Expert review of neurotherapeutics
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Expert Rev Neurother · Feb 2013
ReviewA new multiple sclerosis spasticity treatment option: effect in everyday clinical practice and cost-effectiveness in Germany.
Sativex® (GW Pharmaceuticals PLC, Porton Down, UK; Laboratorios Almirall, SA, Barcelona, Spain), a cannabinoid oromucosal spray containing a 1:1 ratio of 9-δ-tetrahydrocannabinol and cannabidiol, has been licensed in Germany since July 2011 as add-on therapy for moderate-to-severe multiple sclerosis (MS) treatment-resistant spasticity symptoms. The 'MOVE 2' study evaluated clinical outcomes, treatment satisfaction, quality of life (QoL) and provision of care in MS patients with spasticity receiving Sativex in everyday clinical practice. Data from 300 patients were collected from 42 specialized MS centers across Germany and were available for this analysis. ⋯ Sativex was generally well tolerated. The majority of patients (84%) reported no adverse events, and there was only a limited risk of serious adverse reactions. Furthermore, based on data from Sativex clinical trials, a Markov model-based analysis has shown that Sativex is a cost-effective treatment option for patients with MS spasticity in Germany.
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Expert Rev Neurother · Jan 2013
ReviewSacroiliac joint pain: a comprehensive review of epidemiology, diagnosis and treatment.
Sacroiliac joint (SIJ) pain is an underappreciated source of mechanical low back pain, affecting between 15 and 30% of individuals with chronic, nonradicular pain. Predisposing factors for SIJ pain include true and apparent leg length discrepancy, older age, inflammatory arthritis, previous spine surgery, pregnancy and trauma. Compared with facet-mediated and discogenic low back pain, individuals with SIJ pain are more likely to report a specific inciting event, and experience unilateral pain below L5. ⋯ Evidence supports both intra- and extra-articular causes for SIJ pain, with clinical studies demonstrating intermediate-term benefit for both intra- and extra-articular steroid injections. In those who fail to experience sustained relief from SIJ injections, radiofrequency denervation may provide significant relief lasting up to 1 year. This review covers all aspects of SIJ pain, with the treatment section being primarily focused on procedural interventions.
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Expert Rev Neurother · Jan 2013
Scientific advances in headache research: an update on neurostimulation.
The pathophysiological understanding of migraine and other primary headaches has been substantially improved over the last 20 years. A milestone that paved the way for successful research was the development of the International Classification of Headache Disorders published by the International Headache Society in 1988. ⋯ Recent advances in the understanding of headache disorders have been driven by the availability of new research tools, such as advanced imaging techniques, genetic tools, pharmaceutical compounds and devices for electrical or magnetic stimulation. The latest scientific and clinical advances were presented at the recent European Headache and Migraine Trust International Congress (EHMTIC) in London (UK).
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Expert Rev Neurother · Nov 2012
ReviewSubcutaneous IFN-β1a to treat relapsing-remitting multiple sclerosis.
Multiple sclerosis (MS) is the main nontraumatic cause of handicap in young adults. Immunomodulators and treatments limiting lymphocyte migration have been proven efficient to treat relapsing-remitting MS. Subcutaneous IFN-β1a improve relapse rate and MRI parameters in a series of double-blind, placebo-controlled trials in relapsing-remitting MS patients. ⋯ Except for the rare liver toxicity, the drug is well tolerated and has no severe adverse reaction. When compared with intramuscular IFN-β1a, both relapse rate and MRI parameters were modulated in favor of the subcutaneous administration. Although the effect of subcutaneous IFN-β1a on disability progression is limited, the good tolerance profile together with the efficiency of the drug explain why this treatment, as well as the other interferons and glatiramer acetate, is a first-line therapy for relapsing-remitting MS.