BRAF Mutations in CNS Tumors —Prognostic Markers and Therapeutic Targets
AbstractGliomas are a heterogeneous group of brain tumors with limited therapeutic options. However, identification ofBRAF V600E mutations in a subset of gliomas has provided a genomic-targeted approach for management of these diseases. In this review, we aimed to review the role ofBRAF V600E in gliomagenesis, to characterize concurrent genomic alterations and their potential prognostic implications, and to review comprehensively the efficacy data ofBRAF inhibitors (combined or not withMEK inhibitors) for the treatment of low- and high-grade gliomas. We also provide a summary of the toxicity of these agents and describe re...
Source: CNS Drugs - June 2, 2023 Category: Neurology Source Type: research
Calcitonin in the Treatment of Phantom Limb Pain: A Systematic Review
ConclusionThe available evidence supported the use of calcitonin as either monotherapy or adjuvant therapy in the treatment of PLP during the acute phase, while the evidence surrounding calcitonin treatment in chronic PLP is heterogeneous. Given the limited treatment options for the management of PLP and calcitonin ’s relatively wide therapeutic index, further research is warranted to determine the role that calcitonin may play in the treatment of PLP and other pain disorders. (Source: CNS Drugs)
Source: CNS Drugs - June 1, 2023 Category: Neurology Source Type: research
Early Non-Response to Antipsychotic Treatment in Schizophrenia: A Systematic Review and Meta-Analysis of Evidence-Based Management Options
ConclusionsDespite robust accuracy of early antipsychotic non-response predicting ultimate response, the evidence for treatment strategies that should be used for early non-response after 2 –3 weeks is limited. While meta-analytic findings were non-significant, some individual studies suggest advantages of antipsychotic switch or dose escalation. Therefore, any conclusions should be interpreted carefully, given the insufficient high-quality evidence. (Source: CNS Drugs)
Source: CNS Drugs - June 1, 2023 Category: Neurology Source Type: research
Pharmacological Management of Borderline Personality Disorder and Common Comorbidities
AbstractComorbidity between borderline personality disorder (BPD) and other mental disorders is common. Although no specific pharmacological treatments have been approved for the treatment of BPD, many drugs, including antidepressants such as selective serotonin reuptake inhibitors (SSRIs), mood stabilizers, second-generation antipsychotics, and even benzodiazepines, are routinely prescribed off label. Nonetheless, recommendations for off-label drugs in these patients are highly varied, with a notable lack of agreement among clinical guidelines. The most common reason for pharmacological treatment and polypharmacy in these...
Source: CNS Drugs - May 31, 2023 Category: Neurology Source Type: research
A Retrospective Real-Life Multicenter Study on Concurrent Oral Preventive Treatments in Patients with Chronic Migraine Treated with OnabotulinumtoxinA
ConclusionsPrescription of oral concomitant preventive treatment is common in patients with chronic migraine receiving BoNTA. We did not identify any unexpected safety or tolerability issues in patients receiving BoNTA and a CT+M. However, patients with a CT+M experienced a smaller reduction in monthly headache days when compare d with those with CT−, which might be associated with a higher resistance to treatment in that subgroup of patients. (Source: CNS Drugs)
Source: CNS Drugs - May 22, 2023 Category: Neurology Source Type: research
New Pharmacological Approaches to the Management of Premenstrual Dysphoric Disorder
AbstractPremenstrual symptoms are experienced by many female individuals during their fertile age. Premenstrual dysphoric disorder (PMDD), a sex-specific mood disorder, affects about 5% of female individuals during the luteal phase of the menstrual cycle. Treatment with selective serotonin reuptake inhibitors represents a valid solution to manage PMDD for many, but not all, patients. Owing to maladaptive neural reactivity to gonadal hormone fluctuations, that is, the putative mechanism postulated to underlie PMDD, drugs suppressing or stabilizing such variations have been tested. Recently, a clinically significant reductio...
Source: CNS Drugs - May 12, 2023 Category: Neurology Source Type: research
Nonstimulant Medications for Attention-Deficit/Hyperactivity Disorder (ADHD) in Adults: Systematic Review and Meta-analysis
ConclusionsAll investigated nonstimulants were more efficacious in the treatment of ADHD in adults, than placebo, while the placebo had better acceptability and tolerability.Protocolhttps://osf.io/5vnmt/?view_only=2bf87ed12ba94645babedceeee4c0120. (Source: CNS Drugs)
Source: CNS Drugs - May 11, 2023 Category: Neurology Source Type: research
Targeting Sigma Receptors for the Treatment of Neurodegenerative and Neurodevelopmental Disorders
AbstractThe sigma-1 receptor is a 223 amino acid-long protein with a recently identified structure. The sigma-2 receptor is a genetically unrelated protein with a similarly shaped binding pocket and acts to influence cellular activities similar to the sigma-1 receptor. Both proteins are highly expressed in neuronal tissues. As such, they have become targets for treating neurological diseases, including Alzheimer ’s disease (AD), Huntington’s disease (HD), Parkinson’s disease (PD), multiple sclerosis (MS), Rett syndrome (RS), developmental and epileptic encephalopathies (DEE), and motor neuron disease/amyotrophic late...
Source: CNS Drugs - May 11, 2023 Category: Neurology Source Type: research
Matching-Adjusted Indirect Comparisons of Diroximel Fumarate, Ponesimod, and Teriflunomide for Relapsing Multiple Sclerosis
ConclusionsWe did not observe differences between DRF and PON for ARR, CDP, and absence of new/newly enlarging T2 lesions, but there was a higher proportion of patients free of Gd+ T1 lesions among DRF-treated patients than PON-treated patients. DRF had improved efficacy versus TERI for all clinical and radiological outcomes, except for absence of new/newly enlarging T2 lesions.Clinical Trials RegistrationEVOLVE-MS-1 (ClinicalTrials.gov identifier: NCT02634307); OPTIMUM (ClinicalTrials.gov identifier: NCT02425644). (Source: CNS Drugs)
Source: CNS Drugs - May 8, 2023 Category: Neurology Source Type: research
Andexanet Alfa to Reverse the Effect of Factor Xa Inhibitors in Intracranial Hemorrhage
AbstractAndexanet alfa (AA) is a recombinant factor Xa competing for binding with factor Xa inhibitors, thereby reversing their anticoagulation effects. Since 2019, it has been approved for individuals under apixaban or rivaroxaban therapy suffering from life-threatening or uncontrolled bleeding. Apart from the piv otal trial, real-world data on the use of AA in daily clinics are scarce. We reviewed the current literature on patients with intracranial hemorrhage (ICH) and summarized the available evidence regarding several outcome parameters. On the basis of this evidence, we provide a standard operating proce dure (SOP)...
Source: CNS Drugs - May 3, 2023 Category: Neurology Source Type: research
Idiopathic Hypersomnia: Neurobiology, Diagnosis, and Management
This article provides a historical review of the evolving diagnostic classification of idiopathic hypersomnia, potential insights to the underlying pathophysiology, and a summary of proposed approaches for diagnosis and therapeutic intervention. (Source: CNS Drugs)
Source: CNS Drugs - April 18, 2023 Category: Neurology Source Type: research
Correction to: Efgartigimod Alfa in Generalised Myasthenia Gravis: A Profile of Its Use
(Source: CNS Drugs)
Source: CNS Drugs - April 17, 2023 Category: Neurology Source Type: research
Pharmacologic Management of Cognitive Disengagement Syndrome (CDS) and Implications for Attention-Deficit/Hyperactivity Disorder (ADHD) Treatment: Emerging Treatments and Recommendations for Future Research
The objective of this leading article was to investigate the existing evidence on medication treatment and CDS, including studies that have examined CDS response to medication and CDS as a moderator of ADHD treatment response. A total of seven studies were identified. At present, the limited existing literature suggests that psychostimulants such as methylphenidate and lisdexamfetamine, as well as atomoxetine, may improve CDS symptoms, although replication and research on related medications is needed. However, there are indications that CDS symptoms may predict a reduced response to methylphenidate in children with ADHD. ...
Source: CNS Drugs - April 15, 2023 Category: Neurology Source Type: research
Efgartigimod Alfa in Generalised Myasthenia Gravis: A Profile of Its Use
AbstractIntravenous efgartigimod alfa (also known as efgartigimod alfa-fcab in the USA; Vyvgart®) is the first neonatal Fc receptor antagonist approved in several countries worldwide, including the USA and EU for the treatment of generalised myasthenia gravis (gMG) in adults who are anti-acetylcholine receptor (AChR) antibody positive, and in Japan for the treatment of gMG regardless of antibody status. In the double-blind, placebo-controlled phase 3 ADAPT trial in patients with gMG, efgartigimod alfa significantly and rapidly reduced disease burden and improved muscle strength and quality of life compared with placebo. T...
Source: CNS Drugs - March 31, 2023 Category: Neurology Source Type: research
Sex Differences in Outcomes of Intravenous Thrombolysis in Acute Ischemic Stroke Patients with Preadmission Use of Antiplatelets
ConclusionNo sex differences were observed in the safety of IVT regarding preadmission use of antiplatelets. Males showed more favourable 3-month functional independence than females; however, this sex difference was apparently not explained by a sex-specific mechanism related to preadmission use of antiplatelets. (Source: CNS Drugs)
Source: CNS Drugs - March 28, 2023 Category: Neurology Source Type: research
