Early use of interferon beta patients with multiple sclerosis.

In recent years, major advances have been made in the management of multiple sclerosis (MS) in the form of new disease-modifying therapies, the most widely used of which is interferon (IFN) beta. A growing body of evidence indicates that the beneficial effects of IFN beta are maximised if treatment is started as soon as possible after the diagnosis of MS, and if patients are given the highest possible dose. The argument in favour of early treatment is based primarily on the finding that the inflammation of the central nervous system characteristic of MS leads to irreversible axonal destruction starting very early in the course of the disease.

Bilateral abductor vocal fold paralysis due to myasthenia gravis.

We report a case of bilateral abductor vocal fold paralysis due to myasthenia gravis in a 61-year-old man who presented with stridor requiring tracheostomy. The stridor had been preceded by several weeks' history of diplopia.

The effect of anti-alpha4 integrin antibody on brain lesion activity in MS. The UK Antegren Study Group.

Objective: To determine the effect of humanized monoclonal antibody against alpha4 integrin (reactive with alpha4beta1 integrin or very-late antigen-4) on MRI lesion activity in MS.

Methods: A randomized, double-blind, placebo-controlled trial in 72 patients with active relapsing-remitting and secondary progressive MS was performed. Each patient received two IV infusions of anti-alpha4 integrin antibody (natalizumab; Antegren) or placebo 4 weeks apart and was followed up for 24 weeks with serial MRI and clinical assessment.

Implications of the 5-year CR FIRST trial. Sinemet CR Five-Year International Response Fluctuation Study.

Almost since the introduction of levodopa for Parkinson's disease (PD), its side effects have concerned clinicians. One strategy to avoid side effects has been to delay levodopa therapy; an alternative has been to use early therapy but to avoid fluctuations in plasma levodopa levels. This latter strategy led to the development of sustained-release carbidopa-levodopa, which was compared with immediate-release carbidopa-levodopa in the CR Five-Year International Response Fluctuation Study (FIRST), a 5-year multicenter study of early, levodopa-naive PD patients.