Conference Recap

The latest data on myasthenia gravis (MG) research, reported at the American Association of Neuromuscular and Electrodiagnostic Medicine 2024 Annual Meeting, are presented by Dr Pushpa Narayanswami of Harvard Medical School in Boston, Massachusetts.  

Dr Narayanswami begins with a safety, tolerability, and efficacy study for subcutaneous efgartigimod. Results showed that the mean change in MG activities of daily living (MG-ADL) was no different between the fixed-dose and cyclic regimens, demonstrating another dosage option for patients.

Next, Dr Narayanswami discusses two separate complement C5 inhibitor therapy trials. The first was a global registry study looking at ravulizumab. Patient cohorts consisted of those who started and remained on ravulizumab vs another that switched from initial eculizumab to ravulizumab. In both groups, MG-ADL was improved. The other study investigated zilucoplan in acetylcholine receptor autoantibody–positive generalized MG patient populations; similarly, researchers found favorable results.

She then details a study looking at the safety outcomes in pregnant patients treated with eculizumab. Because of limited disease-specific data in the registry, further investigation is recommended.

Finally, Dr Narayanaswami examines results for inebilizumab, a first-in-class anti-CD19 B cell–depleting agent. The drug demonstrated safety and beneficial efficacy compared with placebo in seropositive generalized MG patients.

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Pushpa Narayanaswami, MD, Associate Professor, Department of Neurology, Harvard Medical School; Vice Chair of Clinical Operations, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, Massachusetts

Pushpa Narayanaswami, MD, has disclosed the following relevant financial relationships:

Serve(d) as an advisor or consultant for: Alexion; Argenx; Janssen; Dianthus; UCB; GSK

Received research grant from: Alexion; UCB; Dianthus; Janssen

The latest data on myasthenia gravis (MG) research, reported at the American Association of Neuromuscular and Electrodiagnostic Medicine 2024 Annual Meeting, are presented by Dr Pushpa Narayanswami of Harvard Medical School in Boston, Massachusetts.  

Dr Narayanswami begins with a safety, tolerability, and efficacy study for subcutaneous efgartigimod. Results showed that the mean change in MG activities of daily living (MG-ADL) was no different between the fixed-dose and cyclic regimens, demonstrating another dosage option for patients.

Next, Dr Narayanswami discusses two separate complement C5 inhibitor therapy trials. The first was a global registry study looking at ravulizumab. Patient cohorts consisted of those who started and remained on ravulizumab vs another that switched from initial eculizumab to ravulizumab. In both groups, MG-ADL was improved. The other study investigated zilucoplan in acetylcholine receptor autoantibody–positive generalized MG patient populations; similarly, researchers found favorable results.

She then details a study looking at the safety outcomes in pregnant patients treated with eculizumab. Because of limited disease-specific data in the registry, further investigation is recommended.

Finally, Dr Narayanaswami examines results for inebilizumab, a first-in-class anti-CD19 B cell–depleting agent. The drug demonstrated safety and beneficial efficacy compared with placebo in seropositive generalized MG patients.

--

Pushpa Narayanaswami, MD, Associate Professor, Department of Neurology, Harvard Medical School; Vice Chair of Clinical Operations, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, Massachusetts

Pushpa Narayanaswami, MD, has disclosed the following relevant financial relationships:

Serve(d) as an advisor or consultant for: Alexion; Argenx; Janssen; Dianthus; UCB; GSK

Received research grant from: Alexion; UCB; Dianthus; Janssen

The latest data on myasthenia gravis (MG) research, reported at the American Association of Neuromuscular and Electrodiagnostic Medicine 2024 Annual Meeting, are presented by Dr Pushpa Narayanswami of Harvard Medical School in Boston, Massachusetts.  

Dr Narayanswami begins with a safety, tolerability, and efficacy study for subcutaneous efgartigimod. Results showed that the mean change in MG activities of daily living (MG-ADL) was no different between the fixed-dose and cyclic regimens, demonstrating another dosage option for patients.

Next, Dr Narayanswami discusses two separate complement C5 inhibitor therapy trials. The first was a global registry study looking at ravulizumab. Patient cohorts consisted of those who started and remained on ravulizumab vs another that switched from initial eculizumab to ravulizumab. In both groups, MG-ADL was improved. The other study investigated zilucoplan in acetylcholine receptor autoantibody–positive generalized MG patient populations; similarly, researchers found favorable results.

She then details a study looking at the safety outcomes in pregnant patients treated with eculizumab. Because of limited disease-specific data in the registry, further investigation is recommended.

Finally, Dr Narayanaswami examines results for inebilizumab, a first-in-class anti-CD19 B cell–depleting agent. The drug demonstrated safety and beneficial efficacy compared with placebo in seropositive generalized MG patients.

--

Pushpa Narayanaswami, MD, Associate Professor, Department of Neurology, Harvard Medical School; Vice Chair of Clinical Operations, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, Massachusetts

Pushpa Narayanaswami, MD, has disclosed the following relevant financial relationships:

Serve(d) as an advisor or consultant for: Alexion; Argenx; Janssen; Dianthus; UCB; GSK

Received research grant from: Alexion; UCB; Dianthus; Janssen

Efficacy data on ensifentrine, recently FDA-approved for moderate to severe COPD, as well as dupilumab use for symptom control, are key updates in COPD from the CHEST Annual Meeting. Dharani Narendra, MD, FCCP, CHEST Physician Editorial Board Member, from Baylor College of Medicine in Houston, Texas, reports on the findings.

Dr. Narendra begins with a trial examining the role of muscle relaxants in COPD exacerbation. The results showed that patients with COPD who were taking muscle relaxants experienced a rising risk for exacerbations over 1, 3, and 5 years, with a 20% relative risk increase by year 5.

Next, Dr. Narendra reports on ensifentrine efficacy in a subgroup analysis of the ENHANCE phase 3 trial, which provided the basis for FDA approval. Ensifentrine significantly improved peak and average FEV₁ at week 12, compared with placebo.

Dr. Narendra discusses a second presentation on ensifentrine — a meta-analysis of six randomized controlled trials of ensifentrine vs placebo in 2,365 patients. Significant improvements were seen in peak FEV₁ and average FEV₁, confirming ensifentrine efficacy in symptomatic patients with COPD with moderate to severe obstruction.

She also reviews subgroup analyses from the BOREAS and NOTUS trials, which led to the approval of dupilumab. One analysis demonstrated that dupilumab improved respiratory symptoms in patients with COPD with type 2 inflammation. Another showed significant reduction in annual exacerbation rates in patients with and without emphysema.

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Dharani K. Narendra, MD, FCCP, Assistant Professor, Department of Pulmonary, Critical Care, and Sleep Medicine, Baylor College of Medicine, Houston, Texas

Dharani K. Narendra, MD, FCCP, has disclosed no relevant financial relationships.

Efficacy data on ensifentrine, recently FDA-approved for moderate to severe COPD, as well as dupilumab use for symptom control, are key updates in COPD from the CHEST Annual Meeting. Dharani Narendra, MD, FCCP, CHEST Physician Editorial Board Member, from Baylor College of Medicine in Houston, Texas, reports on the findings.

Dr. Narendra begins with a trial examining the role of muscle relaxants in COPD exacerbation. The results showed that patients with COPD who were taking muscle relaxants experienced a rising risk for exacerbations over 1, 3, and 5 years, with a 20% relative risk increase by year 5.

Next, Dr. Narendra reports on ensifentrine efficacy in a subgroup analysis of the ENHANCE phase 3 trial, which provided the basis for FDA approval. Ensifentrine significantly improved peak and average FEV₁ at week 12, compared with placebo.

Dr. Narendra discusses a second presentation on ensifentrine — a meta-analysis of six randomized controlled trials of ensifentrine vs placebo in 2,365 patients. Significant improvements were seen in peak FEV₁ and average FEV₁, confirming ensifentrine efficacy in symptomatic patients with COPD with moderate to severe obstruction.

She also reviews subgroup analyses from the BOREAS and NOTUS trials, which led to the approval of dupilumab. One analysis demonstrated that dupilumab improved respiratory symptoms in patients with COPD with type 2 inflammation. Another showed significant reduction in annual exacerbation rates in patients with and without emphysema.

--

Dharani K. Narendra, MD, FCCP, Assistant Professor, Department of Pulmonary, Critical Care, and Sleep Medicine, Baylor College of Medicine, Houston, Texas

Dharani K. Narendra, MD, FCCP, has disclosed no relevant financial relationships.

Efficacy data on ensifentrine, recently FDA-approved for moderate to severe COPD, as well as dupilumab use for symptom control, are key updates in COPD from the CHEST Annual Meeting. Dharani Narendra, MD, FCCP, CHEST Physician Editorial Board Member, from Baylor College of Medicine in Houston, Texas, reports on the findings.

Dr. Narendra begins with a trial examining the role of muscle relaxants in COPD exacerbation. The results showed that patients with COPD who were taking muscle relaxants experienced a rising risk for exacerbations over 1, 3, and 5 years, with a 20% relative risk increase by year 5.

Next, Dr. Narendra reports on ensifentrine efficacy in a subgroup analysis of the ENHANCE phase 3 trial, which provided the basis for FDA approval. Ensifentrine significantly improved peak and average FEV₁ at week 12, compared with placebo.

Dr. Narendra discusses a second presentation on ensifentrine — a meta-analysis of six randomized controlled trials of ensifentrine vs placebo in 2,365 patients. Significant improvements were seen in peak FEV₁ and average FEV₁, confirming ensifentrine efficacy in symptomatic patients with COPD with moderate to severe obstruction.

She also reviews subgroup analyses from the BOREAS and NOTUS trials, which led to the approval of dupilumab. One analysis demonstrated that dupilumab improved respiratory symptoms in patients with COPD with type 2 inflammation. Another showed significant reduction in annual exacerbation rates in patients with and without emphysema.

--

Dharani K. Narendra, MD, FCCP, Assistant Professor, Department of Pulmonary, Critical Care, and Sleep Medicine, Baylor College of Medicine, Houston, Texas

Dharani K. Narendra, MD, FCCP, has disclosed no relevant financial relationships.

The latest research on therapeutic management of patients with relapsing-remitting multiple sclerosis (MS) presented at the European Committee for Treatment and Research in Multiple Sclerosis 2024 Congress is reported by Dr Patricia Coyle from Stony Brook University Hospital, in Stony Brook, New York. 

Dr Coyle first discusses a registry study looking at initiation of monoclonal antibody therapy for patients with pediatric-onset MS. Results showed a significant reduction in disability at age 23 and beyond when therapy was initiated in childhood.   

Next, Dr Coyle discusses a trial examining the safety and efficacy of frexalimab, a second-generation anti-CD40L antibody. In an open-label extension trial through 72 weeks, frexalimab provided a sustained reduction of disease activity, as measured by MRI, and was well tolerated. 

She then details a study looking at the effects of disease-modifying therapies (DMTs) on pregnancy outcomes in patients with MS. Using a German MS registry, researchers looked at 3722 pregnancies, 2885 with DMT exposure, and concluded that most pregnancy outcomes are unaffected by DMT exposure; however, the data showed the potential risk for reduced birth rates. 

Finally, Dr Coyle examines the efficacy of the Bruton tyrosine kinase (BTK) inhibitor tolebrutinib, as evidenced by the HERCULES trial and the two GEMINI trials. In HERCULES, the BTK inhibitor reduced 6-month disability progression by a significant 31% compared with placebo.  

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Patricia K. Coyle, MD, Professor and Interim Chair, Department of Neurology; Director, MS Comprehensive Care Center, Stony Brook University Hospital, Stony Brook, New York

Patricia K. Coyle, MD, has disclosed the following relevant financial relationships: 
 
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Accordant; Amgen; Biogen; Bristol Myers Squibb; Eli Lilly & Company; EMD Serono; GSK; Genentech; Horizon; LabCorp; Mylan; Novartis; Sanofi Genzyme; Viatris 
Received research grant from: Celgene; CorEvitas LLC; Genentech/Roche; National Institute of Neurological Disorders and Stroke; Sanofi Genzyme

The latest research on therapeutic management of patients with relapsing-remitting multiple sclerosis (MS) presented at the European Committee for Treatment and Research in Multiple Sclerosis 2024 Congress is reported by Dr Patricia Coyle from Stony Brook University Hospital, in Stony Brook, New York. 

Dr Coyle first discusses a registry study looking at initiation of monoclonal antibody therapy for patients with pediatric-onset MS. Results showed a significant reduction in disability at age 23 and beyond when therapy was initiated in childhood.   

Next, Dr Coyle discusses a trial examining the safety and efficacy of frexalimab, a second-generation anti-CD40L antibody. In an open-label extension trial through 72 weeks, frexalimab provided a sustained reduction of disease activity, as measured by MRI, and was well tolerated. 

She then details a study looking at the effects of disease-modifying therapies (DMTs) on pregnancy outcomes in patients with MS. Using a German MS registry, researchers looked at 3722 pregnancies, 2885 with DMT exposure, and concluded that most pregnancy outcomes are unaffected by DMT exposure; however, the data showed the potential risk for reduced birth rates. 

Finally, Dr Coyle examines the efficacy of the Bruton tyrosine kinase (BTK) inhibitor tolebrutinib, as evidenced by the HERCULES trial and the two GEMINI trials. In HERCULES, the BTK inhibitor reduced 6-month disability progression by a significant 31% compared with placebo.  

--

Patricia K. Coyle, MD, Professor and Interim Chair, Department of Neurology; Director, MS Comprehensive Care Center, Stony Brook University Hospital, Stony Brook, New York

Patricia K. Coyle, MD, has disclosed the following relevant financial relationships: 
 
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Accordant; Amgen; Biogen; Bristol Myers Squibb; Eli Lilly & Company; EMD Serono; GSK; Genentech; Horizon; LabCorp; Mylan; Novartis; Sanofi Genzyme; Viatris 
Received research grant from: Celgene; CorEvitas LLC; Genentech/Roche; National Institute of Neurological Disorders and Stroke; Sanofi Genzyme

The latest research on therapeutic management of patients with relapsing-remitting multiple sclerosis (MS) presented at the European Committee for Treatment and Research in Multiple Sclerosis 2024 Congress is reported by Dr Patricia Coyle from Stony Brook University Hospital, in Stony Brook, New York. 

Dr Coyle first discusses a registry study looking at initiation of monoclonal antibody therapy for patients with pediatric-onset MS. Results showed a significant reduction in disability at age 23 and beyond when therapy was initiated in childhood.   

Next, Dr Coyle discusses a trial examining the safety and efficacy of frexalimab, a second-generation anti-CD40L antibody. In an open-label extension trial through 72 weeks, frexalimab provided a sustained reduction of disease activity, as measured by MRI, and was well tolerated. 

She then details a study looking at the effects of disease-modifying therapies (DMTs) on pregnancy outcomes in patients with MS. Using a German MS registry, researchers looked at 3722 pregnancies, 2885 with DMT exposure, and concluded that most pregnancy outcomes are unaffected by DMT exposure; however, the data showed the potential risk for reduced birth rates. 

Finally, Dr Coyle examines the efficacy of the Bruton tyrosine kinase (BTK) inhibitor tolebrutinib, as evidenced by the HERCULES trial and the two GEMINI trials. In HERCULES, the BTK inhibitor reduced 6-month disability progression by a significant 31% compared with placebo.  

--

Patricia K. Coyle, MD, Professor and Interim Chair, Department of Neurology; Director, MS Comprehensive Care Center, Stony Brook University Hospital, Stony Brook, New York

Patricia K. Coyle, MD, has disclosed the following relevant financial relationships: 
 
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Accordant; Amgen; Biogen; Bristol Myers Squibb; Eli Lilly & Company; EMD Serono; GSK; Genentech; Horizon; LabCorp; Mylan; Novartis; Sanofi Genzyme; Viatris 
Received research grant from: Celgene; CorEvitas LLC; Genentech/Roche; National Institute of Neurological Disorders and Stroke; Sanofi Genzyme

The latest research on treatment of patients with COPD presented at the American Thoracic Society (ATS) 2024 annual meeting is reported on by Diego J. Maselli, MD, FCCP, CHEST Physician Editorial Board Member, from UT Health San Antonio in Texas.

Dr. Maselli discusses the phase 2a COURSE study, which looked at patients with moderate to severe COPD to determine whether novel tezepelumab would help reduce exacerbations over 52 weeks. The study reached a nonsignificant numerical reduction in the annual rate vs placebo, but Dr. Maselli suggests that outcomes in patients. with high blood eosinophil counts merit further study.

Next, Dr. Maselli discusses the phase 3 NOTUS trial, looking at the efficacy and safety of the monoclonal antibody dupilumab in patients with moderate to severe COPD. The researchers found a 34% reduction in exacerbations in the dupilumab group vs placebo after 52 weeks.

He then details a 272-patient study looking at nebulized ensifentrine, a dual inhibitor of PDE3 and PDE4. The study demonstrated improved lung function as well as a reduction in exacerbation rate to patients with moderate to severe COPD treated with ensifentrined added to long-acting beta agonists-inhaled corticosteroid maintenance therapy.

Finally, Dr. Maselli highlights the MAZI study, a large retrospective analysis comparing the mortality rate in patients with COPD taking single-inhaler triple therapy (SITT) vs multiple-inhaler triple therapy (MITT). The researchers found that SITT was superior to MITT.

--

Diego J. Maselli, MD, FCCP, Professor, Chief, Division of Pulmonary Diseases & Critical Care, UT Health San Antonio, Texas

Diego J. Maselli, MD, FCCP has disclosed the following relevant financial relationships:

Serve(d) as a speaker or a member of a speakers bureau for: GSK; AstraZeneca; Sanofi/Regeneron; Amgen

Received research grant from: Gates Foundation; COPD Foundation; NIH

The latest research on treatment of patients with COPD presented at the American Thoracic Society (ATS) 2024 annual meeting is reported on by Diego J. Maselli, MD, FCCP, CHEST Physician Editorial Board Member, from UT Health San Antonio in Texas.

Dr. Maselli discusses the phase 2a COURSE study, which looked at patients with moderate to severe COPD to determine whether novel tezepelumab would help reduce exacerbations over 52 weeks. The study reached a nonsignificant numerical reduction in the annual rate vs placebo, but Dr. Maselli suggests that outcomes in patients. with high blood eosinophil counts merit further study.

Next, Dr. Maselli discusses the phase 3 NOTUS trial, looking at the efficacy and safety of the monoclonal antibody dupilumab in patients with moderate to severe COPD. The researchers found a 34% reduction in exacerbations in the dupilumab group vs placebo after 52 weeks.

He then details a 272-patient study looking at nebulized ensifentrine, a dual inhibitor of PDE3 and PDE4. The study demonstrated improved lung function as well as a reduction in exacerbation rate to patients with moderate to severe COPD treated with ensifentrined added to long-acting beta agonists-inhaled corticosteroid maintenance therapy.

Finally, Dr. Maselli highlights the MAZI study, a large retrospective analysis comparing the mortality rate in patients with COPD taking single-inhaler triple therapy (SITT) vs multiple-inhaler triple therapy (MITT). The researchers found that SITT was superior to MITT.

--

Diego J. Maselli, MD, FCCP, Professor, Chief, Division of Pulmonary Diseases & Critical Care, UT Health San Antonio, Texas

Diego J. Maselli, MD, FCCP has disclosed the following relevant financial relationships:

Serve(d) as a speaker or a member of a speakers bureau for: GSK; AstraZeneca; Sanofi/Regeneron; Amgen

Received research grant from: Gates Foundation; COPD Foundation; NIH

The latest research on treatment of patients with COPD presented at the American Thoracic Society (ATS) 2024 annual meeting is reported on by Diego J. Maselli, MD, FCCP, CHEST Physician Editorial Board Member, from UT Health San Antonio in Texas.

Dr. Maselli discusses the phase 2a COURSE study, which looked at patients with moderate to severe COPD to determine whether novel tezepelumab would help reduce exacerbations over 52 weeks. The study reached a nonsignificant numerical reduction in the annual rate vs placebo, but Dr. Maselli suggests that outcomes in patients. with high blood eosinophil counts merit further study.

Next, Dr. Maselli discusses the phase 3 NOTUS trial, looking at the efficacy and safety of the monoclonal antibody dupilumab in patients with moderate to severe COPD. The researchers found a 34% reduction in exacerbations in the dupilumab group vs placebo after 52 weeks.

He then details a 272-patient study looking at nebulized ensifentrine, a dual inhibitor of PDE3 and PDE4. The study demonstrated improved lung function as well as a reduction in exacerbation rate to patients with moderate to severe COPD treated with ensifentrined added to long-acting beta agonists-inhaled corticosteroid maintenance therapy.

Finally, Dr. Maselli highlights the MAZI study, a large retrospective analysis comparing the mortality rate in patients with COPD taking single-inhaler triple therapy (SITT) vs multiple-inhaler triple therapy (MITT). The researchers found that SITT was superior to MITT.

--

Diego J. Maselli, MD, FCCP, Professor, Chief, Division of Pulmonary Diseases & Critical Care, UT Health San Antonio, Texas

Diego J. Maselli, MD, FCCP has disclosed the following relevant financial relationships:

Serve(d) as a speaker or a member of a speakers bureau for: GSK; AstraZeneca; Sanofi/Regeneron; Amgen

Received research grant from: Gates Foundation; COPD Foundation; NIH

Outside of treating major depressive disorder (MDD) through the monoamine system with selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, exploration of other treatment pathways has opened the possibility of faster onset of action and fewer side effects.

In this ReCAP, Dr Joseph Goldberg, from Mount Sinai Hospital in New York, NY, outlines how a better understanding of the glutamate system has led to the emergence of ketamine and esketamine as important treatment options, as well as the combination therapy of dextromethorphan with bupropion.

Dr Goldberg also discusses new results from serotonin system modulation through the 5HT1A receptor with gepirone, or the 5HT2A receptor with psilocybin. He also reports on a new compound esmethadone, known as REL-1017. Finally, he discusses the first approval of a digital therapeutic app designed to augment pharmacotherapy, and the dopamine partial agonist cariprazine as an adjunctive therapy.

--

Joseph F. Goldberg, MD, Clinical Professor, Department of Psychiatry, Icahn School of Medicine at Mount Sinai; Teaching Attending, Department of Psychiatry, Mount Sinai Hospital, New York, NY

Joseph F. Goldberg, MD, has disclosed the following relevant financial relationships:

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Genomind; Luye Pharma; Neuroma; Neurelis; Otsuka; Sunovion

Serve(d) as a speaker or a member of a speakers bureau for: AbbVie; Alkermes; Axsome; Intracellular Therapies

Receive(d) royalties from: American Psychiatric Publishing; Cambridge University Press

Outside of treating major depressive disorder (MDD) through the monoamine system with selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, exploration of other treatment pathways has opened the possibility of faster onset of action and fewer side effects.

In this ReCAP, Dr Joseph Goldberg, from Mount Sinai Hospital in New York, NY, outlines how a better understanding of the glutamate system has led to the emergence of ketamine and esketamine as important treatment options, as well as the combination therapy of dextromethorphan with bupropion.

Dr Goldberg also discusses new results from serotonin system modulation through the 5HT1A receptor with gepirone, or the 5HT2A receptor with psilocybin. He also reports on a new compound esmethadone, known as REL-1017. Finally, he discusses the first approval of a digital therapeutic app designed to augment pharmacotherapy, and the dopamine partial agonist cariprazine as an adjunctive therapy.

--

Joseph F. Goldberg, MD, Clinical Professor, Department of Psychiatry, Icahn School of Medicine at Mount Sinai; Teaching Attending, Department of Psychiatry, Mount Sinai Hospital, New York, NY

Joseph F. Goldberg, MD, has disclosed the following relevant financial relationships:

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Genomind; Luye Pharma; Neuroma; Neurelis; Otsuka; Sunovion

Serve(d) as a speaker or a member of a speakers bureau for: AbbVie; Alkermes; Axsome; Intracellular Therapies

Receive(d) royalties from: American Psychiatric Publishing; Cambridge University Press

Outside of treating major depressive disorder (MDD) through the monoamine system with selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, exploration of other treatment pathways has opened the possibility of faster onset of action and fewer side effects.

In this ReCAP, Dr Joseph Goldberg, from Mount Sinai Hospital in New York, NY, outlines how a better understanding of the glutamate system has led to the emergence of ketamine and esketamine as important treatment options, as well as the combination therapy of dextromethorphan with bupropion.

Dr Goldberg also discusses new results from serotonin system modulation through the 5HT1A receptor with gepirone, or the 5HT2A receptor with psilocybin. He also reports on a new compound esmethadone, known as REL-1017. Finally, he discusses the first approval of a digital therapeutic app designed to augment pharmacotherapy, and the dopamine partial agonist cariprazine as an adjunctive therapy.

--

Joseph F. Goldberg, MD, Clinical Professor, Department of Psychiatry, Icahn School of Medicine at Mount Sinai; Teaching Attending, Department of Psychiatry, Mount Sinai Hospital, New York, NY

Joseph F. Goldberg, MD, has disclosed the following relevant financial relationships:

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Genomind; Luye Pharma; Neuroma; Neurelis; Otsuka; Sunovion

Serve(d) as a speaker or a member of a speakers bureau for: AbbVie; Alkermes; Axsome; Intracellular Therapies

Receive(d) royalties from: American Psychiatric Publishing; Cambridge University Press

The latest research on therapeutic management of patients with relapsing-remitting multiple sclerosis (RRMS) presented at the American Academy of Neurology (AAN) 2024 annual meeting is reported by Dr Pavan Bhargava from the Johns Hopkins University School of Medicine in Baltimore, Maryland. 

Dr Bhargava first discusses a small study out of Germany exploring child development after exposure to monoclonal antibodies (mAbs) during breastfeeding. Currently, most mAbs are not approved for use during lactation. However, researchers found that infants studied for up to 36 months showed no evidence of adverse development or health effects compared with controls.   

Next, Dr Bhargava discusses a trial examining pregnancy and infant outcomes in patients receiving ocrelizumab. They analyzed registry data of 3000 pregnancies and determined that in-utero exposure to ocrelizumab was not associated with an increased risk for adverse outcomes.  

He then details a small, single-center cohort study evaluating the infection rates associated with anti-CD20 use in pediatric-onset RRMS. The study reported that approximately one third of participants experienced moderate to severe infections over 5 years of follow-up.  

Finally, Dr Bhargava highlights the CHIMES trial, a 1-year analysis of efficacy and safety data from Black and Hispanic persons with RRMS who received ocrelizumab. Researchers found that the overall efficacy and safety results were similar to prior ocrelizumab clinical trials.

--

Pavan Bhargava, MD, Associate Professor, Staff Physician, Department of Neurology, Johns Hopkins Hospital, Baltimore, Maryland 

Pavan Bhargava, MD, has disclosed no relevant financial relationships 

The latest research on therapeutic management of patients with relapsing-remitting multiple sclerosis (RRMS) presented at the American Academy of Neurology (AAN) 2024 annual meeting is reported by Dr Pavan Bhargava from the Johns Hopkins University School of Medicine in Baltimore, Maryland. 

Dr Bhargava first discusses a small study out of Germany exploring child development after exposure to monoclonal antibodies (mAbs) during breastfeeding. Currently, most mAbs are not approved for use during lactation. However, researchers found that infants studied for up to 36 months showed no evidence of adverse development or health effects compared with controls.   

Next, Dr Bhargava discusses a trial examining pregnancy and infant outcomes in patients receiving ocrelizumab. They analyzed registry data of 3000 pregnancies and determined that in-utero exposure to ocrelizumab was not associated with an increased risk for adverse outcomes.  

He then details a small, single-center cohort study evaluating the infection rates associated with anti-CD20 use in pediatric-onset RRMS. The study reported that approximately one third of participants experienced moderate to severe infections over 5 years of follow-up.  

Finally, Dr Bhargava highlights the CHIMES trial, a 1-year analysis of efficacy and safety data from Black and Hispanic persons with RRMS who received ocrelizumab. Researchers found that the overall efficacy and safety results were similar to prior ocrelizumab clinical trials.

--

Pavan Bhargava, MD, Associate Professor, Staff Physician, Department of Neurology, Johns Hopkins Hospital, Baltimore, Maryland 

Pavan Bhargava, MD, has disclosed no relevant financial relationships 

The latest research on therapeutic management of patients with relapsing-remitting multiple sclerosis (RRMS) presented at the American Academy of Neurology (AAN) 2024 annual meeting is reported by Dr Pavan Bhargava from the Johns Hopkins University School of Medicine in Baltimore, Maryland. 

Dr Bhargava first discusses a small study out of Germany exploring child development after exposure to monoclonal antibodies (mAbs) during breastfeeding. Currently, most mAbs are not approved for use during lactation. However, researchers found that infants studied for up to 36 months showed no evidence of adverse development or health effects compared with controls.   

Next, Dr Bhargava discusses a trial examining pregnancy and infant outcomes in patients receiving ocrelizumab. They analyzed registry data of 3000 pregnancies and determined that in-utero exposure to ocrelizumab was not associated with an increased risk for adverse outcomes.  

He then details a small, single-center cohort study evaluating the infection rates associated with anti-CD20 use in pediatric-onset RRMS. The study reported that approximately one third of participants experienced moderate to severe infections over 5 years of follow-up.  

Finally, Dr Bhargava highlights the CHIMES trial, a 1-year analysis of efficacy and safety data from Black and Hispanic persons with RRMS who received ocrelizumab. Researchers found that the overall efficacy and safety results were similar to prior ocrelizumab clinical trials.

--

Pavan Bhargava, MD, Associate Professor, Staff Physician, Department of Neurology, Johns Hopkins Hospital, Baltimore, Maryland 

Pavan Bhargava, MD, has disclosed no relevant financial relationships 

Biomarkers indicating worsening of progressive multiple sclerosis (MS) can inform decisions about treatment, and two studies presented at the 2024 American Academy of Neurology meeting show promise in this area.

Dr Patricia Coyle of Stony Brook University Hospital in Stony Brook, New York, discusses a study showing that stool glial fibrillary acidic protein (GFAP) was markedly increased in patients with progressive MS vs those with relapsing-remitting disease or healthy controls.

A separate study using brain and cervical spine MRI showed that cervical spine gray matter atrophy, particularly at C2-3, strongly correlated with disability markers in patients with progressive MS.

Dr Coyle closes by outlining a small but important study showing that nasal foralumab dampened microglial activation and stabilized clinical progression in patients with progressive MS.

--

Patricia K. Coyle, MD, Professor and Interim Chair, Department of Neurology; Director, MS Comprehensive Care Center, Stony Brook University Hospital, Stony Brook, New York 

Patricia K. Coyle, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Accordant; Amgen; Biogen; Bristol Myers Squibb; Eli Lilly & Company; EMD Serono; GSK; Genentech; Horizon; LabCorp; Mylan; Novartis; Sanofi Genzyme; Viatris 

Received research grant from: Celgene; CorEvitas LLC; Genentech/Roche; NINDS; Sanofi Genzyme

Biomarkers indicating worsening of progressive multiple sclerosis (MS) can inform decisions about treatment, and two studies presented at the 2024 American Academy of Neurology meeting show promise in this area.

Dr Patricia Coyle of Stony Brook University Hospital in Stony Brook, New York, discusses a study showing that stool glial fibrillary acidic protein (GFAP) was markedly increased in patients with progressive MS vs those with relapsing-remitting disease or healthy controls.

A separate study using brain and cervical spine MRI showed that cervical spine gray matter atrophy, particularly at C2-3, strongly correlated with disability markers in patients with progressive MS.

Dr Coyle closes by outlining a small but important study showing that nasal foralumab dampened microglial activation and stabilized clinical progression in patients with progressive MS.

--

Patricia K. Coyle, MD, Professor and Interim Chair, Department of Neurology; Director, MS Comprehensive Care Center, Stony Brook University Hospital, Stony Brook, New York 

Patricia K. Coyle, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Accordant; Amgen; Biogen; Bristol Myers Squibb; Eli Lilly & Company; EMD Serono; GSK; Genentech; Horizon; LabCorp; Mylan; Novartis; Sanofi Genzyme; Viatris 

Received research grant from: Celgene; CorEvitas LLC; Genentech/Roche; NINDS; Sanofi Genzyme

Biomarkers indicating worsening of progressive multiple sclerosis (MS) can inform decisions about treatment, and two studies presented at the 2024 American Academy of Neurology meeting show promise in this area.

Dr Patricia Coyle of Stony Brook University Hospital in Stony Brook, New York, discusses a study showing that stool glial fibrillary acidic protein (GFAP) was markedly increased in patients with progressive MS vs those with relapsing-remitting disease or healthy controls.

A separate study using brain and cervical spine MRI showed that cervical spine gray matter atrophy, particularly at C2-3, strongly correlated with disability markers in patients with progressive MS.

Dr Coyle closes by outlining a small but important study showing that nasal foralumab dampened microglial activation and stabilized clinical progression in patients with progressive MS.

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Patricia K. Coyle, MD, Professor and Interim Chair, Department of Neurology; Director, MS Comprehensive Care Center, Stony Brook University Hospital, Stony Brook, New York 

Patricia K. Coyle, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Accordant; Amgen; Biogen; Bristol Myers Squibb; Eli Lilly & Company; EMD Serono; GSK; Genentech; Horizon; LabCorp; Mylan; Novartis; Sanofi Genzyme; Viatris 

Received research grant from: Celgene; CorEvitas LLC; Genentech/Roche; NINDS; Sanofi Genzyme

Highlights of the latest research on therapeutic management of patients with myasthenia gravis (MG) presented at the American Academy of Neurology (AAN) 2024 annual meeting are discussed by Dr Richard Nowak of Yale University, New Haven, Connecticut. 

Dr Nowak first discusses LUMINESCE, a phase 3, randomized, double-blind study assessing the efficacy and safety of satralizumab, a humanized interleukin-6 receptor monoclonal recycling antibody. In this trial with 188 participants, satralizumab provided a statistically relevant, though modest, improvement in the Myasthenia Gravis Activities of Daily Living score.  

Next, Dr Nowak details part A of ADAPT NXT, comparing a fixed- cycle dosing vs every-other-week dosing of intravenous efgartigimod. The researchers found that efgartigimod was well tolerated regardless of the regimen used, offering a way to individualize treatment for patients with MG.  

He then discusses the CHAMPION MG open-label extension trial, which examined the long-term efficacy and safety of ravulizumab in adults with anti-acetylcholine receptor antibody–positive generalized MG. The final analysis demonstrated the drug's durable efficacy through 164 weeks in this patient population. 

Finally, Dr Nowak reports on a small trial using retrospective data determining the effectiveness of eculizumab treatment by start time. The study found that early eculizumab initiation in the first 2 years of diagnosis may offer greater clinical benefit compared with later initiation.

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Richard J. Nowak, MD 

Director, Yale Myasthenia Gravis Clinic, Associate Professor of Neurology; Division of Neuromuscular Medicine, Department of Neurology 

Yale School of Medicine, New Haven, Connecticut

Richard J. Nowak, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a board of directors for: Myasthenia Gravis Foundation of America 

Serve(d) as a consultant for: Alexion; argenx; Amgen; Janssen; Cour; UCB; Immunovant 

Received research grant from: National Institutes of Health; Myasthenia Gravis Foundation of America; Alexion; argenx; Amgen; Janssen; Immunovant; UCB 

Highlights of the latest research on therapeutic management of patients with myasthenia gravis (MG) presented at the American Academy of Neurology (AAN) 2024 annual meeting are discussed by Dr Richard Nowak of Yale University, New Haven, Connecticut. 

Dr Nowak first discusses LUMINESCE, a phase 3, randomized, double-blind study assessing the efficacy and safety of satralizumab, a humanized interleukin-6 receptor monoclonal recycling antibody. In this trial with 188 participants, satralizumab provided a statistically relevant, though modest, improvement in the Myasthenia Gravis Activities of Daily Living score.  

Next, Dr Nowak details part A of ADAPT NXT, comparing a fixed- cycle dosing vs every-other-week dosing of intravenous efgartigimod. The researchers found that efgartigimod was well tolerated regardless of the regimen used, offering a way to individualize treatment for patients with MG.  

He then discusses the CHAMPION MG open-label extension trial, which examined the long-term efficacy and safety of ravulizumab in adults with anti-acetylcholine receptor antibody–positive generalized MG. The final analysis demonstrated the drug's durable efficacy through 164 weeks in this patient population. 

Finally, Dr Nowak reports on a small trial using retrospective data determining the effectiveness of eculizumab treatment by start time. The study found that early eculizumab initiation in the first 2 years of diagnosis may offer greater clinical benefit compared with later initiation.

--

Richard J. Nowak, MD 

Director, Yale Myasthenia Gravis Clinic, Associate Professor of Neurology; Division of Neuromuscular Medicine, Department of Neurology 

Yale School of Medicine, New Haven, Connecticut

Richard J. Nowak, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a board of directors for: Myasthenia Gravis Foundation of America 

Serve(d) as a consultant for: Alexion; argenx; Amgen; Janssen; Cour; UCB; Immunovant 

Received research grant from: National Institutes of Health; Myasthenia Gravis Foundation of America; Alexion; argenx; Amgen; Janssen; Immunovant; UCB 

Highlights of the latest research on therapeutic management of patients with myasthenia gravis (MG) presented at the American Academy of Neurology (AAN) 2024 annual meeting are discussed by Dr Richard Nowak of Yale University, New Haven, Connecticut. 

Dr Nowak first discusses LUMINESCE, a phase 3, randomized, double-blind study assessing the efficacy and safety of satralizumab, a humanized interleukin-6 receptor monoclonal recycling antibody. In this trial with 188 participants, satralizumab provided a statistically relevant, though modest, improvement in the Myasthenia Gravis Activities of Daily Living score.  

Next, Dr Nowak details part A of ADAPT NXT, comparing a fixed- cycle dosing vs every-other-week dosing of intravenous efgartigimod. The researchers found that efgartigimod was well tolerated regardless of the regimen used, offering a way to individualize treatment for patients with MG.  

He then discusses the CHAMPION MG open-label extension trial, which examined the long-term efficacy and safety of ravulizumab in adults with anti-acetylcholine receptor antibody–positive generalized MG. The final analysis demonstrated the drug's durable efficacy through 164 weeks in this patient population. 

Finally, Dr Nowak reports on a small trial using retrospective data determining the effectiveness of eculizumab treatment by start time. The study found that early eculizumab initiation in the first 2 years of diagnosis may offer greater clinical benefit compared with later initiation.

--

Richard J. Nowak, MD 

Director, Yale Myasthenia Gravis Clinic, Associate Professor of Neurology; Division of Neuromuscular Medicine, Department of Neurology 

Yale School of Medicine, New Haven, Connecticut

Richard J. Nowak, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a board of directors for: Myasthenia Gravis Foundation of America 

Serve(d) as a consultant for: Alexion; argenx; Amgen; Janssen; Cour; UCB; Immunovant 

Received research grant from: National Institutes of Health; Myasthenia Gravis Foundation of America; Alexion; argenx; Amgen; Janssen; Immunovant; UCB 

Lipid highlights from the 2024 American College of Cardiology Scientific Sessions included positive outcomes for bempedoic acid in statin-intolerant patients and a inclisiran-first strategy for patients with atherosclerosis. The presentations are reported by Dr Erin Michos, associate director of preventive cardiology, Johns Hopkins University. Dr Michos begins with an update of the CLEAR Outcomes trial, which examined bempedoic acid, a nonstatin inhibitor of cholesterol synthesis, in patients who had cardiovascular disease or were at high risk of developing it. The trial found that bempedoic acid safely reduced cardiovascular events by 13% compared with placebo — findings of particular value for patients unable or unwilling to take guideline-recommended doses of statins. Commendably, the trial enrolled 48% women and 17% Hispanic/Latinx persons. Dr Michos also reports on a trial investigating an inclisiran-first strategy vs usual care in patients with atherosclerosis. The reduction in LDL cholesterol was 60% for patients in the inclisiran upfront arm vs only 7% for patients provided with usual care. In closing, Dr Michos discusses the TACTIC trial, which was an evaluation of a technology-assisted web application used to qualify patients for nonprescription statin administration.

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Erin D. Michos, MD, MHS, Associate Professor, Department of Medicine (Cardiology), Johns Hopkins University School of Medicine; Director of Women's Cardiovascular Health Research, Associate Director of Preventive Cardiology, Johns Hopkins Hospital, Baltimore, Maryland

Erin D. Michos, MD, MHS, has disclosed the following relevant financial relationships: Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Amgen; AstraZeneca; Boehringer Ingelheim; Edwards Lifesciences; Esperion; Merck; Medtronic; New Amsterdam; Novo Nordisk; Novartis; Pfizer

Lipid highlights from the 2024 American College of Cardiology Scientific Sessions included positive outcomes for bempedoic acid in statin-intolerant patients and a inclisiran-first strategy for patients with atherosclerosis. The presentations are reported by Dr Erin Michos, associate director of preventive cardiology, Johns Hopkins University. Dr Michos begins with an update of the CLEAR Outcomes trial, which examined bempedoic acid, a nonstatin inhibitor of cholesterol synthesis, in patients who had cardiovascular disease or were at high risk of developing it. The trial found that bempedoic acid safely reduced cardiovascular events by 13% compared with placebo — findings of particular value for patients unable or unwilling to take guideline-recommended doses of statins. Commendably, the trial enrolled 48% women and 17% Hispanic/Latinx persons. Dr Michos also reports on a trial investigating an inclisiran-first strategy vs usual care in patients with atherosclerosis. The reduction in LDL cholesterol was 60% for patients in the inclisiran upfront arm vs only 7% for patients provided with usual care. In closing, Dr Michos discusses the TACTIC trial, which was an evaluation of a technology-assisted web application used to qualify patients for nonprescription statin administration.

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Erin D. Michos, MD, MHS, Associate Professor, Department of Medicine (Cardiology), Johns Hopkins University School of Medicine; Director of Women's Cardiovascular Health Research, Associate Director of Preventive Cardiology, Johns Hopkins Hospital, Baltimore, Maryland

Erin D. Michos, MD, MHS, has disclosed the following relevant financial relationships: Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Amgen; AstraZeneca; Boehringer Ingelheim; Edwards Lifesciences; Esperion; Merck; Medtronic; New Amsterdam; Novo Nordisk; Novartis; Pfizer

Lipid highlights from the 2024 American College of Cardiology Scientific Sessions included positive outcomes for bempedoic acid in statin-intolerant patients and a inclisiran-first strategy for patients with atherosclerosis. The presentations are reported by Dr Erin Michos, associate director of preventive cardiology, Johns Hopkins University. Dr Michos begins with an update of the CLEAR Outcomes trial, which examined bempedoic acid, a nonstatin inhibitor of cholesterol synthesis, in patients who had cardiovascular disease or were at high risk of developing it. The trial found that bempedoic acid safely reduced cardiovascular events by 13% compared with placebo — findings of particular value for patients unable or unwilling to take guideline-recommended doses of statins. Commendably, the trial enrolled 48% women and 17% Hispanic/Latinx persons. Dr Michos also reports on a trial investigating an inclisiran-first strategy vs usual care in patients with atherosclerosis. The reduction in LDL cholesterol was 60% for patients in the inclisiran upfront arm vs only 7% for patients provided with usual care. In closing, Dr Michos discusses the TACTIC trial, which was an evaluation of a technology-assisted web application used to qualify patients for nonprescription statin administration.

--

Erin D. Michos, MD, MHS, Associate Professor, Department of Medicine (Cardiology), Johns Hopkins University School of Medicine; Director of Women's Cardiovascular Health Research, Associate Director of Preventive Cardiology, Johns Hopkins Hospital, Baltimore, Maryland

Erin D. Michos, MD, MHS, has disclosed the following relevant financial relationships: Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Amgen; AstraZeneca; Boehringer Ingelheim; Edwards Lifesciences; Esperion; Merck; Medtronic; New Amsterdam; Novo Nordisk; Novartis; Pfizer

Andrew Solomon, MD, from the University of Vermont in Burlington, highlights key findings presented at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2024.

Dr Solomon begins by discussing a study on the potential benefits of antipyretics to manage overheating associated with exercise, a common symptom among MS patients. Results showed that MS patients who took aspirin or acetaminophen had less increase in body temperature after a maximal exercise test than those who took placebo.

He next reports on a study that examined whether a combination of two imaging biomarkers specific for MS, namely the central vein sign and the paramagnetic rim lesion, could improve diagnostic specificity. This study found that the presence of at least one of the signs contributed to improved diagnosis.

Dr Solomon then discusses a post hoc analysis of the ULTIMATE I and II trials which reconsidered how to confirm relapses of MS. The study found that follow-up MRI could distinguish relapse from pseudoexacerbations.

Finally, he reports on a study that examined the feasibility and tolerability of low-field brain MRI in MS. The equipment is smaller, portable, and more cost-effective than standard MRI and has high acceptability from patients. Although the precision of these devices needs further testing, Dr Solomon suggests that portable MRI could make MS diagnosis and monitoring available to broader populations.

--

Andrew J. Solomon, MD, Professor, Neurological Sciences, Larner College of Medicine, University of Vermont; Division Chief, Multiple Sclerosis, University Health Center, Burlington, Vermont

Andrew J. Solomon, MD, has disclosed the following relevant financial relationships: Received research grant from: Bristol Myers Squibb

Andrew Solomon, MD, from the University of Vermont in Burlington, highlights key findings presented at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2024.

Dr Solomon begins by discussing a study on the potential benefits of antipyretics to manage overheating associated with exercise, a common symptom among MS patients. Results showed that MS patients who took aspirin or acetaminophen had less increase in body temperature after a maximal exercise test than those who took placebo.

He next reports on a study that examined whether a combination of two imaging biomarkers specific for MS, namely the central vein sign and the paramagnetic rim lesion, could improve diagnostic specificity. This study found that the presence of at least one of the signs contributed to improved diagnosis.

Dr Solomon then discusses a post hoc analysis of the ULTIMATE I and II trials which reconsidered how to confirm relapses of MS. The study found that follow-up MRI could distinguish relapse from pseudoexacerbations.

Finally, he reports on a study that examined the feasibility and tolerability of low-field brain MRI in MS. The equipment is smaller, portable, and more cost-effective than standard MRI and has high acceptability from patients. Although the precision of these devices needs further testing, Dr Solomon suggests that portable MRI could make MS diagnosis and monitoring available to broader populations.

--

Andrew J. Solomon, MD, Professor, Neurological Sciences, Larner College of Medicine, University of Vermont; Division Chief, Multiple Sclerosis, University Health Center, Burlington, Vermont

Andrew J. Solomon, MD, has disclosed the following relevant financial relationships: Received research grant from: Bristol Myers Squibb

Andrew Solomon, MD, from the University of Vermont in Burlington, highlights key findings presented at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2024.

Dr Solomon begins by discussing a study on the potential benefits of antipyretics to manage overheating associated with exercise, a common symptom among MS patients. Results showed that MS patients who took aspirin or acetaminophen had less increase in body temperature after a maximal exercise test than those who took placebo.

He next reports on a study that examined whether a combination of two imaging biomarkers specific for MS, namely the central vein sign and the paramagnetic rim lesion, could improve diagnostic specificity. This study found that the presence of at least one of the signs contributed to improved diagnosis.

Dr Solomon then discusses a post hoc analysis of the ULTIMATE I and II trials which reconsidered how to confirm relapses of MS. The study found that follow-up MRI could distinguish relapse from pseudoexacerbations.

Finally, he reports on a study that examined the feasibility and tolerability of low-field brain MRI in MS. The equipment is smaller, portable, and more cost-effective than standard MRI and has high acceptability from patients. Although the precision of these devices needs further testing, Dr Solomon suggests that portable MRI could make MS diagnosis and monitoring available to broader populations.

--

Andrew J. Solomon, MD, Professor, Neurological Sciences, Larner College of Medicine, University of Vermont; Division Chief, Multiple Sclerosis, University Health Center, Burlington, Vermont

Andrew J. Solomon, MD, has disclosed the following relevant financial relationships: Received research grant from: Bristol Myers Squibb