Thursday, February 26, 2009

Memantine transiently worsens MS

Villoslada P et al. Memantine induces reversible neurologic impairment in patients with MS.
30 patients underwent a one year randomized crossover trial with 30 mg memantine. Patients had poor cognitive scores and MS . The trial was halted after 9 patients due to blurred vision, fatigue, headache, increased muscle weakness, trouble walking/gait. Symptoms only occurred at maximum dose.

Early MRI in ON" Risk for disability

Swanton et al. Neurology 2009; 72: 542-550. (Queen's Square)
106/143 patients reached scheduled five year followup after being diagnosed with ON. 100 were evaluated clinically. At median 6 years, 48 % converted to CDMS 52 % did not. At baseline, the presence and number of spinal cord lesions and new T2 lesions at followup (odds ratio, respectively of 3.3, 1.94, 7.12) predicted higher disability. Also Gd+ lesions and number of infratentotial lesions at baseline were predictive.

Many factors were not predictive including age, gender, baseline EDSS, spectros/MTR measures, NOT baseline lesion number although lesion load at 5 years and increase from baseline was predictive.

ACT trial negative

Cohen et al. Neurology 2009: 72:535-541.

There were 313 subjects, no benefit of adding IVMP or MTX to interferon beta one alpha. Trend to less NABs. It was safe and well tolerated. There was a trend to benefit in the IVMP group.