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1. Neuralgic Amyotrophy: A Commonly Overlooked Cause of Acute Shoulder Pain.

Author

Holle, J. F., Limmroth, V., Windisch, W., and Zimmermann, M.

Abstract

Background: Neuralgic amyotrophy (NA) is a multifactorial, monophasic neuritis that mainly affects the nerves of the shoulder girdle. It is characterized by very severe pain and by weakness that arises some time after the pain. Its reported incidence is high (100 cases per 100 000 persons per year), but our data suggest that many or most cases are diagnosed late or not at all. Methods: This review of the epidemiology, pathophysiology, diagnosis, and treatment of NA is based on pertinent publications retrieved by a selective literature search, and on data provided by the scientific institute of AOK, a German statutory health-insurance carrier. Results: It is currently thought that the combination of a genetic predisposition, an immunological trigger factor, and mechanical stress on the affected nerve segment(s) is pathophysiologically determinative. The prognosis of untreated NA is poor, with 25% of patients remaining unable to work at three years. The main form of treatment is with corticosteroids that are administered as early as possible. If there is evidence of nerve constriction or torsion, surgery may also help. There have only been six controlled cohort studies on the treatment of NA, and no randomized trials. It is not uncommon for the acute phase to develop into a chronic pain syndrome requiring multidimensional treatment. Conclusion: Particularly in view of the high incidence and improved therapeutic options, NA should be included in the differential diagnosis of all patients with suggestive symptoms. [ABSTRACT FROM AUTHOR]

Published
2024
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3. Autoren

Author

Andresen, V., primary, Bingel, U., additional, Brandt, T., additional, Brassel, F., additional, Daniels, C., additional, Deuschl, G., additional, Diener, H.-C., additional, Eckstein, H.-H., additional, Elger, C.E., additional, Eyüpoglu, I., additional, Faissner, S., additional, Forsting, M., additional, Gold, R., additional, Heuß, D., additional, Hopf, H.C., additional, Jeup, M., additional, Jordan, B., additional, Kastrup, O., additional, Klein, M., additional, Kleine-Borgmann, J., additional, Kovac, S., additional, Kuramatsu, J.B., additional, Layer, P., additional, Limmroth, V., additional, Nacimiento, W., additional, Nickenig, G., additional, Pfister, H.-W., additional, Schipper, J., additional, Schneider-Gold, C., additional, Scholz, M., additional, Sommer, C.-M., additional, Strupp, M., additional, Sure, U., additional, Toyka, K.V., additional, von Schassen, K.H., additional, Wallesch, C.-W., additional, and Zierz, S., additional

Published
2021
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6. Autoren

Author

Andrié, R.P., primary, Angenendt, J., additional, Aubin, H., additional, Baldus, S., additional, Balzer, J., additional, Baltzer, J., additional, Behr, J., additional, Benz, Marcus, additional, Berger, M., additional, Blank, N., additional, Blind, E., additional, Buchfelder, M., additional, Burk, A., additional, Detter, C., additional, Diel, R., additional, Diener, H.-C., additional, Domschke, W., additional, Doppler, K., additional, Ellinger, J., additional, Epple, H.-J., additional, Erbel, R., additional, Fichtner-Feigl, S., additional, Fischereder, M., additional, Forsting, M., additional, Friedrich, M., additional, Frommberger, U., additional, Frye, B.C., additional, Goebel, F.-D., additional, Grabitz, K., additional, Groeneveld, A., additional, Gundling, F., additional, Gutt, C.N., additional, Haidl, G., additional, Hartmann, U., additional, Hausteiner-Wiehle, C., additional, Herpertz-Dahlmann, B., additional, Heuß, D., additional, Heußner, P., additional, Hiller, E., additional, Hohenfellner, U., additional, Honegger, J., additional, Hornung, T., additional, Jansen, F., additional, Jelinek, T., additional, Jordan, B., additional, Keck, C., additional, Kelm, M., additional, Kilian, A., additional, Kleindienst, A., additional, Kölbl, H., additional, Kreis, M.E., additional, Kroener-Herwig, B., additional, Külz, A.K., additional, Lammert, F., additional, Lichtenberg, A., additional, Limmroth, V., additional, Lindner, K., additional, Loddenkemper, R., additional, Lorenz, H.-M., additional, Lügering, N., additional, Mallmann, P., additional, Max, R., additional, Merle, U., additional, Mellert, F., additional, Michels, G., additional, Müller, R.-U., additional, Müller, S.C., additional, Müller-Lissner, S., additional, Müller-Quernheim, J., additional, Neuhof, C., additional, Parhofer, K.G., additional, Petri, E., additional, Pfeiffer, T., additional, Pilatz, Adrian, additional, Pizarro, C., additional, Probst, C., additional, Rascher, W., additional, Raue, F., additional, Reindl, C., additional, Riedner, C., additional, Riemann, D., additional, Röckelein, V., additional, Sandmann, W., additional, Sauerbruch, T., additional, Schahab, N., additional, Schaper, A., additional, Schepp, W., additional, Schliep, S., additional, Schnürch, H.-G., additional, Schölmerich, J., additional, Schönermarck, Ulf, additional, Schopohl, J., additional, Schuchert, A., additional, Schulze-Koops, H., additional, Schupp, J., additional, Segerer, S.E., additional, Senninger, N., additional, Seybold, U., additional, Siegmund, B., additional, Skowasch, D., additional, Sommer, C., additional, Stahl, M., additional, Stallmach, A., additional, Sticherling, M., additional, Stremmel, W., additional, Sure, U., additional, Tacke, F., additional, Vloet, T., additional, Voderholzer, U., additional, von Kodolitsch, Y., additional, Wagenlehner, F., additional, Wahlers, T., additional, Weber, L.T., additional, Weidner, W., additional, Weis-Müller, B.T., additional, Werner, N., additional, Wintergerst, U., additional, Wolf, Gunter, additional, Ziegler, D., additional, Zierz, S., additional, and Zimmermann, Th., additional

Published
2019
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7. Autoinjector preference among patients with multiple sclerosis: results from a national survey

Author

Limmroth V, Reischl J, Mann B, Morosov X, Kokoschka A, Weller I, and Schreiner T

Subjects
adherence, multiple sclerosis, immunomodulatory therapy, electronic autoinjector, market survey, Medicine (General), R5-920
Abstract

V Limmroth,1 J Reischl,2 B Mann,3 X Morosov,2 A Kokoschka,2 I Weller,2 T Schreiner2 1Clinic for Neurology and Palliative Medicine, Municipal Hospital Köln-Merheim, Cologne, 2Bayer Vital GmbH, Leverkusen, 3IFAK Institute GmbH & Co. KG, Taunusstein, Germany Purpose: Autoinjectors are well-established in supporting multiple sclerosis (MS) therapy. This market survey was aimed at investigating patients’ rating of three devices for subcutaneous interferon beta formulations: the electronic autoinjectors Betaconnect® and RebiSmart™ as well as the mechanical ExtaviPro™ device. Patients and methods: Organization and conduction of structured face-to-face interviews in five German cities were managed through an independent external market research company. After questionnaire validation (n=15), 85 participants currently either using the Betaconnect (n=39), the RebiSmart (n=36) or the ExtaviPro injector (n=10) were asked 22 questions in the same order. First, patients named their current device in use, watched the corresponding instruction video, and were queried about their device. Second, patients were asked about their opinion of an ideal autoinjector. Third, instruction videos for the two non-used devices were presented and participants could dummy-inject into a pillow. Last, patients evaluated device features and indicated their preferred autoinjector. Results: Before having been presented the two other autoinjectors not in use, evaluation of patients’ satisfaction with their own device revealed that 82% of the Betaconnect users, 67% of the RebiSmart and 60% of the ExtaviPro users were highly satisfied. All patients desired some improvement of their own device particularly concerning optimization of size and handling. Subsequent to testing and watching instruction videos of all devices, the Betaconnect received the best rating regarding different functions. Finally, participants indicated their preferred autoinjector, provided their own medication was suitable for all three devices: 56.5% of the participants (n=48/85) chose the Betaconnect, 36.5% the RebiSmart (n=31/85), and 5% the ExtaviPro device (n=4/85); 2% did not answer (n=2/85). Conclusion: In this survey, the Betaconnect device was the preferred autoinjector and may currently best meet patients’ needs. As it was closest to participants’ opinion of an ideal device, the Betaconnect might contribute to treatment adherence. Our results need to be confirmed in further studies. Keywords: adherence, multiple sclerosis, immunomodulatory therapy, electronic autoinjector, market survey

Published
2017

10. Monitoring von Blutparametern unter verlaufsmodifizierender MS-Therapie: Substanzspezifische Relevanz und aktuelle Handlungsempfehlungen

Author

Klotz, L., Berthele, A., Brück, W., Chan, A., Flachenecker, P., Gold, R., Haghikia, A., Hellwig, K., Hemmer, B., Hohlfeld, R., Korn, T., Kümpfel, T., Lang, M., Limmroth, V., Linker, R. A., Meier, U., Meuth, S. G., Paul, F., Salmen, A., Stangel, M., Tackenberg, B., Tumani, H., Warnke, C., Weber, M. S., Ziemssen, T., Zipp, F., and Wiendl, H.

Published
2016
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12. Aktuelles zur Therapieumstellung bei Multipler Sklerose

Author

Kolber, P., Luessi, F., Meuth, S.G., Klotz, L., Korn, T., Trebst, C., Tackenberg, B., Kieseier, B., Kümpfel, T., Fleischer, V., Tumani, H., Wildemann, B., Lang, M., Flachenecker, P., Meier, U., Brück, W., Limmroth, V., Haghikia, A., Hartung, H.-P., Stangel, M., Hohlfeld, R., Hemmer, B., Gold, R., Wiendl, H., and Zipp, F.

Published
2015
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16. Multiple Sclerosis Therapy Consensus Group (MSTCG): position statement on disease-modifying therapies for multiple sclerosis (white paper)

Author

Wiendl, H., Gold, R., Berger, T., Derfuss, T., Linker, R., Mäurer, M., Aktas, O., Baum, K., Berghoff, M., Bittner, S., Chan, A., Czaplinski, A., Deisenhammer, F., Di Pauli, F., Du Pasquier, R., Enzinger, C., Fertl, E., Gass, A., Gehring, K., Gobbi, C., Goebels, N., Guger, M., Haghikia, A., Hartung, H.P., Heidenreich, F., Hoffmann, O., Kallmann, B., Kleinschnitz, C., Klotz, L., Leussink, V.I., Leutmezer, F., Limmroth, V., Lünemann, J.D., Lutterotti, A., Meuth, S.G., Meyding-Lamadé, U., Platten, M., Rieckmann, P., Schmidt, S., Tumani, H., Weber, F., Weber, M.S., Zettl, U.K., Ziemssen, T., Zipp, F., and ‘Multiple Sclerosis Therapy Consensus Group' (MSTCG)

Subjects
disease-modifying therapy, guideline, multiple sclerosis, treatment recommendation
Abstract

Multiple sclerosis is a complex, autoimmune-mediated disease of the central nervous system characterized by inflammatory demyelination and axonal/neuronal damage. The approval of various disease-modifying therapies and our increased understanding of disease mechanisms and evolution in recent years have significantly changed the prognosis and course of the disease. This update of the Multiple Sclerosis Therapy Consensus Group treatment recommendation focuses on the most important recommendations for disease-modifying therapies of multiple sclerosis in 2021. Our recommendations are based on current scientific evidence and apply to those medications approved in wide parts of Europe, particularly German-speaking countries (Germany, Austria, and Switzerland).

Published
2021

17. Communication, Coordination, and Security for people with Multiple Sclerosis (COCOS-MS): a randomised phase II clinical trial protocol

Author

Golla, H, Dillen, K, Hellmich, M, Dojan, T, Ungeheuer, S, Schmalz, P, Staß, A, Mildenberger, V, Goereci, Y, Dunkl, V, Strupp, J, Fink, GR, Voltz, R, Stock, S, Cornely, OA, Stahmann, A, Müller, A, Löcherbach, P, Burghaus, L, Limmroth, V, Bonmann, E, Gerbershagen, K, Nelles, G, Joist, T, Haas, J, Temmes, H, Warnke, C, Golla, H, Dillen, K, Hellmich, M, Dojan, T, Ungeheuer, S, Schmalz, P, Staß, A, Mildenberger, V, Goereci, Y, Dunkl, V, Strupp, J, Fink, GR, Voltz, R, Stock, S, Cornely, OA, Stahmann, A, Müller, A, Löcherbach, P, Burghaus, L, Limmroth, V, Bonmann, E, Gerbershagen, K, Nelles, G, Joist, T, Haas, J, Temmes, H, and Warnke, C

Published
2021

21. The CSF JCV antibody index for diagnosis of natalizumab-associated PML: OS2124

Author

Warnke, C., von Geldern, G., Markwerth, P., Dehmel, T., Hoepner, R., Gold, R., Pawlita, M., Kümpfel, T., Mäurer, M., Stangel, M., Wegner, F., Hohlfeld, R., Straeten, V., Limmroth, V., Weber, T., Hermsen, D., Kleinschnitz, C., Hartung, H.-P., Wattjes, M. P., Svenningson, A., Major, E., Olsson, T., Kieseier, B. C., and Adams, O.

Published
2014

26. A comprehensive monitoring study on electrocardiographic assessments and cardiac events after fingolimod first dose - possible predictors of cardiac outcomes

Author

Limmroth, V., Ziemssen, T., Kleiter, I., Wagner, B., Schmidt, S., Lassek, C., Baier-Ebert, M., Wendt, G., Dechend, R., and Haverkamp, W.

Subjects
Cardiovascular and Metabolic Diseases
Abstract

BACKGROUND: First dose observation for cardiac effects is required for fingolimod. Previous results in patients with relapsing remitting multiple sclerosis (RRMS) suggest that transient bradycardia and conduction abnormalities during the observation phase are rare, benign and reversible. Prior analyses corroborate these findings. The present large scale dataset allows subgroup analyses for differences in the incidence of cardiac findings depending on patient characteristics. METHODS: START was an open-label, multi-center study that enrolled 6,998 RRMS patients. Primary endpoints were incidence of bradycardia (heart rate < 45 bpm) and second-/third-degree atrioventricular (AV) block during treatment initiation. Subgroup analyses were performed according to age, gender, body mass index (BMI), baseline expanded disability status scale (EDSS), and concomitant medication to determine the impact of these variables on cardiac outcomes parameters. RESULTS: 63 patients (0.9%) developed bradycardia (

Published
2020

27. Efficacy of alemtuzumab in relapsing-remitting MS patients who received additional courses after the initial two courses: Pooled analysis of the CARE-MS, extension, and TOPAZ studies

Author

Comi, G, Alroughani, R, Boster, AL, Bass, AD, Berkovich, R, Fernandez, O, Kim, HJ, Limmroth, V, Lycke, J, Macdonell, RAL, Sharrack, B, Singer, BA, Vermersch, P, Wiendl, H, Ziemssen, T, Jacobs, A, Daizadeh, N, Rodriguez, CE, Traboulsee, A, Comi, G, Alroughani, R, Boster, AL, Bass, AD, Berkovich, R, Fernandez, O, Kim, HJ, Limmroth, V, Lycke, J, Macdonell, RAL, Sharrack, B, Singer, BA, Vermersch, P, Wiendl, H, Ziemssen, T, Jacobs, A, Daizadeh, N, Rodriguez, CE, and Traboulsee, A

Abstract

BACKGROUND: Alemtuzumab is given as two annual courses. Patients with continued disease activity may receive as-needed additional courses. OBJECTIVE: To evaluate efficacy and safety of additional alemtuzumab courses in the CARE-MS (Comparison of Alemtuzumab and Rebif® Efficacy in Multiple Sclerosis) studies and their extensions. METHODS: Subgroups were based on the number of additional alemtuzumab courses received. Exclusion criteria: other disease-modifying therapy (DMT); <12-month follow-up after last alemtuzumab course. RESULTS: In the additional-courses groups, Courses 3 and 4 reduced annualized relapse rate (12 months before: 0.73 and 0.74, respectively; 12 months after: 0.07 and 0.08). For 36 months after Courses 3 and 4, 89% and 92% of patients were free of 6-month confirmed disability worsening, respectively, with 20% and 26% achieving 6-month confirmed disability improvement. Freedom from magnetic resonance imaging (MRI) disease activity increased after Courses 3 and 4 (12 months before: 43% and 53%, respectively; 12 months after: 73% and 74%). Safety was similar across groups; serious events occurred irrespective of the number of courses. CONCLUSION: Additional alemtuzumab courses significantly improved outcomes, without increased safety risks, in CARE-MS patients with continued disease activity after Course 2. How this compares to outcomes if treatment is switched to another DMT instead remains unknown.

Published
2020

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