A randomized, controlled trial of fingolimod (FTY720) in Japanese patients with multiple sclerosis

BACKGROUND

Fingolimod (FTY720) has previously shown clinical efficacy in phase II/III studies of predominantly Caucasian populations with multiple sclerosis (MS).

OBJECTIVES

To report six-month efficacy and safety outcomes in Japanese patients with relapsing MS treated with fingolimod.

METHODS

In this double-blind, parallel-group, phase II study, 171 Japanese patients with relapsing MS were randomized to receive once-daily fingolimod 0.5 mg or 1.25 mg, or matching placebo for six months. The primary and secondary endpoints were the percentages of patients free from gadolinium (Gd)-enhanced lesions at months 3 and 6, and relapses over six months, respectively; safety outcomes were also assessed.

RESULTS

147 patients completed the study. Higher proportions of patients were free from Gd-enhanced lesions at months 3 and 6 with fingolimod (0.5 mg: 70%, p = 0.004; 1.25 mg: 86%, p < 0.001) than with placebo (40%). Odds ratios for the proportions of relapse-free patients over six months favoured fingolimod versus placebo but were not significant. Adverse events related to fingolimod included transient bradycardia and atrioventricular block at treatment initiation, and elevated liver enzyme levels.

CONCLUSIONS

This study demonstrated the clinical efficacy of fingolimod for the first time in Japanese patients with MS, consistent with the established effects of fingolimod in Caucasian patients.

Electrodynamic trapping of spinless neutral atoms with an atom chip

Three-dimensional electrodynamic trapping of neutral atoms has been demonstrated. By applying time-varying inhomogeneous electric fields with micron-sized electrodes, nearly 10(2) strontium atoms in the 1S0 state have been trapped with a lifetime of 80 ms. In order to design the electrodes, we numerically analyzed the electric field and simulated atomic trajectories in the trap, which showed reasonable agreement with the experiment.

[Characteristics of psychosocial nursing care--the dimensions of psychosocial nursing care to promote empowerment among patients]

Nurses provide the psychosocial nursing care to promote the patients' empowerment. In spite of recognizing the importance of psychosocial nursing. The research reported here is part of a large study designed to explore the psychosocial nursing intervention strategies. This part of the study is focused on characteristics of psychosocial nursing care as identified by nurses. Research design was descriptive and qualitative. Subjects were a convenient sample of nurses who have more than 5 years experience and agreed to participate in this research. Data was collected through semistructured interviews. Data was recorded on a tape and transcribed, then analyzed based on Grounded Theory Approach.

SUBJECTS

The number of subjects consisted of 39 nurses. The average age and duration of clinical experience was 36.6 years old and 12.6 years.

RESULT

Sixteen of the characteristics of psychosocial nursing to promote the empowerment among the patients were identified; 1) respect the patients' decision making, 2) clinical judgment from multiple perspectives, 3) predictability, 4) flexibility, 5) classification of the patients by comparison, 6) monitoring, 7) relief from reality, 8) relief from pain and suffering, 9) enhancement of the patients' ego strength, 10) nurture of hope, 11) support individualized daily living styles, 12) encouragement of the patients'own problem solving abilities, 13) respect of individuality, 14) self-utilization, 15) self-control based on professional identity, 16) utilization of team power.

DISCUSSION

Nurses choose from the sixteen dimensions of psychosocial nursing and organizing them in order to stabilizing the patients' conditions.