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Siebert N, Duchow A, Paul F, Infante-Duarte C, Bellmann-Strobl J. Inebilizumab in AQP4-Ab-positive neuromyelitis optica spectrum disorder. Drugs Today (Barc) 2021; 57:321-336. [PMID: 34061127 DOI: 10.1358/dot.2021.57.5.3265453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Until recently, the use of preventative immunotherapy in neuromyelitis optica spectrum disorders (NMOSD) was based on observational studies and clinical experiences. Meanwhile, the first drugs, among others the monoclonal antibody inebilizumab, were approved for the treatment of aquaporin-4 (AQP4) antibody-positive NMOSD. Inebilizumab binds to the CD19 antigen on B cells and leads to B-cell depletion. The first two dosages of 300 mg inebilizumab are administered intravenously at an interval of 2 weeks followed by further infusions every 6 months. In the placebo-controlled pivotal phase II/III study N-MOmentum, inebilizumab significantly prolonged the time to a first adjudicated relapse in AQP4 antibody-positive patients compared with placebo. The most frequent side effects were infusion reactions, urinary and respiratory tract infections, and arthralgia. This review presents data on clinical and preclinical pharmacology, administration, safety aspects and clinical trials of inebilizumab.
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Affiliation(s)
- N Siebert
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Clinical Research Center, Berlin, Germany. .,Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A Duchow
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Clinical Research Center, Berlin, Germany.,Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - F Paul
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Clinical Research Center, Berlin, Germany.,Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - C Infante-Duarte
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - J Bellmann-Strobl
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Clinical Research Center, Berlin, Germany.,Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Berlin, Germany
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Hälbig TD, Wüstenberg T, Giess RM, Kunte H, Bellmann-Strobl J, Ruprecht K, Paul F. Emotional experience in patients with clinically isolated syndrome and early multiple sclerosis. Eur J Neurol 2020; 27:1537-1545. [PMID: 32307769 DOI: 10.1111/ene.14269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 04/02/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND PURPOSE Evidence suggests that there are changes in the processing of emotional information (EP) in people with multiple sclerosis (MS). It is unclear which functional domains of EP are affected, whether these changes are secondary to other MS-related neuropsychological or psychiatric symptoms and if EP changes are present in early MS. The aim of the study was to investigate EP in patients with early MS (clinically isolated syndrome and early relapsing/remitting MS) and healthy controls (HCs). METHODS A total of 29 patients without neuropsychological or psychiatric deficits and 29 matched HCs were presented with pictures from the International Affective Picture System with negative, positive or neutral content. Participants rated the induced emotion regarding valence and arousal using nine-level Likert scales. A speeded recognition test assessed memory for the emotional stimuli and for the emotional modulation of response time. A subgroup of participants was tested during a magnetic resonance imaging (MRI) session. RESULTS Patients in the MRI subgroup rated the experience induced by pictures with positive or negative emotional content significantly more weakly than HCs. Further, these patients were significantly less aroused when watching the pictures from the International Affective Picture System. There were no effects in the non-MRI subgroup or effects on emotional memory or response times. CONCLUSIONS Emotional processing changes may be present in early MS in the form of flattened emotional experience on both the valence and arousal dimensions. These changes do not appear to be secondary to neuropsychological or psychiatric deficits. The fact that emotional flattening was only found in the MRI setting suggests that EP changes may be unmasked within stressful environments and points to the potential yet underestimated impact of the MRI setting on behavioral outcomes.
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Affiliation(s)
- T D Hälbig
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - T Wüstenberg
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - R M Giess
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - H Kunte
- Faculty of Natural Sciences, MSB, Medical School Berlin, Berlin, Germany
| | - J Bellmann-Strobl
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - K Ruprecht
- Department of Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - F Paul
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Berlin, Germany
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Chien C, Brandt AU, Schmidt F, Bellmann-Strobl J, Ruprecht K, Paul F, Scheel M. MRI-Based Methods for Spinal Cord Atrophy Evaluation: A Comparison of Cervical Cord Cross-Sectional Area, Cervical Cord Volume, and Full Spinal Cord Volume in Patients with Aquaporin-4 Antibody Seropositive Neuromyelitis Optica Spectrum Disorders. AJNR Am J Neuroradiol 2018; 39:1362-1368. [PMID: 29748202 DOI: 10.3174/ajnr.a5665] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 03/13/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Measures for spinal cord atrophy have become increasingly important as imaging biomarkers in the assessment of neuroinflammatory diseases, especially in neuromyelitis optica spectrum disorders. The most commonly used method, mean upper cervical cord area, is relatively easy to measure and can be performed on brain MRIs that capture cervical myelon. Measures of spinal cord volume (eg, cervical cord volume or total cord volume) require longer scanning and more complex analysis but are potentially better suited as spinal cord atrophy measures. This study investigated spinal cord atrophy measures in a cohort of healthy subjects and patients with aquaporin-4 antibody seropositive neuromyelitis optica spectrum disorders and evaluated the discriminatory performance of mean upper cervical cord cross-sectional area compared with cervical cord volume and total cord volume. MATERIALS AND METHODS Mean upper cervical cord area, cervical cord volume, and total cord volume were measured using 3T MRIs from healthy subjects (n = 19) and patients with neuromyelitis optica spectrum disorders (n = 30). Group comparison and receiver operating characteristic analyses between healthy controls and patients with neuromyelitis optica spectrum disorders were performed. RESULTS Mean upper cervical cord area, cervical cord volume, and total cord volume measures showed similar and highly significant group differences between healthy control subjects and patients with neuromyelitis optica spectrum disorders (P < .01 for all). All 3 measures showed similar receiver operating characteristic-area under the curve values (mean upper cervical cord area = 0.70, cervical cord volume = 0.75, total cord volume = 0.77) with no significant difference between them. No associations among mean upper cervical cord cross-sectional area, cervical cord volume, or total cord volume with disability measures were found. CONCLUSIONS All 3 measures showed similar discriminatory power between healthy control and neuromyelitis optica spectrum disorders groups. Mean upper cervical cord area is easier to obtain compared with cervical cord volume and total cord volume and can be regarded as an efficient representative measure of spinal cord atrophy in the neuromyelitis optica spectrum disorders context.
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Affiliation(s)
- C Chien
- From the NeuroCure Clinical Research Center (C.C., A.U.B., F.S., J.B.-S., F.P. M.S.)
| | - A U Brandt
- From the NeuroCure Clinical Research Center (C.C., A.U.B., F.S., J.B.-S., F.P. M.S.)
| | - F Schmidt
- From the NeuroCure Clinical Research Center (C.C., A.U.B., F.S., J.B.-S., F.P. M.S.).,Departments of Neurology (F.S., K.R., F.P.)
| | - J Bellmann-Strobl
- From the NeuroCure Clinical Research Center (C.C., A.U.B., F.S., J.B.-S., F.P. M.S.).,Experimental and Clinical Research Center (J.B.-S., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - K Ruprecht
- Departments of Neurology (F.S., K.R., F.P.)
| | - F Paul
- From the NeuroCure Clinical Research Center (C.C., A.U.B., F.S., J.B.-S., F.P. M.S.) .,Departments of Neurology (F.S., K.R., F.P.).,Experimental and Clinical Research Center (J.B.-S., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - M Scheel
- From the NeuroCure Clinical Research Center (C.C., A.U.B., F.S., J.B.-S., F.P. M.S.).,Neuroradiology (M.S.), Charité-Universitätsmedizin Berlin, Berlin, Germany
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Gaede G, Tiede M, Lorenz I, Pfueller C, Doerr J, Bellmann-Strobl J, Zangen A, Schippling S, Paul F. 1799 – Deep transcranial magnet stimulation improves depression and fatigue in multiple sclerosis. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)76769-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Oberwahrenbrock T, Ringelstein M, Jenschke S, Schippling S, Deuschle K, Bellmann-Strobl J, Hartung H, Ruprecht K, Paul F, Aktas O, Brandt A. Spatial Profile Analysis Detects Early Retinal Ganglion Cell Layer Reduction in Patients with Clinically Isolated Syndrome (P01.167). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p01.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Gäde G, Zimmermann H, Brandt A, Dörr JM, Bellmann-Strobl J, Hellweg R, Paul F, Pfüller C. Tiefe repetitive transkranielle Magnetstimulation bei gesunden Probanden-Studie zur Evaluation der Effekte auf die BDNF Serumkonzentration. KLIN NEUROPHYSIOL 2012. [DOI: 10.1055/s-0032-1301609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Veauthier C, Radbruch H, Gaede G, Pfueller CF, Dörr J, Bellmann-Strobl J, Wernecke KD, Zipp F, Paul F, Sieb JP. Fatigue in multiple sclerosis is closely related to sleep disorders: a polysomnographic cross-sectional study. Mult Scler 2011; 17:613-22. [PMID: 21278050 DOI: 10.1177/1352458510393772] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Sleep disorders can cause tiredness. The relationship between sleep disorders and fatigue in patients with multiple sclerosis (MS) has not yet been investigated systematically. OBJECTIVE To investigate the relationship between fatigue and sleep disorders in patients with MS. METHODS Some 66 MS patients 20 to 66 years old were studied by overnight polysomnography. Using a cut-off point of 45 in the Modified Fatigue Impact Scale (MFIS), the entire cohort was stratified into a fatigued MS subgroup (n=26) and a non-fatigued MS subgroup (n=40). RESULTS Of the fatigued MS patients, 96% (n=25) were suffering from a relevant sleep disorder, along with 60% of the non-fatigued MS patients (n=24) (p=0.001). Sleep-related breathing disorders were more frequent in the fatigued MS patients (27%) than in the non-fatigued MS patients (2.5%). Significantly higher MFIS values were detected in all (fatigued and non-fatigued) patients with relevant sleep disorders (mean MFIS 42.8; SD 18.3) than in patients without relevant sleep disorders (mean MFIS 20.5; SD 17.0) (p<0.001). Suffering from a sleep disorder was associated with an increased risk of fatigue in MS (odds ratio: 18.5; 95% CI 1.6-208; p=0.018). CONCLUSION Our results demonstrate a clear and significant relationship between fatigue and sleep disorders.
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Affiliation(s)
- C Veauthier
- Hanse-Klinikum, Department of Neurology, Stralsund, Germany.
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Bellmann-Strobl J, Wuerfel J, Aktas O, Dorr J, Wernecke KD, Zipp F, Paul F. Poor PASAT performance correlates with MRI contrast enhancement in multiple sclerosis. Neurology 2009; 73:1624-7. [DOI: 10.1212/wnl.0b013e3181c1de4f] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Bellmann-Strobl J, Stiepani H, Wuerfel J, Bohner G, Paul F, Warmuth C, Aktas O, Wandinger KP, Zipp F, Klingebiel R. MR spectroscopy (MRS) and magnetisation transfer imaging (MTI), lesion load and clinical scores in early relapsing remitting multiple sclerosis: a combined cross-sectional and longitudinal study. Eur Radiol 2009; 19:2066-74. [PMID: 19308417 DOI: 10.1007/s00330-009-1364-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2008] [Revised: 01/12/2009] [Accepted: 01/21/2009] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to correlate magnetic resonance imaging (MRI)-based lesion load assessment with clinical disability in early relapsing remitting multiple sclerosis (RRMS). Seventeen untreated patients (ten women, seven men; mean age 33.0 +/- 7.9 years) with the initial diagnosis of RRMS were included for cross-sectional as well as longitudinal (24 months) clinical and MRI-based assessment in comparison with age-matched healthy controls. Conventional MR sequences, MR spectroscopy (MRS) and magnetisation transfer imaging (MTI) were performed at 1.5 T. Lesion number and volume, MRS and MTI measurements for lesions and normal appearing white matter (NAWM) were correlated to clinical scores [Expanded Disability Status Scale (EDSS), Multiple Sclerosis Functional Composite (MSFC)] for monitoring disease course after treatment initiation (interferon beta-1a). MTI and MRS detected changes [magnetisation transfer ratio (MTR), N-acetylaspartate (NAA)/creatine ratio] in NAWM over time. EDSS and lesional MTR increases correlated throughout the disease course. Average MTR of NAWM raised during the study (p < 0.05) and correlated to the MSFC score (r = 0.476, p < 0.001). At study termination, NAA/creatine ratio of NAWM correlated to the MSFC score (p < 0.05). MTI and MRS were useful for initial disease assessment in NAWM. MTI and MRS correlated with clinical scores, indicating potential for monitoring the disease course and gaining new insights into treatment-related effects.
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Affiliation(s)
- J Bellmann-Strobl
- Cecilie Vogt Clinic for Neurology, Charité-University Medicine Berlin and Max Delbrueck Center for Molecular Medicine, Berlin, Germany
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Stiepani H, Bellmann-Strobl J, Bohner G, Gartenschläger S, Wandinger KP, Warmuth C, Zipp F, Klingebiel K. Multiple Sklerose: Magnetisierungstransfer-Messungen zeigen Erholung der NAWM unter Therapie mit Interferon beta 1a. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-941137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bellmann-Strobl J, Aktas O, Würfel J, Schmierer K, Paul F, Zschenderlein R, Villringer A, Zipp F. Primary progressive multiple sclerosis: evidence for uncoupling disease progression and inflammation. Akt Neurol 2006. [DOI: 10.1055/s-2006-953204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bellmann-Strobl J, Waiczies S, Würfel J, Aktas O, Zipp F. Hochdosis-Therapie mit Atorvastatin: gute Verträglichkeit bei Multipler Sklerose auch unter Kombination mit Interferontherapie. Akt Neurol 2005. [DOI: 10.1055/s-2005-919391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Stiepani H, Bellmann-Strobl J, Luenemann JD, Wandinger KP, Zipp F, Klingebiel R. Korrelation fortgeschrittener MR-Techniken (MTR, MRS, DWI) mit immunbiologischer Aktivität und klinischem Status im Frühstadium der Multiplen Sklerose. ROFO-FORTSCHR RONTG 2004. [DOI: 10.1055/s-2004-828190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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