Publications by authors named "C L Munster"
Importance: Increasing numbers of people with multiple sclerosis (MS) use disease-modifying therapy (DMT). Long-term stable disease while taking such medications provides a rationale for considering DMT discontinuation given patient burden, costs, and potential adverse effects of immunomodulating therapy.
Objective: To investigate whether first-line DMT can be safely discontinued in patients with long-term stable MS.
Background: Biomarkers of neuronal and axonal damage (serum neurofilament light (sNfL) and serum glial fibrillary acidic protein (sGFAP)) may provide insight into the aetiology of natalizumab wearing-off symptoms (WoSs).
Objectives: We investigated the longitudinal association between and predictive value of sNfL and sGFAP and the occurrence of WoS in MS patients treated with natalizumab.
Methods: We performed longitudinal measurements of sNfL and sGFAP in NEXT-MS trial participants who completed a questionnaire about WoS.
Article Synopsis
- - Primary cilia in pancreatic beta cells are crucial for paracrine signaling, and their dysfunction is linked to diabetes, but their structural functions are not well understood.
- - Researchers used electron and expansion microscopy to create 3D models of these cilia, revealing they are confined in deep pockets, lack movement components, and have an unstructured organization.
- - The study identified unique interactions between beta cell cilia and other cells, including specialized connections to cholinergic nerves, emphasizing the importance of cilia in integrating signals that affect islet function in relation to health and diabetes.
Background And Objectives: Wearing-off symptoms during natalizumab treatment in multiple sclerosis are characterized by an increase of MS-related symptoms prior to natalizumab administration. The influence of extended interval dosing (EID) on wearing-off symptoms are important to consider, as this might cause hesitancy in initiating or continuing EID.
Methods: Participants of the NEXT-MS trial, in which treatment intervals are adjusted based on drug concentrations, were divided into two groups: an extended group containing participants with at least one week of additional interval extension, and a group with a fixed interval during the trial (range 4-7 weeks).
Prospective trial of natalizumab personalised extended interval dosing by therapeutic drug monitoring in relapsing-remitting multiple sclerosis (NEXT-MS).
J Neurol Neurosurg Psychiatry
April 2024
Background: Extended interval dosing (EID) of natalizumab is a promising strategy to optimise treatment in multiple sclerosis (MS). Personalised EID by therapeutic drug monitoring can enable further extension of treatment intervals.
Methods: The NEXT-MS trial is an investigator-initiated prospective phase IV non-randomised study.