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Start Over Author "G. Orefice" Journal neurology
5 results on '"G. Orefice"'

1. COMBINING BETA INTERFERON AND ATORVASTATIN MAY INCREASE DISEASE ACTIVITY IN MULTIPLE SCLEROSIS

Author

E. Salvatore, V. B. Morra, G. Orefice, G. Birnbaum, B. Cree, I. Altafullah, and A. Reder

Subjects
Oncology, medicine.medical_specialty, Statin, Clinically isolated syndrome, Combination therapy, business.industry, medicine.drug_class, Atorvastatin, Multiple sclerosis, Interferon beta-1a, medicine.disease, Interim analysis, Simvastatin, Internal medicine, Immunology, Medicine, Neurology (clinical), business, medicine.drug
Abstract

We read with interest the report by Birnbaum et al.1 They report results that differ from multiple studies testing interferon beta (IFNΒ) and statin combination therapy in patients with multiple sclerosis (MS). We completed a 12-month study of 10 patients with clinically isolated syndrome (CIS) suggestive of MS in which simvastatin was added in a high dose (80 mg) to an IFNΒ-1a weekly intramuscular therapy in a placebo-controlled approach. We reported that combination therapy was safe and well tolerated in this pilot study. All patients remained clinically stable.2 Our second ongoing placebo-controlled clinical trial in patients with CIS testing high-dose IFNΒ-1a and high-dose atorvastatin (80 mg) combination therapy has enrolled 30 patients, 14 of whom completed a 12-month treatment. The treatment was well tolerated, and only three patients whose assignment is still blinded had clinical relapse.3 Our in vitro Affymetrix gene expression study on peripheral blood mononuclear cells derived from 15 patients with CIS before treatment onset and 7 matched healthy controls did not show inhibition of IFNΒ-induced genes in cultures co-treated with simvastatin.2 Similarly, interim analysis of a SIMCOMBIN study that has reported data on 47 patients randomized to IFNΒ-1a alone or to a combination of IFNΒ-1a with simvastatin (80 mg daily) reported a comparable annualized relapse rate and the expression of IFNΒ biomarkers in both treatment groups.4 A gene expression study by Rudick et al.5 in 40 patients treated with both IFNΒ-1a and 20 mg of simvastatin found no evidence that statins antagonize the IFNΒ effects. All the above-mentioned studies have used high-dose statins in combination with IFNΒ. The above results are consistent with the open-label baseline-to-treatment study by Friedmann et al.,6 who reported a significant decrease in the number and volume of Gd-enhancing …

Published
2009
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2. Combining beta interferon and atorvastatin may increase disease activity in multiple sclerosis.

Author

Salvatore E, Morra VB, and Orefice G

Subjects
Adjuvants, Immunologic administration & dosage, Atorvastatin, Disease Progression, Drug Therapy, Combination, Heptanoic Acids administration & dosage, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors administration & dosage, Interferon beta-1a, Interferon-beta administration & dosage, Multiple Sclerosis, Relapsing-Remitting pathology, Pyrroles administration & dosage, Adjuvants, Immunologic adverse effects, Heptanoic Acids adverse effects, Hydroxymethylglutaryl-CoA Reductase Inhibitors adverse effects, Interferon-beta adverse effects, Multiple Sclerosis, Relapsing-Remitting drug therapy, Pyrroles adverse effects
Published
2009
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3. Brain atrophy and lesion load in a large population of patients with multiple sclerosis.

Author

Tedeschi G, Lavorgna L, Russo P, Prinster A, Dinacci D, Savettieri G, Quattrone A, Livrea P, Messina C, Reggio A, Bresciamorra V, Orefice G, Paciello M, Brunetti A, Coniglio G, Bonavita S, Di Costanzo A, Bellacosa A, Valentino P, Quarantelli M, Patti F, Salemi G, Cammarata E, Simone IL, Salvatore M, Bonavita V, and Alfano B

Subjects
Adolescent, Adult, Age of Onset, Aged, Atrophy complications, Atrophy physiopathology, Brain physiopathology, Brain Mapping, Cross-Sectional Studies, Disease Progression, Educational Status, Female, Humans, Interferon-beta therapeutic use, Linear Models, Magnetic Resonance Imaging, Male, Middle Aged, Multiple Sclerosis complications, Multiple Sclerosis physiopathology, Nerve Fibers, Myelinated pathology, Neural Pathways pathology, Neural Pathways physiopathology, Predictive Value of Tests, Prognosis, Sex Factors, Atrophy diagnosis, Brain pathology, Multiple Sclerosis diagnosis
Abstract

Objective: To measure white matter (WM) and gray matter (GM) atrophy and lesion load in a large population of patients with multiple sclerosis (MS) using a fully automated, operator-independent, multiparametric segmentation method., Methods: The study population consisted of 597 patients with MS and 104 control subjects. The MRI parameters were abnormal WM fraction (AWM-f), global WM-f (gWM-f), and GM fraction (GM-f)., Results: Significant differences between patients with MS and control subjects included higher AWM-f and reduced gWM-f and GM-f. MRI data showed significant differences between patients with relapsing-remitting and secondary progressive forms of MS. Significant correlations between MRI parameters and between MRI and clinical data were found., Conclusions: Patients with multiple sclerosis have significant atrophy of both white matter (WM) and gray matter (GM); secondary progressive patients have significantly more atrophy of both WM and GM than do relapsing-remitting patients and a significantly higher lesion load (abnormal WM fraction); lesion load is related to both WM and even more to GM atrophy; lesion load and WM and GM atrophy are significantly related to Expanded Disability Status Scale score and age at onset (suggesting that the younger the age at disease onset, the worse the lesion load and brain atrophy); and GM atrophy is the most significant MRI variable in determining the final disability.

Published
2005
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5. HLA-DRB1*1501 and response to copolymer-1 therapy in relapsing-remitting multiple sclerosis.

Author

Fusco C, Andreone V, Coppola G, Luongo V, Guerini F, Pace E, Florio C, Pirozzi G, Lanzillo R, Ferrante P, Vivo P, Mini M, Macrì M, Orefice G, and Lombardi ML

Subjects
Adult, Alleles, Female, Glatiramer Acetate, HLA-DRB1 Chains, Humans, Interferon beta-1a, Interferon-beta adverse effects, Interferon-beta therapeutic use, Male, Middle Aged, Multiple Sclerosis, Relapsing-Remitting diagnosis, Multiple Sclerosis, Relapsing-Remitting genetics, Neurologic Examination drug effects, Patient Selection, Peptides adverse effects, Prognosis, HLA-DR Antigens genetics, Multiple Sclerosis, Relapsing-Remitting drug therapy, Peptides therapeutic use
Abstract

Background: Copolymer 1 (Cop-1) is a random synthetic amino acid copolymer, effective in the treatment of the relapsing-remitting form of MS (RRMS). In vitro and in vivo studies suggest that the mechanism of Cop-1 involves its binding to major histocompatibility complex class II molecules as an initial step., Objective: To assess a possible relationship between human leukocyte antigen (HLA) alleles and response to Cop-1 therapy., Methods: Eighty-three patients with RRMS, 44 treated with Cop-1 and 39 with interferon beta-1a (IFNbeta-1a) for 2 years, were typed by molecular methods for HLA class II genes and subgrouped according to clinical outcome., Results: Data have shown a possible positive correlation between presence of DRB1*1501 and response to Cop-1 therapy (p = 0.008). No relationship between HLA alleles and therapy has been found in IFNbeta-1a treated patients., Conclusions: Results suggest that DRB1*1501 might be relevant for the clinical outcome in Cop-1 treated patients and, if confirmed in larger studies, it could be helpful in the selection of RRMS patients for different therapeutic options.

Published
2001
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