Erythrocyte Fragility in Progressive Multiple Sclerosis
Jacob C, Williams TE, Stuart CM, Witkover A, Hametner S, Lassmann H, Bangham CRM, Chataway J and Galea I
Erythrocyte Fragility in Progressive Multiple Sclerosis
Jacob C, Williams TE, Stuart CM, Witkover A, Hametner S, Lassmann H, Bangham CRM, Chataway J and Galea I
Aberrant iron homeostasis is increasingly recognized as a key pathological feature in progressive multiple sclerosis (MS). Although the source of excess brain iron remains unclear, haemoglobin is one possible source. To test this hypothesis, we conducted a case-control study to determine whether erythrocytes are more fragile in people with progressive MS (PwPMS) and examined associations between erythrocyte fragility and brain atrophy.
Psychometric properties of the Chinese version of the Subarachnoid Hemorrhage Outcomes Tool (SAHOT) in elderly SAH patients
Han Y, Galea I, Wang Y, Wang Z, Zhu S, Ren X, Zhao X, Liu X, Wang T, Zhang J, Zhang J and Fang K
Psychometric properties of the Chinese version of the Subarachnoid Hemorrhage Outcomes Tool (SAHOT) in elderly SAH patients
Han Y, Galea I, Wang Y, Wang Z, Zhu S, Ren X, Zhao X, Liu X, Wang T, Zhang J, Zhang J and Fang K
Elderly patients with subarachnoid hemorrhage (SAH) experience long-term disability and persistent cognitive and psychosocial sequelae, with poor patient-reported outcomes (PROs). However, China currently lacks tools to assess PROs in elderly SAH patients. This study aims to translate the Subarachnoid Hemorrhage Outcomes Tool (SAHOT) into Chinese and evaluate its psychometric properties among elderly SAH patients in China.
Real-World Performance of CSF Kappa Free Light Chains in the 2024 McDonald Criteria
Leibowitz MM, Cooper R, Kaninia S, Challis KI, Greenway W, Bonello M, Elbahnasawi M, Shode DT, Gajdasik D, Iliev V, Whitelegg AME and Galea I
Real-World Performance of CSF Kappa Free Light Chains in the 2024 McDonald Criteria
Leibowitz MM, Cooper R, Kaninia S, Challis KI, Greenway W, Bonello M, Elbahnasawi M, Shode DT, Gajdasik D, Iliev V, Whitelegg AME and Galea I
Kappa free light chains (KFLCs) in the cerebrospinal fluid (CSF) have a similar performance to CSF-restricted oligoclonal bands (OCB) for multiple sclerosis (MS) diagnosis. To help with implementation, we set out to resolve several remaining uncertainties: (1) performance in a real-world cohort and the 2024 McDonald criteria; (2) equivalence to OCB in the specific clinical scenario when demonstration of intrathecal immunoglobulin synthesis is essential for MS diagnosis; (3) which KFLC metric has the best diagnostic performance.
Extensive Proximal Deep Vein Thrombosis Despite Normal Age-Adjusted D-Dimer Levels: A Case Report
Dimech L, Galea I and Calleja J
Extensive Proximal Deep Vein Thrombosis Despite Normal Age-Adjusted D-Dimer Levels: A Case Report
Dimech L, Galea I and Calleja J
Deep vein thrombosis (DVT) refers to the formation of a blood clot within a deep vein, most often in the lower extremities, which can partially or completely obstruct venous blood flow. This case discusses a 93-year-old female nursing home resident who developed extensive left lower limb swelling with a laboratory D-dimer level of 316 ng/mL (normal range for a 93-year-old: 0-930 ng/mL). Based on her age-adjusted D-dimer threshold of 930 ng/mL, thrombosis would ordinarily be considered unlikely. However, given her predominantly wheelchair-bound status and a Wells score of 3, the clinical suspicion for DVT remained high. Doppler ultrasound subsequently confirmed extensive proximal thrombosis with complete occlusion of the left popliteal and femoral veins. This case illustrates the limitations of relying solely on D-dimer testing to exclude DVT in elderly patients and underscores the importance of clinical judgment.
Effect of repurposed simvastatin on disability progression in secondary progressive multiple sclerosis (MS-STAT2): a phase 3, randomised, double-blind, placebo-controlled trial
Chataway J, Williams T, Blackstone J, John N, Braisher M, De Angelis F, Bianchi A, Calvi A, Doshi A, Apap Mangion S, Wade C, Bordea E, Merry R, Barton G, Lyle D, Jarman E, Mahad D, Shehu A, Arun T, McDonnell G, Geraldes R, Craner M, Hillier C, Ganesalingam J, Fisniku L, Hobart J, Spilker C, Robertson NP, Kalra S, Pluchino S, Harikrishnan S, Mattoscio M, Harrower T, Young C, Lee M, Chhetri SK, Ahmed F, Rog D, Silber E, Gallagher P, Duddy M, Straukiene A, Nicholas R, Rice C, Tebbs S, Hawton A, Hunter R, Giovannoni G, Ciccarelli O, Beveridge J, Nixon S, Thompson AJ, Greenwood J, Pearson OR, Evangelou N, Sharrack B, Galea I, Gray E, Pavitt S, Chandran S, Ford HL, Frost C, Nicholas JM and
Effect of repurposed simvastatin on disability progression in secondary progressive multiple sclerosis (MS-STAT2): a phase 3, randomised, double-blind, placebo-controlled trial
Chataway J, Williams T, Blackstone J, John N, Braisher M, De Angelis F, Bianchi A, Calvi A, Doshi A, Apap Mangion S, Wade C, Bordea E, Merry R, Barton G, Lyle D, Jarman E, Mahad D, Shehu A, Arun T, McDonnell G, Geraldes R, Craner M, Hillier C, Ganesalingam J, Fisniku L, Hobart J, Spilker C, Robertson NP, Kalra S, Pluchino S, Harikrishnan S, Mattoscio M, Harrower T, Young C, Lee M, Chhetri SK, Ahmed F, Rog D, Silber E, Gallagher P, Duddy M, Straukiene A, Nicholas R, Rice C, Tebbs S, Hawton A, Hunter R, Giovannoni G, Ciccarelli O, Beveridge J, Nixon S, Thompson AJ, Greenwood J, Pearson OR, Evangelou N, Sharrack B, Galea I, Gray E, Pavitt S, Chandran S, Ford HL, Frost C, Nicholas JM and
Despite the success of immune modulation in the treatment of relapsing multiple sclerosis, disability progression is a major problem driven by multiple mechanisms. Comorbidities (eg, vascular risk) and ageing are thought to augment these neurodegenerative pathologies. In the phase 2b MS-STAT trial of simvastatin (80 mg) versus placebo in secondary progressive multiple sclerosis (SPMS), the adjusted difference in brain atrophy rate between groups was -0·254% per year: a 43% reduction. In this phase 3 MS-STAT2 trial, we aimed to assess the efficacy of simvastatin versus placebo in slowing the progression of disability in SPMS.