of Generalized Myasthenia Gravis: A Systematic Review and Bayesian Network Meta-analysis
ConclusionsBatoclimab had the best efficacy and safety for the treatment of gMG and was ranked first out of the 10 targeted drugs included in this study. Eculizumab was ranked second, and nipocalimab had the worst efficacy. With the exception of batoclimab, the incidence of AEs for the remaining drugs was not statistically significantly different from placebo. We note, however, that wide CrIs reflect the uncertainty in this analysis owing to the small number of available studies and low numbers of study participants; moreover, batoclimab had the wide st CrI of all drugs in this analysis. More well-designed studies with l...
Source: CNS Drugs - February 1, 2024 Category: Neurology Source Type: research
Trends in Pregabalin Use and Prescribing Patterns in the Adult Population: A 10-Year Pharmacoepidemiologic Study
ConclusionPregabalin use has increased significantly in the Israeli adult-based CHS population, consistent with worldwide data. A growing use over time may indicate overprescription. More studies are needed on misuse patterns to identify populations most susceptible to high-dose and high-intensity pregabalin use. (Source: CNS Drugs)
Source: CNS Drugs - January 25, 2024 Category: Neurology Source Type: research
Early Experiences with Intrathecal Administration of Amphotericin B Liposomal Formulation at a Neurosurgical Center
ConclusionsLiposomal amphotericin B may be feasibly administered intrathecally for the adjunctive treatment of severe fungal meningitis. (Source: CNS Drugs)
Source: CNS Drugs - January 25, 2024 Category: Neurology Source Type: research
Effect of Cenobamate on Cognition in Patients with Drug-Resistant Epilepsy with Focal Onset Seizures: An Exploratory Study
ConclusionsSignificant improvements in cognition, seizure frequency, and concomitant ASM usage were observed after the introduction of cenobamate in patients with DRE in a real-world setting. Covariance analysis supports the reduction in concomitant ASMs as the most important factor driving cognitive improvements with cenobamate. As this was an exploratory study with an uncontrolled, retrospective design and a low number of patients, further studies are required to confirm the findings. (Source: CNS Drugs)
Source: CNS Drugs - January 24, 2024 Category: Neurology Source Type: research
Treatment of Sleep, Motor and Sensory Symptoms with the Orexin Antagonist Suvorexant in Adults with Idiopathic Restless Legs Syndrome: A Randomized Double-Blind Crossover Proof-of-Concept Study
ConclusionsOur results provide the first proof of evidence of the therapeutic efficacy of DORAs in improving sleep and sensory and motor symptoms in RLS. Given orexin ’s role in pain and sensory processing, potential mechanisms of action are discussed.Classification of EvidenceThe study provides class II evidence supporting the therapeutic efficacy of suvorexant in patients with RLS with sleep disturbance. Trial Registration: EudraCT#: 2017-004580-12. (Source: CNS Drugs)
Source: CNS Drugs - January 21, 2024 Category: Neurology Source Type: research
Evaluating Monitoring Guidelines of Clozapine-Induced Adverse Effects: a Systematic Review
ConclusionsFuture guidelines should develop more comprehensive recommendations about specific clozapine-induced adverse effects, including constipation, myocarditis, tachycardia, and seizures, as well as include a rechallenge policy. There is an urgent need for well-developed, methodologically stringent, guidelines.RegistrationPROSPERO registration number, CRD42023402480. (Source: CNS Drugs)
Source: CNS Drugs - January 18, 2024 Category: Neurology Source Type: research
Myasthenia Gravis Treatment: From Old Drugs to Innovative Therapies with a Glimpse into the Future
AbstractMyasthenia gravis (MG) is a rare autoimmune disease that causes debilitating muscle weakness due to impaired neuromuscular transmission. Since most (about 80 –90%) MG patients present autoantibodies against the acetylcholine receptor, standard medical therapy consists of symptomatic treatment with acetylcholinesterase inhibitors (e.g., pyridostigmine). In addition, considering the autoimmune basis of MG, standard therapy includes immunomodulating agent s, such as corticosteroids, azathioprine, cyclosporine A, and cyclophosphamide. New strategies have been proposed for the treatment of MG and include complement bl...
Source: CNS Drugs - January 11, 2024 Category: Neurology Source Type: research
Factors Associated with Symptom Stabilization that Allow for Successful Transition from Once-Monthly Paliperidone Palmitate to Three-Monthly Paliperidone Palmitate: A Post Hoc Analysis Examined Clinical Characteristics in Chinese Patients with Schizophrenia
ConclusionA lower CGI-S total score at baseline and greater reductions in PANSS and CGI-S scores at week 13 were associated with patients achieving disease stabilization, that may allow for a successful transition. Evidence from this study indicates that better disease condition at baseline, early functional improvement and symptomatic relief were the key factors associated with disease stabilization. The findings may guide clinicians to identify suitable patients for transition from PP1M to PP3M and further optimize the use of PP3M in China.Clinical Trials RegistrationEudraCT number: 2011-004889-15 and ClinicalTrials.gov ...
Source: CNS Drugs - January 8, 2024 Category: Neurology Source Type: research
