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1. Validation of an iPad version of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS)

Author

Costabile, Teresa, Signoriello, Elisabetta, Lauro, Francesca, Altieri, Manuela, Ziello, Antonio Rosario, D'Ambrosio, Alessandro, Bisecco, Alvino, Maniscalco, Giorgia, Bonavita, Simona, Gallo, Antonio, Brescia Morra, Vincenzo, Lus, Giacomo, Saccà, Francesco, Russo, Cinzia Valeria, Costabile, Teresa, Signoriello, Elisabetta, Lauro, Francesca, Altieri, Manuela, Ziello, Antonio Rosario, D'Ambrosio, Alessandro, Bisecco, Alvino, Maniscalco, Giorgia, Bonavita, Simona, Gallo, Antonio, Brescia Morra, Vincenzo, Lus, Giacomo, Saccà, Francesco, and Russo, Cinzia Valeria

Subjects
Cognitive impairment, Neurology, Neurology (clinical), General Medicine, Multiple sclerosis (MS), Neuropsychological assessment, BICAMS
Abstract

Background: The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) is the most widely used screening tool for cognitive impairment in Multiple Sclerosis (MS). However, the administration and scoring procedures of the paper version are time consuming and prone to errors. Aim of our study was to develop a tablet version of BICAMS (iBICAMS), and to assess its reliability compared to the paper version.Methods: We administered both BICAMS and iBICAMS to 139 MS patients in two different sessions. We compared scores on both versions using a paired t-test. We used a repeated measures ANOVA to test the impact of rater, order of administration and test-retest time on test-retest performances. We used the Intraclass Correlation Coefficient (ICC) to assess the reliability between BICAMS and iBICAMS.Results: All three sub-tests of the BICAMS (SDMT, CVLT-II and BVMT-R) were different between the paper and the tablet versions. Order of administration influenced test-retest performances at the SDMT (pConclusions: Results suggest that using the iBICAMS guarantees a better adherence to standardized procedures in both administration and scoring phase of tests. The high reliability between the two versions and the inherent advantages of automated scoring, favor the iBICAMS as the most appropriate method.

Published
2023

2. Effectiveness of teriflunomide on No Evidence of Disease Activity and cognition in relapsing remitting multiple sclerosis: results of the NEDA3PLUS study

Author

Amato, Maria Pia, Bergamaschi, Roberto, Centonze, Diego, Mirabella, Massimiliano, Marfia, Girolama Alessandra, Totaro, Rocco, Lus, Giacomo, Brescia Morra, Vincenzo, Aguglia, Umberto, Comi, Cristoforo, Cavalla, Paola, Zaffaroni, Mauro, Rovaris, Marco, Grimaldi, Luigi Maria, Leoni, Stefania, Malucchi, Simona, Baldi, Eleonora, Romano, Marcello, Falcini, Mario, Perini, Paola, Assetta, Maurizio, Portaccio, Emilio, Sommacal, Sergio, Olivieri, Nunzio, Parodi, Franco, Todaro, Daniele Santo, Grassivaro, Nicoletta, Farina, Alberto, Mondino, Margaret Mary, Filippi, Massimo, and Trojano, Maria

Subjects
Multiple sclerosis, Settore MED/26 - NEUROLOGIA, Cognition, Teriflunomide, No Evidence of Disease Activity, Observational
Published
2023

3. Hematopoietic Stem Cell Transplantation in People With Active Secondary Progressive Multiple Sclerosis

Author

Boffa, Giacomo, Signori, Alessio, Massacesi, Luca, Mariottini, Alice, Sbragia, Elvira, Cottone, Salvatore, Amato, Maria Pia, Gasperini, Claudio, Moiola, Lucia, Meletti, Stefano, Repice, Anna Maria, Brescia Morra, Vincenzo, Salemi, Giuseppe, Patti, Francesco, Filippi, Massimo, De Luca, Giovanna, Lus, Giacomo, Zaffaroni, Mauro, Sola, Patrizia, Conte, Antonella, Nistri, Riccardo, Aguglia, Umberto, Granella, Franco, Galgani, Simonetta, Caniatti, Luisa Maria, Lugaresi, Alessandra, Romano, Silvia, Iaffaldano, Pietro, Cocco, Eleonora, Saccardi, Riccardo, Angelucci, Emanuele, Trojano, Maria, Mancardi, Giovanni Luigi, Sormani, Maria Pia, Inglese, Matilde, Capobianco, Marco, Zimatore, Giovanni Bosco, Frau, Jessica, Scarpini, Elio, Meucci, Giuseppe, Guidetti, Donata, Gualandi, Francesca, Varaldo, Riccardo, Raiola, Anna Maria, Innocenti, Chiara, Zoli, Valerio, Ciceri, Fabio, Greco, Raffaella, Scim`e, Rosanna, De Gobbi, Marco, Barilaro, Alessandro, Boffa, Giacomo, Signori, Alessio, Massacesi, Luca, Mariottini, Alice, Sbragia, Elvira, Cottone, Salvatore, Amato, Maria Pia, Gasperini, Claudio, Moiola, Lucia, Meletti, Stefano, Repice, Anna Maria, Brescia Morra, Vincenzo, Salemi, Giuseppe, Patti, Francesco, Filippi, Massimo, De Luca, Giovanna, Lus, Giacomo, Zaffaroni, Mauro, Sola, Patrizia, Conte, Antonella, Nistri, Riccardo, Aguglia, Umberto, Granella, Franco, Galgani, Simonetta, Caniatti, Luisa Maria, Lugaresi, Alessandra, Romano, Silvia, Iaffaldano, Pietro, Cocco, Eleonora, Saccardi, Riccardo, Angelucci, Emanuele, Trojano, Maria, Mancardi, Giovanni Luigi, Sormani, Maria Pia, and Inglese, Matilde

Subjects
Hematopoietic Stem Cell Transplantation, Active Secondary Progressive Multiple Sclerosis, Neurology (clinical), Research Article
Abstract

Background and ObjectivesUncontrolled evidence suggests that autologous hematopoietic stem cell transplantation (AHSCT) can be effective in people with active secondary progressive multiple sclerosis (SPMS). In this study, we compared the effect of AHSCT with that of other anti-inflammatory disease-modifying therapies (DMTs) on long-term disability worsening in active SPMS.MethodsWe collected data from the Italian Bone Marrow Transplantation Study Group and the Italian Multiple Sclerosis Register. Patients were considered eligible if treatment had been started after the diagnosis of SPMS. Disability worsening was assessed by the cumulative proportion of patients with a 6-month confirmed disability progression (CDP) according to the Expanded Disability Status Scale (EDSS) score. Key secondary endpoints were the EDSS time trend after treatment start and the prevalence of disability improvement over time. Time to first CDP was assessed by means of proportional hazard Cox regression models. A linear mixed model with a time × treatment group interaction was used to assess the longitudinal EDSS time trends. Prevalence of improvement was estimated using a modified Kaplan-Meier estimator and compared between groups by bootstrapping the area under the curve.ResultsSeventy-nine AHSCT-treated patients and 1975 patients treated with other DMTs (beta interferons, azathioprine, glatiramer-acetate, mitoxantrone, fingolimod, natalizumab, methotrexate, teriflunomide, cyclophosphamide, dimethyl fumarate, and alemtuzumab) were matched to reduce treatment selection bias using propensity score and overlap weighting approaches. Time to first CDP was significantly longer in transplanted patients (hazard ratio [HR] = 0.50; 95% CI = 0.31–0.81;p= 0.005), with 61.7% of transplanted patients free from CPD at 5 years. Accordingly, EDSS time trend over 10 years was higher in patients treated with other DMTs than in AHSCT-treated patients (+0.157 EDSS points per year compared with −0.013 EDSS points per year; interactionp< 0.001). Patients who underwent AHSCT were more likely to experience a sustained disability improvement: 34.7% of patients maintained an improvement (a lower EDSS than baseline) 3 years after transplant vs 4.6% of patients treated by other DMTs (p< 0.001).DiscussionThe use of AHSCT in people with active SPMS is associated with a slowing of disability progression and a higher likelihood of disability improvement compared with standard immunotherapy.Classification of EvidenceThis study provides Class III evidence that autologous hematopoietic stem cell transplants prolonged the time to CDP compared with other DMTs.

Published
2022

4. Impact of treatment with dimethyl fumarate on sleep quality in patients with relapsing-remitting multiple sclerosis: A multicentre Italian wearable tracker study

Author

Comi, Giancarlo, Leocani, Letizia, Ferini-Strambi, Luigi, Radaelli, Marta, Costa, Gloria D, Lanzillo, Roberta, Lus, Giacomo, Bianchi, Valentina, Traccis, Sebastiano, Capone, Fioravante, Grimaldi, Luigi Me, Salemi, Giuseppe, Cardillo, Alessandra, Zipoli, Valentina, Comi, Giancarlo, Leocani, Letizia, Ferini-Strambi, Luigi, Radaelli, Marta, Costa, Gloria D, Lanzillo, Roberta, Lus, Giacomo, Bianchi, Valentina, Traccis, Sebastiano, Capone, Fioravante, Grimaldi, Luigi Me, Salemi, Giuseppe, Cardillo, Alessandra, and Zipoli, Valentina

Subjects
Cellular and Molecular Neuroscience, relapsing remitting multiple sclerosis, Settore MED/26 - Neurologia, Neurology (clinical), sleep, Dimethyl fumarate, wearable tracker
Abstract

Background Sleep disorders are common in patients with multiple sclerosis and have a bidirectional interplay with fatigue and depression. Objective To evaluate the effect of treatment with oral dimethyl fumarate on the quality of sleep in relapsing-remitting multiple sclerosis. Methods This was a multicentre observational study with 223 relapsing-remitting multiple sclerosis subjects starting treatment with dimethyl fumarate ( n=177) or beta interferon ( n=46). All patients underwent subjective (Pittsburgh Sleep Quality Index) and objective (wearable tracker) measurements of quality of sleep. Fatigue, depression, and quality of life were also investigated and physical activity was monitored. Results Patients treated with dimethyl fumarate had significant improvement in the quality of sleep as measured with the Pittsburgh Sleep Quality Index ( pConclusion In patients with relapsing-remitting multiple sclerosis, the treatment with dimethyl fumarate was associated with improvements in patient-reported quality of sleep. Further randomised clinical trials are needed to confirm the benefits of long-term treatment with dimethyl fumarate.

Published
2023

5. Ocrelizumab in a case of refractory Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) with antibodies anti Rituximab

Author

Casertano, Sara, Signoriello, Elisabetta, Rossi, Fabiana, Di Pietro, Andrea, Tuccillo, Francesco, Bonavita, Simona, Lus, Giacomo, Casertano, Sara, Signoriello, Elisabetta, Rossi, Fabiana, Di Pietro, Andrea, Tuccillo, Francesco, Bonavita, Simona, and Lus, Giacomo

Abstract

Rituximab (RTX), a chimeric anti-CD20 monoclonal antibody, has demonstrated a good efficacy as treatment in patients with resistant Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), but it is highly immunogenic due to its structure. Ocrelizumab (OCR) is a humanized anti-CD20 antibody, with higher tolerability and lower immunogenic profile compared to RTX. We present a case of refractory CIDP effectively treated with OCR switched from RTX after the development of anti-drug antibodies (ADA).

Published
2020

6. Diffuse glioblastoma resembling acute hemorrhagic leukoencephalitis

Author

Carla, Schettino, Ferdinando, Caranci, LUS, Giacomo, Elisabetta, Signoriello, Marica, Eoli, Elena, Anghileri, Bianca, Pollo, MELONE, Mariarosa Anna Beatrice, DI IORIO, Giuseppe, Gaetano, Finocchiaro, Lorenzo, Ugga, Enrico, Tedeschi, CARANCI, Ferdinando, Schettino, Carla, Caranci, Ferdinando, Lus, Giacomo, Signoriello, Elisabetta, Eoli, Marica, Anghileri, Elena, Pollo, Bianca, Melone, Mariarosa A. B., Di Iorio, Giuseppe, Finocchiaro, Gaetano, Ugga, Lorenzo, Tedeschi, Enrico, Carla, Schettino, Ferdinando, Caranci, Marica, Eoli, Elena, Anghileri, Bianca, Pollo, Melone, Mariarosa Anna Beatrice, DI IORIO, Giuseppe, Gaetano, Finocchiaro, Lorenzo, Ugga, and Enrico, Tedeschi

Subjects
Pathology, medicine.medical_specialty, Radiology, Nuclear Medicine and Imaging, Ataxia, Case Report, Neuropathology, Acute disseminated encephalomyelitis, Acute hemorrhagic encephalitis, Diffuse glioma, Neurooncology, 03 medical and health sciences, Diffuse Glioma, 0302 clinical medicine, Nuclear Medicine and Imaging, medicine, 030212 general & internal medicine, Acute hemorrhagic encephaliti, Acute Hemorrhagic Encephalitis, medicine.diagnostic_test, business.industry, Brain biopsy, medicine.disease, Acute disseminated encephalomyeliti, medicine.symptom, Differential diagnosis, Radiology, business, 030217 neurology & neurosurgery
Abstract

We report the case of a young man with sudden onset of diplopia after an upper respiratory tract infection. Based on the first radiological findings acute hemorrhagic leukoencephalitis, a variant of acute disseminated encephalomyelitis, was suspected and treatment with high dose intravenous dexamethasone was started but it was stopped for intolerance. The patient clinically worsened, developing gait instability, ataxia and ophthalmoplegia; brain MRI performed 20 days later showed severe progression of the disease with subependymal dissemination. After brain biopsy of the right temporal lesion the histological diagnosis was glioblastoma. These findings suggest that MRI features of acute hemorrhagic leukoencephalitis may dissimulate the diagnosis of diffuse glioma/glioblastoma. This case underscores the importance of considering diffuse glioma in the differential diagnosis of atypical signs and symptoms of acute hemorrhagic leukoencephalitis and underlines the relevant role of integrating neuroradiologic findings with neuropathology.

Published
2017

7. Prognostic indicators in pediatric clinically isolated syndrome

Author

Iaffaldano, Pietro, Simone, Marta, Lucisano, Giuseppe, Ghezzi, Angelo, Coniglio, Gabriella, Brescia Morra, Vincenzo, Salemi, Giuseppe, Patti, Francesco, Lugaresi, Alessandra, Izquierdo, Guillermo, Bergamaschi, Roberto, Cabrera-Gomez, Jose Antonio, Pozzilli, Carlo, Millefiorini, Enrico, Alroughani, Raed, Boz, Cavit, Pucci, Eugenio, Zimatore, Giovanni Bosco, Sola, Patrizia, Lus, Giacomo, Maimone, Davide, Avolio, Carlo, Cocco, Eleonora, Sajedi, Seyed Aidin, Costantino, Gianfranco, Duquette, Pierre, Shaygannejad, Vahid, Petersen, Thor, Fernández Bolaños, Ricardo, Paolicelli, Damiano, Tortorella, Carla, Spelman, Tim, Margari, Lucia, Amato, Maria Pia, Comi, Giancarlo, Butzkueven, Helmut, Trojano, Maria, Spitaleri, Daniele, Rottoli, Maria Rosa, Ardito, Bonaventura, Iuliano, Gerardo, Montanari, Enrico, Granieri, Enrico, Tedeschi, Gioacchino, Bertolotto, Antonio, Granella, Franco, Di Battista, Giancarlo, Gallo, Paolo, Cavalla, Paola, Bellantonio, Paolo, De Robertis, Francesca, Durelli, Luca, Scarpini, Elio, Rezzonico, Monica, Protti, Alessandra, Solaro, Claudio, Corea, Francesco, Bosco, Antonio, Vianello, Marika, Ferrò, Maria Teresa, Balgera, Roberto, Grasso, Roberta, De Luca, Giovanna, Farina, Deboah, Travaglini, Daniela, di Ioia, Maria, Di Tommaso, Valeria, Mancinelli, Luca, Pietrolongo, Erika, Hupperts, Raymond, Rio, Maria Edite, Terzi, Murat, Barnett, Michael, Slee, Mark, Van Pesch, Vincent, Savino, Aldo, Lechner-Scott, Jeannette, Grammond, Pierre, Singhal, Bhim, Zwanikken, Cees, Fiol, Marcela, Patrucco, Liliana, Paine, Mark, Mccombefrom, Pamela, Grand'Maison, Francois, Iaffaldano, Pietro, Simone, Marta, Lucisano, Giuseppe, Ghezzi, Angelo, Coniglio, Gabriella, Brescia Morra, Vincenzo, Salemi, Giuseppe, Patti, Francesco, Lugaresi, Alessandra, Izquierdo, Guillermo, Bergamaschi, Roberto, Cabrera-Gomez, Jose Antonio, Pozzilli, Carlo, Millefiorini, Enrico, Alroughani, Raed, Boz, Cavit, Pucci, Eugenio, Zimatore, Giovanni Bosco, Sola, Patrizia, Lus, Giacomo, Maimone, Davide, Avolio, Carlo, Cocco, Eleonora, Sajedi, Seyed Aidin, Costantino, Gianfranco, Duquette, Pierre, Shaygannejad, Vahid, Petersen, Thor, Fernández Bolaños, Ricardo, Paolicelli, Damiano, Tortorella, Carla, Spelman, Tim, Margari, Lucia, Amato, Maria Pia, Comi, Giancarlo, Butzkueven, Helmut, Trojano, Maria, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, MUMC+: MA Med Staf Spec Neurologie (9), Klinische Neurowetenschappen, Morra, Vincenzo Brescia, Cabrera Gomez, Jose Antonio, and Bolaños, Ricardo Fernández

Subjects
Registrie, Male, Multiple Sclerosis, Adolescent, Age of Onset, Child, Demyelinating Diseases, Female, Follow-Up Studies, Humans, Prognosis, Retrospective Studies, Risk Factors, Disease Progression, Registries, Neurology, Neurology (clinical), Prognosi, ONSET MULTIPLE-SCLEROSIS, CHILDHOOD, CHILDREN, PARACLINICAL FEATURES, DISABILITY PROGRESSION, NO, Follow-Up Studie, Retrospective Studie, prognostic indicators, Multiple Sclerosi, pediatric, multiple sclerosis, prognosis, indicators, OPTIC NEURITIS, Risk Factor, Demyelinating Disease, NATURAL-HISTORY, multiple sclerosis, clinically isolated syndrome, prognostic indicators, TRANSVERSE MYELITIS, clinically isolated syndrome, INTERFERON BETA-1B, Settore MED/26 - Neurologia, FOLLOW-UP, Human
Abstract

To assess prognostic factors for a second clinical attack and a first disability worsening event in pediatric clinically isolated syndrome (pCIS) suggestive of Multiple Sclerosis (MS) patients. Objective: To assess prognostic factors for a second clinical attack and a first disability-worsening event in pediatric clinically isolated syndrome (pCIS) suggestive of multiple sclerosis (MS) patients. Methods: A cohort of 770 pCIS patients was followed up for at least 10 years. Cox proportional hazard models and Recursive Partitioning and Amalgamation (RECPAM) tree-regression were used to analyze data. Results: In pCIS, female sex and a multifocal onset were risk factors for a second clinical attack (hazard ratio [HR], 95% confidence interval [CI] = 1.28, 1.06–1.55; 1.42, 1.10–1.84, respectively), whereas disease-modifying drug (DMD) exposure reduced this risk (HR, 95% CI = 0.75, 0.60–0.95). After pediatric onset MS (POMS) diagnosis, age at onset younger than 15 years and DMD exposure decreased the risk of a first Expanded Disability Status Scale (EDSS)-worsening event (HR, 95% CI = 0.59, 0.42–0.83; 0.75, 0.71–0.80, respectively), whereas the occurrence of relapse increased this risk (HR, 95% CI = 5.08, 3.46–7.46). An exploratory RECPAM analysis highlighted a significantly higher incidence of a first EDSS-worsening event in patients with multifocal or isolated spinal cord or optic neuritis involvement at onset in comparison to those with an isolated supratentorial or brainstem syndrome. A Cox regression model including RECPAM classes confirmed DMD exposure as the most protective factor against EDSS-worsening events and relapses as the most important risk factor for attaining EDSS worsening. Interpretation: This work represents a step forward in identifying predictors of unfavorable course in pCIS and POMS and supports a protective effect of early DMD treatment in preventing MS development and disability accumulation in this population. Ann Neurol 2017;81:729–739.

Published
2017

8. Fingolimod versus interferon beta/glatiramer acetate after natalizumab suspension in multiple sclerosis

Author

Iaffaldano, Pietro, Lucisano, Giuseppe, Pozzilli, Carlo, Brescia Morra, Vincenzo, Ghezzi, Angelo, Millefiorini, Enrico, Patti, Francesco, Zimatore, Giovanni Bosco, Marrosu, Maria Giovanna, Amato, Maria Pia, Bertolotto, Antonio, Bergamaschi, Roberto, Granella, Franco, Coniglio, Gabriella, Tedeschi, Gioacchino, Sola, Patrizia, Lus, Giacomo, Ferrò, Maria Teresa, Iuliano, Gerardo, Corea, Francesco, Protti, Alessandra, Cavalla, Paola, Guareschi, Angelica, Rodegher, Mariaemma, Paolicelli, Damiano, Tortorella, Carla, Lepore, Vito, Prosperini, Luca, Saccà, Francesco, Baroncini, Damiano, Comi, Giancarlo, Trojano, Maria, Italian iMed Web database, LUGARESI, ALESSANDRA, Iaffaldano, Pietro, Lucisano, Giuseppe, Pozzilli, Carlo, Brescia Morra, Vincenzo, Ghezzi, Angelo, Millefiorini, Enrico, Patti, Francesco, Lugaresi, Alessandra, Zimatore, Giovanni Bosco, Marrosu, Maria Giovanna, Amato, Maria Pia, Bertolotto, Antonio, Bergamaschi, Roberto, Granella, Franco, Coniglio, Gabriella, Tedeschi, Gioacchino, Sola, Patrizia, Lus, Giacomo, Ferrò, Maria Teresa, Iuliano, Gerardo, Corea, Francesco, Protti, Alessandra, Cavalla, Paola, Guareschi, Angelica, Rodegher, Mariaemma, Paolicelli, Damiano, Tortorella, Carla, Lepore, Vito, Prosperini, Luca, Saccà, Francesco, Baroncini, Damiano, Comi, Giancarlo, Trojano, Maria, Italian iMed-Web database, Iaffaldano, P, Lucisano, G, Pozzilli, C, Brescia Morra, V, Ghezzi, A, Millefiorini, E, Patti, F, Lugaresi, A, Zimatore, Gb, Marrosu, Mg, Amato, Mp, Bertolotto, A, Bergamaschi, R, Granella, F, Coniglio, G, Tedeschi, G, Sola, P, Lus, G, Ferrò, Mt, Iuliano, G, Corea, F, Protti, A, Cavalla, P, Guareschi, A, Rodegher, M, Paolicelli, D, Tortorella, C, Lepore, V, Prosperini, L, Saccà, F, Baroncini, D, Trojano, M, Italian iMed Web, Database, BRESCIA MORRA, Vincenzo, Sacca', Francesco, and DIPARTIMENTO DI SCIENZE BIOMEDICHE E NEUROMOTORIE

Subjects
Registrie, Male, fingolimod, glatiramer acetate, interferon beta, multiple sclerosis, natalizumab discontinuation, Adult, Cohort Studies, Drug Substitution, Drug Therapy, Combination, Female, Fingolimod Hydrochloride, Glatiramer Acetate, Humans, Immunologic Factors, Immunosuppressive Agents, Interferon-beta, Italy, Middle Aged, Multiple Sclerosis, Relapsing-Remitting, Natalizumab, Poisson Distribution, Prospective Studies, Regression Analysis, Treatment Outcome, Registries, Medicine (all), Arts and Humanities (miscellaneous), Neurology (clinical), Relapsing-Remitting, Rate ratio, Gastroenterology, Immunosuppressive Agent, Immunologic Factor, Medicine, Prospective cohort study, Hazard ratio, Fingolimod, multiple sclerosi, Combination, medicine.drug, Human, medicine.medical_specialty, Multiple Sclerosis, Regression Analysi, Drug Therapy, Internal medicine, Glatiramer acetate, business.industry, Multiple sclerosis, medicine.disease, fingolimod, multiple sclerosis, Surgery, Prospective Studie, Cohort Studie, business
Abstract

none 34 no studio multicentrico The comparative effectiveness of fingolimod versus interferon beta/glatiramer acetate was assessed in a multicentre, observational, prospectively acquired cohort study including 613 patients with relapsing multiple sclerosis discontinuing natalizumab in the Italian iMedWeb registry. First, after natalizumab suspension, the relapse risk during the untreated wash-out period and during the course of switch therapies was estimated through Poisson regression analyses in separated models. During the wash-out period an increased risk of relapses was found in patients with a higher number of relapses before natalizumab treatment (incidence rate ratio = 1.31, P = 0.0014) and in patients discontinuing natalizumab due to lack of efficacy (incidence rate ratio = 2.33, P = 0.0288), patient's choice (incidence rate ratio = 2.18, P = 0.0064) and adverse events (incidence rate ratio = 2.09, P = 0.0084). The strongest independent factors influencing the relapse risk after the start of switch therapies were a wash-out duration longer than 3 months (incidence rate ratio = 1.78, P < 0.0001), the number of relapses experienced during and before natalizumab treatment (incidence rate ratio = 1.61, P < 0.0001; incidence rate ratio = 1.13, P = 0.0118, respectively) and the presence of comorbidities (incidence rate ratio = 1.4, P = 0.0097). Switching to fingolimod was associated with a 64% reduction of the adjusted-risk for relapse in comparison with switching to interferon beta/glatiramer acetate (incidence rate ratio = 0.36, P < 0.0001). Secondly, patients who switched to fingolimod or to interferon beta/glatiramer acetate were propensity score-matched on a 1-to-1 basis at the switching date. In the propensity score-matched sample a Poisson model showed a significant lower incidence of relapses in patients treated with fingolimod in comparison with those treated with interferon beta/glatiramer acetate (incidence rate ratio = 0.52, P = 0.0003) during a 12-month follow-up. The cumulative probability of a first relapse after the treatment switch was significantly lower in patients receiving fingolimod than in those receiving interferon beta/glatiramer acetate (P = 0.028). The robustness of this result was also confirmed by sensitivity analyses in subgroups with different wash-out durations (less or more than 3 months). Time to 3-month confirmed disability progression was not significantly different between the two groups (Hazard ratio = 0.58; P = 0.1931). Our results indicate a superiority of fingolimod in comparison to interferon beta/glatiramer acetate in controlling disease reactivation after natalizumab discontinuation in the real life setting. none Iaffaldano, Pietro; Lucisano, Giuseppe; Pozzilli, Carlo; Brescia Morra, Vincenzo; Ghezzi, Angelo; Millefiorini, Enrico; Patti, Francesco; Lugaresi, Alessandra; Zimatore, Giovanni Bosco; Marrosu, Maria Giovanna; Amato, Maria Pia; Bertolotto, Antonio; Bergamaschi, Roberto; Granella, Franco; Coniglio, Gabriella; Tedeschi, Gioacchino; Sola, Patrizia; Lus, Giacomo; Ferrò, Maria Teresa; Iuliano, Gerardo; Corea, Francesco; Protti, Alessandra; Cavalla, Paola; Guareschi, Angelica; Rodegher, Mariaemma; Paolicelli, Damiano; Tortorella, Carla; Lepore, Vito; Prosperini, Luca; Saccà, Francesco; Baroncini, Damiano; Comi, Giancarlo; Trojano, Maria; Italian iMed-Web database Iaffaldano, Pietro; Lucisano, Giuseppe; Pozzilli, Carlo; Brescia Morra, Vincenzo; Ghezzi, Angelo; Millefiorini, Enrico; Patti, Francesco; Lugaresi, Alessandra; Zimatore, Giovanni Bosco; Marrosu, Maria Giovanna; Amato, Maria Pia; Bertolotto, Antonio; Bergamaschi, Roberto; Granella, Franco; Coniglio, Gabriella; Tedeschi, Gioacchino; Sola, Patrizia; Lus, Giacomo; Ferrò, Maria Teresa; Iuliano, Gerardo; Corea, Francesco; Protti, Alessandra; Cavalla, Paola; Guareschi, Angelica; Rodegher, Mariaemma; Paolicelli, Damiano; Tortorella, Carla; Lepore, Vito; Prosperini, Luca; Saccà, Francesco; Baroncini, Damiano; Comi, Giancarlo; Trojano, Maria; Italian iMed-Web database

Published
2015

10. Chronic HCV infection and neurological and psychiatric disorders: an overview

Author

ADINOLFI, Luigi Elio, LUS, Giacomo, ROMANO, Ciro Pasquale, ZAMPINO, Rosa, GIORDANO, Mauro, MARRONE, Aldo, NEVOLA R, RESTIVO L, GUERRERA B, RINALDI L, SELLITTO A, Adinolfi, Luigi Elio, Nevola, R, Lus, Giacomo, Restivo, L, Guerrera, B, Romano, Ciro Pasquale, Zampino, Rosa, Rinaldi, L, Sellitto, A, Giordano, Mauro, and Marrone, Aldo

Published
2015

11. Rasagiline improves sleep disorders in Parkinson's disease

Author

MELONE, Mariarosa Anna Beatrice, COPPOLA, Cinzia, LUS, Giacomo, FRATTA, Mario, Dato C, Capaldo G, Saracino D, Melone, Mariarosa Anna Beatrice, Dato, C, Capaldo, G, Saracino, D, Coppola, Cinzia, Lus, Giacomo, and Fratta, Mario

Abstract

Objective: To evaluate the effects of levodopa–rasagiline combination therapy versus levodopa therapy alone in the treatment of sleep disorders in Parkinson's disease (PD). Background: Sleep disorders including sleep fragmentation, REM sleep behaviour, and complex paroxysmal nocturnal motor behavioral disorders are common in PD, and they may precede by decades motor symptoms. Classical antiparkinsonian drugs have shown limited effectiveness in controlling these symptoms. Rasagiline is a monoamine oxidase inhibitor (MAO-I) that ameliorates the symptoms of PD by inhibiting striatal dopamine metabolism. MAO-I are also able to increase melatonin levels in the pineal gland, and may therefore contribute to modulate wakefulness/sleep patterns and circadian rhythms. Methods: We performed a 12-weeks study in 38 patients (mean age:63-64 years; mean disease duration:1.92-2.15 years; Schwab and England activities of daily living scores: approximately 90%). Patients were randomly assigned to: levodopa (200-300 mg daily) (group A) or levodopa–rasagiline (200-300 mg+1 mg) (group B). Sleep parameters were recorded by means of PD Sleep Scale (PDSS) and sleep diaries. Results: The clinical characteristics at baseline of patients are summarized in Fig.1. Almost all patients reported difficulties in initiating and maintaining sleep. Mean total PDSS score was 104.7±21.5 in group A and 103.9±21.8 in group B, correlating with Hoehn&Yahr score (p=0.004).After 12 weeks, patients in group B showed a marked improvement on several aspects of sleep dysfunction, compared to patients in group A (p=0.019). In particular, patients in group B reported a lower sleep latency (Fig.2A), fewer night awakenings (Fig.2B) and longer total sleep duration (Fig.2C). When comparing scores for each item in the PDSS at 12 weeks, the most notable improvements in the treatment of sleep dysfunction referred to items 8 (nocturia), 10 (limb paresthesias), 11 (cramps), 14 (non restorative sleep), 15 (daytime sleepiness): patients in group B reported a lower score, indicating a diminished severity of those symptoms (Fig.2D). Conclusions: Our monocentric study, though small-sized, demonstrates the effectiveness of levodopa–rasagiline combination therapy as a treatment for sleep dysfunction in PD, which will hopefully be confirmed by larger studies.

Published
2014

12. Acute myeloid leukemia in Italian patients with multiple sclerosis treated with mitoxantrone

Author

Martinelli V, Cocco E, Capra R, Salemi G, Gallo P, Capobianco M, Pesci I, Ghezzi A, Pozzilli C, Lugaresi A, Bellantonio P, Amato MP, Grimaldi LM, Trojano M, Mancardi GL, Bergamaschi R, Gasperini C, Rodegher M, Straffi L, Ponzio M, Comi G, Italian Mitoxantrone G.r.o.u.p. COLLABORATORS: Radaelli M, Esposito F, Moiola L, Colombo B, Rossi P, Marrosu MG, Frau J, Lorefice L, Coghe G, Savettieri G, Ragonese P, Cusimano V, Perini P, Rinaldi F, Vidali A, Bertolotto A, Malucchi S, Di Sapio A, Montanari E, Guareschi A, Rizzo A, Zaffaroni M, Baldini S, De Rossi N, Cordioli C, Rasia S, Salvetti M, Buttinelli C, Ausili Cefaro L, De Luca G, Tommaso D, Farina D, Fantozzi R, Ruggieri S, Hakiki B, Zipoli V, Portaccio E, Bartolozzi ML, Scandellari C, Stecchi S, Marchello LP, Palmeri B, Vitello G, Iaffaldano P, Lucchese G, Dattola V, Buccafusca M, Sola P, Simone AM, Barreca F, Patti F, Laisa P, Cavalla P, Masera S, Tavazzi E, Galgani S, Sacco R, Provinciali L, Maura D, LUS, Giacomo, Alfieri G, Ticca A, Piras ML, Maimone D, Bianca M, Iudice A, Giro ME, Galeotti M, Florio C, Spitalieri P, La Mantia L, Motti L, Rottoli MR, Granella F, Solaro C, Scarpini E, Servillo G, Cavalletti G., TEDESCHI, Gioacchino, Martinelli, V, Cocco, E, Capra, R, Salemi, G, Gallo, P, Capobianco, M, Pesci, I, Ghezzi, A, Pozzilli, C, Lugaresi, A, Bellantonio, P, Amato, Mp, Grimaldi, Lm, Trojano, M, Mancardi, Gl, Bergamaschi, R, Gasperini, C, Rodegher, M, Straffi, L, Ponzio, M, Comi, G, COLLABORATORS: Radaelli M, Italian Mitoxantrone G. r. o. u. p., Esposito, F, Moiola, L, Colombo, B, Rossi, P, Marrosu, Mg, Frau, J, Lorefice, L, Coghe, G, Savettieri, G, Ragonese, P, Cusimano, V, Perini, P, Rinaldi, F, Vidali, A, Bertolotto, A, Malucchi, S, Di Sapio, A, Montanari, E, Guareschi, A, Rizzo, A, Zaffaroni, M, Baldini, S, De Rossi, N, Cordioli, C, Rasia, S, Salvetti, M, Buttinelli, C, Ausili Cefaro, L, De Luca, G, Tommaso, D, Farina, D, Fantozzi, R, Ruggieri, S, Hakiki, B, Zipoli, V, Portaccio, E, Bartolozzi, Ml, Scandellari, C, Stecchi, S, Marchello, Lp, Palmeri, B, Vitello, G, Iaffaldano, P, Lucchese, G, Dattola, V, Buccafusca, M, Sola, P, Simone, Am, Barreca, F, Patti, F, Laisa, P, Cavalla, P, Masera, S, Tavazzi, E, Galgani, S, Tedeschi, Gioacchino, Sacco, R, Provinciali, L, Maura, D, Lus, Giacomo, Alfieri, G, Ticca, A, Piras, Ml, Maimone, D, Bianca, M, Iudice, A, Giro, Me, Galeotti, M, Florio, C, Spitalieri, P, La Mantia, L, Motti, L, Rottoli, Mr, Granella, F, Solaro, C, Scarpini, E, Servillo, G, and Cavalletti, G.

Published
2011

14. Real-life impact of early interferonβ therapy in relapsing multiple sclerosis

Author

M. TROJANO, F. PELLEGRINI, D. PAOLICELLI, A. FUIANI, GB ZIMATORE, C. TORTORELLA, IL SIMONE, F, PATTI, A. GHEZZI, E. PORTACCIO, P. ROSSI, C. POZZILLI, G. SALEMI, A. LUGARESI, R. BERGAMASCHI, E, MILLEFIORINI, M. CLERICO, M. VIANELLO, C. AVOLIO, P. CAVALLA, V. LEPORE, P. LIVREA, G. COMI, MP AMATO, LUS, Giacomo, M., Trojano, F., Pellegrini, D., Paolicelli, A., Fuiani, Gb, Zimatore, C., Tortorella, Il, Simone, F, Patti, A., Ghezzi, E., Portaccio, P., Rossi, C., Pozzilli, G., Salemi, A., Lugaresi, R., Bergamaschi, E, Millefiorini, M., Clerico, Lus, Giacomo, M., Vianello, C., Avolio, P., Cavalla, V., Lepore, P., Livrea, G., Comi, and Mp, Amato

Published
2009

15. The OPTimization of interferon for MS study: 375 microg interferon beta-1b in suboptimal responders

Author

DURELLI L, BARBERO P, BERGUI M, VERSINO E, BASSANO MA, VERDUN E, FERRERO B, RIVOIRO C, FERRERO C, PICCO E, RIPELLINO P, VIGLIETTI D, GIULIANI G, MONTANARI E, CLERICO M, LUS, Giacomo, Durelli, L, Barbero, P, Bergui, M, Versino, E, Bassano, Ma, Verdun, E, Ferrero, B, Rivoiro, C, Ferrero, C, Picco, E, Ripellino, P, Viglietti, D, Giuliani, G, Montanari, E, Clerico, M, and Lus, Giacomo

Published
2008

17. Malattie dei nervi periferici

Author

LUS, Giacomo, DI IORIO, Giuseppe, COTRUFO, Roberto, Bonavita V, Di Iorio G, Lus, Giacomo, DI IORIO, Giuseppe, and Cotrufo, Roberto

Published
2007

18. Heterogeneous impact of an early IFN-beta treatment on disability progression in Relapsing MS subgroups with different baseline clinical profiles

Author

M. TROJANO, MP AMATO, C. AVOLIO, R. BERGAMASCHI, P. CAVALLA, L. DURELLI, A. FUIANI, A. GHEZZI, G. GIULIANI, A. LUGARESI, E. MILLEFIORINI, D. PAOLICELLI, F. PATTI, F. PELLEGRINI, C. POZZILLI, P. ROSSI, G. SALEMI, M. VIANELLO, G. COMI ON BEHALF OF ITALIAN MULTIPLE SCLEROSIS DATABASE NETWORK MSDN GROUP, LUS, Giacomo, M., Trojano, Mp, Amato, C., Avolio, R., Bergamaschi, P., Cavalla, L., Durelli, A., Fuiani, A., Ghezzi, G., Giuliani, A., Lugaresi, Lus, Giacomo, E., Millefiorini, D., Paolicelli, F., Patti, F., Pellegrini, C., Pozzilli, P., Rossi, G., Salemi, M., Vianello, and G., COMI ON BEHALF OF ITALIAN MULTIPLE SCLEROSIS DATABASE NETWORK MSDN GROUP

Published
2007

22. Azathioprine and interferon beta(1a) in relapsing-remitting multiple sclerosis patients: increasing efficacy of combined treatment

Author

LUS, Giacomo, ROMANO F., SCUOTTO, Assunta, ACCARDO C., COTRUFO R., Lus, Giacomo, Romano, F., Scuotto, Assunta, Accardo, C., and Cotrufo, R.

Subjects
combined therapy, azathioprine, Interferon Beta1a, multiple sclerosi
Abstract

Current treatments of relapsing-remitting multiple sclerosis (RRMS) with immunosuppressive or immunomodulatory drugs have been shown to modify the course of the disease in a significative number of patients. However, in many cases, the response to either interferon beta (IFN-beta) or azathioprine (AZA) treatments was not satisfactory and new therapeutic approaches are needed. We studied clinical and MRI efficacy, safety and tolerance of AZA and IFN-beta(1a) combined therapy in 23 patients with clinically definite RRMS, who had not previously been responsive to either monotherapies. Our cases were divided into three subgroups: 8 previously untreated patients (subgroup A) with at least 2 years of natural course of the disease, 8 patients (subgroup B) previously treated with AZA for 2 years and 7 patients (subgroup C) previously treated with IFN-beta(1a) for 2 years. The baseline Expanded Disability Status Scale (EDSS) ranged from 2 to 4 in all subgroups. All patients completed 2 years of combined treatment with a dose of AZA adjusted to reduce lymphocyte count down to 1,000 +/- 100/microl in association with IFN-beta(1a) at a dose of 6 MIU every other day. The mean number of relapses during the combined treatment period was significantly lower than that observed before combined therapy in all the three subgroups. Also, the mean Delta EDSS score was significantly lower during combined treatment than in monotherapy in subgroups B and C. Moreover, after 2 years of combined treatment, the number of new T(1) hypointense lesions, the number and volume of proton density/T(2) hyperintense lesions and the gadolinium enhancement of T(1) hypointense lesions were significantly lower than before combined treatment. After 2 years of treatment, this combination therapy appears to be safe and well tolerated and no serious side effects were reported. Despite some limitations of our study design, the information regarding efficacy, safety and tolerance of the association of AZA and IFN-beta is most encouraging. Copyright 2004 S. Karger AG, Basel

Published
2004

25. INSOLITO PNEUMOCEFALO IPERTESO DA OSTEOMA DEL SENO FRONTALE

Author

D’Avanzo R., Fratta M., LUS, Giacomo, Bocchetti A., Barbato R., D’Avanzo C., Cotrufo R., Cioffi F. A., SCUOTTO, Assunta, SUN, D’Avanzo, R., Scuotto, Assunta, Fratta, M., Lus, Giacomo, Bocchetti, A., Barbato, R., D’Avanzo, C., Cotrufo, R., and Cioffi, F. A.

Published
2003

34. Disordini di movimento nella patologia neurologica dell’anziano

Author

Cotrufo R, Di Fede G, Fratta M, LUS, Giacomo, F. Puoti F, PUOTI, Gianfranco, Savarese N., MELONE, Mariarosa Anna Beatrice, M. Varricchio, L. Coppola., Cotrufo, R, Di Fede, G, Fratta, M, Lus, Giacomo, Melone, Mariarosa Anna Beatrice, F., Puoti F, Puoti, Gianfranco, and Savarese, N.

Published
1998

35. Myopathic changes in neurofibromatosis type 1

Author

LUS, Giacomo, G. LAMA, PUOTI, Gianfranco, R. COTRUFO, DI IORIO, Giuseppe, Lus, Giacomo, DI IORIO, Giuseppe, G., Lama, Puoti, Gianfranco, and R., Cotrufo

Published
1997

38. Malattie del nervo periferico

Author

LUS, Giacomo, DI IORIO, Giuseppe, COTRUFO R., NEUROLOGIA CLINICA, Lus, Giacomo, DI IORIO, Giuseppe, and Cotrufo, R.

Published
1996

40. Malattie del muscolo

Author

DI IORIO, Giuseppe, SAMPAOLO, Simone, LUS, Giacomo, BONAVITA V., DI IORIO G., Lus, Giacomo, DI IORIO, Giuseppe, Cotrufo, R., Bonavita V, Di Iorio G, and Sampaolo, Simone

Published
1996

41. Malattie muscolari

Author

DI IORIO, Giuseppe, LUS, Giacomo, COTRUFO R., Bonavita v, Di Iorio G, DI IORIO, Giuseppe, Lus, Giacomo, and Cotrufo, R.

Published
1996

42. Malattie multisistemiche

Author

LUS, Giacomo, DI IORIO, Giuseppe, COTRUFO R., BONAVITA V., DI IORIO G., Lus, Giacomo, DI IORIO, Giuseppe, and Cotrufo, R.

Published
1996

45. Central pontine myelinolisis- case report

Author

CONFORTI, Renata, LUS, Giacomo, Muras I, Mazzariello G, Cotrufo R., Conforti, Renata, Lus, Giacomo, Muras, I, Mazzariello, G, and Cotrufo, R.

Published
1992

47. Histochemical, cytochemical and biochemical observations in orthotopic homotransplants of EDL in adult rats

Author

Cotrufo R, DI IORIO, Giuseppe, MELONE, Mariarosa Anna Beatrice, Rossi AM, De Cristofaro M, De Lucia D, Fratta M, Grimaldi F, LUS, Giacomo, Cutillo C, Savarese N., Proceedings Frey and Freilinger (Eds.), Cotrufo, R, DI IORIO, Giuseppe, Melone, Mariarosa Anna Beatrice, Rossi, Am, De Cristofaro, M, De Lucia, D, Fratta, M, Grimaldi, F, Lus, Giacomo, Cutillo, C, and Savarese, N.

Published
1986

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