Personalized healthcare: how to improve outcomes by increasing benefit and decreasing risk through the use of biomarkers.

The use of personalized healthcare is beginning to show promise as a means of increasing benefit and decreasing risk for patients, but much work needs to be done in order to fully exploit the advances in medical science that have occurred over the last 30 years. In particular, molecular approaches that aim to characterize patient individuality must be combined with genetic approaches to capture the promise of this potential revolution in the practice of medicine.

Roles of B lymphocytes in multiple sclerosis: diversifying beyond the antibody response.

B lymphocytes have several potentially relevant roles in the pathogenesis of multiple sclerosis and have become increasingly important targets for therapy. Beyond the production of antimyelin antibodies, these roles may include antigen presentation, cytokine production and the establishment of ectopic lymphoid tissue in the CNS compartment, which could provide a local inflammatory stimulus driving the chronic progressive stages of the disease. B cells may also have important roles as regulatory cells, especially through the production of anti-inflammatory cytokines such as IL-10.

Galantamine: additional benefits to patients with Alzheimer's disease.

Galantamine, a novel treatment for Alzheimer's disease (AD), has a dual mechanism of action, combining allosteric modulation of nicotinic acetylcholine receptors with reversible, competitive inhibition of acetylcholinesterase. In the Phase III clinical trial programme, over 3,000 patients with mild-to-moderate AD were enrolled in one of five randomized, controlled, double-blind studies. Using the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) to assess memory and other cognitive functions, galantamine was found to be significantly superior to placebo in all five studies at doses of 16, 24 and 32 mg/day.

Cross-reactivity of fosphenytoin in two human plasma phenytoin immunoassays.

The cross-reactivity of fosphenytoin, a phosphate ester prodrug of phenytoin, was investigated in the Abbott phenytoin TDx/TDxFLx fluorescence polarization immunoassay (TDx) and the Behring Diagnostics phenytoin Emit 2000 enzyme-multiplied immunoassay (Emit). The first part of our study investigating cross-reactivity utilized in vitro correlation of the two immunoassays with a validated and specific phenytoin HPLC method used to assay plasma samples prepared in several phenytoin and fosphenytoin concentration combinations. Fosphenytoin cross-reacted with both immunoassays, but to a greater extent with TDx.

Effect of gabapentin (Neurontin) [corrected] on mood and well-being in patients with epilepsy.

1. Global improvement data from five double-blind clinical trials of gabapentin as add-on therapy in patients with epilepsy were reviewed to assess the effects of gabapentin on mood. 2.

Analgesic efficacy of the kappa-receptor agonist, enadoline, in dental surgery pain.

To study the analgesic efficacy of enadoline, a selective agonist of the kappa-opioid receptor, a double-blind, randomized comparison was made of enadoline versus placebo and a combination of acetaminophen-codeine in patients with pain after surgical extraction of impacted molar teeth. An initial study involving a comparison of enadoline, a combination, and placebo failed to show any analgesic effect of enadoline. Therefore, a second study with the same design but using higher doses of enadoline was conducted.

The use of the Computerized Neuropsychological Test Battery (CNTB) in an efficacy and safety trial of BMY 21,502 in Alzheimer's disease.

BMY 21,502 is a nootropic which protects memory and enhances long-term potentiation according to preclinical findings. Alzheimer's disease (AD) patients who were diagnosed by DSM-III-R and NINCDS-ADRDA criteria were enrolled in a 12-week double-blind investigation of BMY 21,502 vs. placebo at 300 mg tid.

Tolerability of remoxipride in the long term treatment of schizophrenia. An overview.

506 patients with schizophrenia, diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (DSM-III) criteria, were included in a long term treatment programme with remoxipride, a selective dopamine (D2)-receptor antagonist. This overview includes pooled data from all patients who have been treated long term with remoxipride in clinical trials, focusing on patients treated for more than 6 months (n = 283). Remoxipride was administered in daily doses of 75 to 600mg.

Diagnosis and treatment of obsessive compulsive disorder.

Obsessive compulsive disorder (OCD) is a common anxiety disorder that appears to be due to a disturbance in central serotonergic functioning. Drugs, such as clomipramine, that inhibit neuronal reuptake of serotonin are effective in treating OCD. Behavioral therapy techniques are also effective.

Placebo-controlled dose-ranging trial designs in phase II development of nefazodone.

Nefazodone is a selective 5-HT2 receptor antagonist. Nefazodone has a pharmacologic profile similar to trazodone and other phenylpiperazine antidepressants, but distinct from nonselective first-generation agents and other selectively acting second-generation agents. Results of a multicenter, double-blind, fixed-dose trial indicate nefazodone is effective in improving depressive symptoms of outpatients with major depressive disorder treated with daily doses of 100 mg to 200 mg.