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  • SAGE Publications  (13)
  • 1
    Online Resource
    Online Resource
    Self-Treatment of Acute Migraine with Subcutaneous Sumatriptan Using an Auto-Injector Device: Comparison With Customary Treatment in An Open, Longitudinal Study
    SAGE Publications ; 1994
    In:  Cephalalgia Vol. 14, No. 1 ( 1994-02), p. 55-63
    Details
    In: Cephalalgia, SAGE Publications, Vol. 14, No. 1 ( 1994-02), p. 55-63
    Abstract: In a multicenter open longitudinal clinical trial where 479 patients suffering from migraine with or without aura were recruited, patients treated at home one to three migraine attacks with their customary treatment, and subsequently, over a 3-month period, one to three migraine attacks with (5 mg sumatriptan sc using an auto-injector. The headache response to customary treatment was 19% at 1 h and 30.5% at 2 h, and was not significantly different when only attacks treated “adequately” according to accepted treatment recommendations were considered: 16% at 1 h and 35% at 2 h. In contrast, 69% and 82% of patients treated with 6 mg sumatriptan sc had mild headache or no headache at 1 and 2 h respectively, regardless of migraine type or duration of symptoms prior to treatment. Other migraine symptoms (nausea, vomiting, photo- and phonophobia) were effectively treated with sumatriptan. Recurrence of migraine was observed in 31% of patients and was well controlled by a second injection of sumatriptan. It is concluded that 6 mg sumatriptan sc, self-administered using an auto-injector, is well tolerated and more effective than most currently used acute treatments for migraine in a population of severely affected patients consulting a neurologist.
    Type of Medium: Online Resource
    ISSN: 0333-1024 , 1468-2982
    URL: Article
    DOI: 10.1046/j.1468-2982.1994.1401055.x
    Language: English
    Publisher: SAGE Publications
    Publication Date: 1994
    detail.hit.zdb_id: 2019999-5
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  • 2
    Online Resource
    Online Resource
    A 10-year follow-up of the European multicenter trial of interferon β-1b in secondary-progressive multiple sclerosis
    SAGE Publications ; 2016
    In:  Multiple Sclerosis Journal Vol. 22, No. 4 ( 2016-04), p. 533-543
    Details
    In: Multiple Sclerosis Journal, SAGE Publications, Vol. 22, No. 4 ( 2016-04), p. 533-543
    Abstract: To explore long-term effects of treatment and prognostic relevance of variables assessed at baseline and during the European secondary progressive multiple sclerosis (SPMS) trial of interferon beta 1b (IFNB-1b). Methods: We assessed 362 patients (60% female; median age 41 years; Expanded Disability Status Scale (EDSS): 5.5; 51% randomized to IFNB-1b) for their EDSS and treatment history after 10 years. Non-parametric analysis of covariance (ANCOVA) and multivariate linear regression models were applied. Results: Median EDSS was 6.0 at the end of the randomized controlled trial (RCT), in the IFNB-1b and placebo groups, and 7.0 in long-term follow-up patients (those receiving IFNB-1b in the RCT were 6.5 and those receiving placebo in the RCT were 7.0; p = 0.086). 24 patients (6.6%) were deceased. The EDSS at baseline and the EDSS change during the RCT were the most important predictors of the EDSS 10 years later (partial R 2 : 0.47). The ability to predict changes in EDSS 10 years after the RCT was limited ( R 2 : 0.12). Magnetic resonance imaging (MRI) measures remained in the predictive models, but explained 〈 5% of the variability. Conclusions: The results from this analysis did not provide convincing evidence to support a favorable long-term outcome in those patients allocated IFNB-1b during the RCT, in our SPMS cohort. The progressive stage of the disease remains largely unpredictable by clinical and conventional MRI measures, so better prognostic markers are needed.
    Type of Medium: Online Resource
    ISSN: 1352-4585 , 1477-0970
    URL: Article
    DOI: 10.1177/1352458515594440
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
    detail.hit.zdb_id: 2008225-3
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  • 3
    Online Resource
    Online Resource
    Serum levels of insulin-like growth factor-1 and insulin-like growth factor binding protein-3 in relapsing and primary progressive multiple sclerosis
    SAGE Publications ; 2005
    In:  Multiple Sclerosis Journal Vol. 11, No. 1 ( 2005-02), p. 13-15
    Details
    In: Multiple Sclerosis Journal, SAGE Publications, Vol. 11, No. 1 ( 2005-02), p. 13-15
    Abstract: Using radioimmunoassay we measured serum levels of insulin-like growth factor (IGF)-1 and IGF binding protein (IGFBP)-3 in patients with relapsing multiple sclerosis (MS) and a benign course (Expanded Disability Status Scale (EDSS)≤ 3 despite 〉 10 years disease duration), relapsing MS with cumulative disability leading to an EDSS score 〉 4 within 10 years of disease duration, primary progressive MS and healthy controls. We found no differences in IGF-1 and IGFBP-3 serum levels, and the IGF-1/IGFBP-3 ratio between the four groups. However, there was a significant correlation (P=0.005) between IGFBP-3 serum levels and both the progression index of disability and the Multiple Sclerosis Severity Score in patients with primary progressive MS.
    Type of Medium: Online Resource
    ISSN: 1352-4585 , 1477-0970
    URL: Article
    DOI: 10.1191/1352458505ms1123oa
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2005
    detail.hit.zdb_id: 2008225-3
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  • 4
    Online Resource
    Online Resource
    Early prediction of a benign course of multiple sclerosis on clinical grounds: a systematic review
    SAGE Publications ; 2001
    In:  Multiple Sclerosis Vol. 7, No. 5 ( 2001-10-1), p. 345-347
    Details
    In: Multiple Sclerosis, SAGE Publications, Vol. 7, No. 5 ( 2001-10-1), p. 345-347
    Type of Medium: Online Resource
    ISSN: 1477-0970 , 1352-4585
    URL: Article
    DOI: 10.1191/135245801681138068
    Language: Unknown
    Publisher: SAGE Publications
    Publication Date: 2001
    detail.hit.zdb_id: 2008225-3
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  • 5
    Online Resource
    Online Resource
    Factors associated with the risk of secondary progression in multiple sclerosis
    SAGE Publications ; 2008
    In:  Multiple Sclerosis Journal Vol. 14, No. 6 ( 2008-07), p. 799-803
    Details
    In: Multiple Sclerosis Journal, SAGE Publications, Vol. 14, No. 6 ( 2008-07), p. 799-803
    Abstract: Objective To investigate factors associated with the risk of secondary progression in relapsing-remitting onset multiple sclerosis (MS). Methods We used Kaplan-Meier survival analyses and a multivariable Cox regression model to estimate the influence of the factors: gender, age at disease onset, use of immunomodulatory drugs (IMD), and clinical manifestation at disease onset on the time to secondary progression in a hospital-based cohort of 571 MS patients with a relapsing-remitting onset. Results Gender and onset manifestation had no significant influence on the timing of secondary progression. A higher age at disease onset was associated with a shorter time to secondary progression (multivariable hazard ratio per year increase: 1.02, 95% CI:1.01 - 1.03). The use of IMD was associated with a longer time to secondary progression (multivariable hazard ratio: 0.30, 95% CI: 0.15 - 0.61). Conclusions The inverse relationship between age at disease onset and onset of secondary progression is in keeping with previous natural history studies. The beneficial effect of IMD treatment on the time to secondary progression should be taken as hypothesis-generating rather than as proof of a treatment effect, and needs to be further evaluated in well-designed randomised controlled trials.
    Type of Medium: Online Resource
    ISSN: 1352-4585 , 1477-0970
    URL: Article
    DOI: 10.1177/1352458508089361
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2008
    detail.hit.zdb_id: 2008225-3
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  • 6
    Online Resource
    Online Resource
    Fatigue, depression and progression in multiple sclerosis
    SAGE Publications ; 2008
    In:  Multiple Sclerosis Journal Vol. 14, No. 6 ( 2008-07), p. 815-822
    Details
    In: Multiple Sclerosis Journal, SAGE Publications, Vol. 14, No. 6 ( 2008-07), p. 815-822
    Abstract: Objective To investigate the effect of fatigue and depression on disease progression in multiple sclerosis (MS), and the long-term prognosis of these symptoms. Methods 228 patients with MS were investigated for fatigue and depression with the Fatigue Severity Scale (FSS) and Center for Epidemiologic Studies Depression Scale (CES-D). These patients regularly attended the MS clinic, where disability scores and the development of secondary progression were monitored. After 10 years, the 149 patients remaining from the original cohort were asked to participate in a repeat assessment of fatigue and depression and 96 (64%) could be re-evaluated. In relapsing–remitting patients, the influence of baseline fatigue and depression on the risk of secondary progression during the following 10 years was assessed with survival analyses. In the whole patient group, we investigated the influence of baseline fatigue and depression on progression of disability at 10 years. We also investigated differences in fatigue, depression and disability scores between baseline and 10 years. Results Fatigue and depression at baseline did not predict the development of secondary progression or progression of disability. Most patients who were fatigued or depressed at baseline remained so at 10 years, and the majority of patients not experiencing these symptoms remained free of them. FSS and CES-D scores were not significantly different between baseline and 10 years, while disability scores significantly increased. Conclusion Our data suggest that fatigue and depression in MS are unrelated to disease progression in MS. Fatigue and depression tend to persist at roughly the same levels over time.
    Type of Medium: Online Resource
    ISSN: 1352-4585 , 1477-0970
    URL: Article
    DOI: 10.1177/1352458508088937
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2008
    detail.hit.zdb_id: 2008225-3
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  • 7
    Online Resource
    Online Resource
    Timing of birth and disease progression in multiple sclerosis
    SAGE Publications ; 2008
    In:  Multiple Sclerosis Journal Vol. 14, No. 6 ( 2008-07), p. 793-798
    Details
    In: Multiple Sclerosis Journal, SAGE Publications, Vol. 14, No. 6 ( 2008-07), p. 793-798
    Abstract: Background The timing of birth has recently been associated with the risk of developing multiple sclerosis (MS) in later life. Whether the timing of birth also influences the disease course of MS is unknown. Objective To investigate whether the season or month of birth influences the timing of secondary progression or the time to landmark disability outcomes in MS. Methods To allow confirmation of findings, all analyses were performed in duplicate in two large natural history cohorts from geographically distinct but seasonally similar locations in Europe and North America. Kaplan–Meier survival analyses were used to investigate the influence of month and season of birth on 1) the time to and age at the development of secondary progression in patients with a relapsing disease onset and 2) the time to reach an Expanded Disability Status Scale (EDSS) score of 6.0 in patients with primary progressive and relapsing MS. Results No association between the month or season of birth and disease progression could be found, which was reproducible in both natural history cohorts. A seasonal trend was observed for the time to and age at secondary progression in Groningen, with March babies exhibiting a shorter time to and younger age at secondary progression. The birth month affected time to EDSS 6 for those with relapsing MS in British Columbia, with January babies exhibiting a longer time to EDSS 6. Neither finding could be reciprocated in the other natural history cohort. Conclusion The season or month of birth does not appear to influence disease progression of MS.
    Type of Medium: Online Resource
    ISSN: 1352-4585 , 1477-0970
    URL: Article
    DOI: 10.1177/1352458508090662
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2008
    detail.hit.zdb_id: 2008225-3
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  • 8
    Online Resource
    Online Resource
    Modifiable factors influencing relapses and disability in multiple sclerosis
    SAGE Publications ; 2010
    In:  Multiple Sclerosis Journal Vol. 16, No. 7 ( 2010-07), p. 773-785
    Details
    In: Multiple Sclerosis Journal, SAGE Publications, Vol. 16, No. 7 ( 2010-07), p. 773-785
    Abstract: A growing body of literature indicates that the natural course of multiple sclerosis can be influenced by a number of factors. Strong evidence suggests that relapses can be triggered by infections, the postpartum period and stressful life events. Vaccinations against influenza, hepatitis B and tetanus appear to be safe. Surgery, general and epidural anaesthesia, and physical trauma are not associated with an increased risk of relapses. Factors that have been associated with a reduced relapse rate are pregnancy, exclusive breastfeeding, sunlight exposure and higher vitamin D levels. A number of medications, including hormonal fertility treatment, seem to be able to trigger relapses. Factors that may worsen progression of disability include stressful life events, radiotherapy to the head, low levels of physical activity and low vitamin D levels. Strong evidence suggests that smoking promotes disease progression, both clinically and on brain magnetic resonance imaging. There is no evidence for an increased progression of disability following childbirth in women with multiple sclerosis. Moderate alcohol intake and exercise might have a neuroprotective effect, but this needs to be confirmed.
    Type of Medium: Online Resource
    ISSN: 1352-4585 , 1477-0970
    URL: Article
    DOI: 10.1177/1352458510367721
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2010
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  • 9
    Online Resource
    Online Resource
    Sunlight exposure and sun sensitivity associated with disability progression in multiple sclerosis
    SAGE Publications ; 2012
    In:  Multiple Sclerosis Journal Vol. 18, No. 4 ( 2012-04), p. 451-459
    Details
    In: Multiple Sclerosis Journal, SAGE Publications, Vol. 18, No. 4 ( 2012-04), p. 451-459
    Abstract: Background: Sunlight and vitamin D have been inversely associated with the risk of multiple sclerosis (MS). Objective: We investigated sunlight exposure and sun sensitivity in relation to disability progression in MS. Methods: We conducted a survey among persons with MS, registered by the Flemish MS society, Belgium, and stratified data according to relapsing-onset and progressive-onset MS. We used Kaplan–Meier survival and Cox proportional hazard regression analyses with time to Expanded Disability Status Scale (EDSS) 6 as outcome measure. Hazard ratios for the time from onset and from birth were calculated for the potentially predictive variables, adjusting for age at onset, gender and immunomodulatory treatment. Results: 704 (51.3%) of the 1372 respondents had reached EDSS 6. In relapsing-onset MS, respondents reporting equal or higher levels of sun exposure than persons of the same age in the last 10 years had a decreased risk of reaching EDSS 6. In progressive-onset MS, increased sun sensitivity was associated with an increased hazard of reaching EDSS 6. Conclusion: The association of higher sun exposure with a better outcome in relapsing-onset MS may be explained by either a protective effect or reverse causality. Mechanisms underlying sun sensitivity might influence progression in progressive-onset MS.
    Type of Medium: Online Resource
    ISSN: 1352-4585 , 1477-0970
    URL: Article
    DOI: 10.1177/1352458511423778
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2012
    detail.hit.zdb_id: 2008225-3
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  • 10
    Online Resource
    Online Resource
    Quality of Life in Patients Treated with First-Line Antiretroviral Therapy Containing Nevirapine And/Or Efavirenz
    SAGE Publications ; 2004
    In:  Antiviral Therapy Vol. 9, No. 5 ( 2004-07), p. 721-728
    Details
    In: Antiviral Therapy, SAGE Publications, Vol. 9, No. 5 ( 2004-07), p. 721-728
    Abstract: To assess whether differences in safety profiles between nevirapine (NVP) and efavirenz (EFV), as observed in the 2NN study, translated into differences in ‘health related quality of life’ (HRQoL). Design A sub-study of the 2NN study, with antiretro-viral-naive patients randomly allocated to NVP (once or twice daily), EFV or NVP+EFV, in addition to stavudine and lamivudine. Methods Comparing differences in changes of HRQoL over 48 weeks as measured with the Medical Outcomes Study HIV Health Survey (MOS-HIV) questionnaire, using analysis of variance. Results The 2NN study enrolled 1216 patients. No validated questionnaires were available for 244 patients, and 55 patients had no HRQoL data at all, leaving 917 patients eligible for this sub-study. A total of 471 (51%) had HRQoL measurements both at baseline and week 48. The majority (69%) of patients without HRQoL measurements did, however, complete the study. The change in the physical health score (PHS) was 3.9 for NVP, 3.4 for EFV and 2.4 for NVP+EFV ( P=0.712). For the mental health score (MHS) these values were 6.1, 7.0 and 3.9, respectively ( P=0.098). A baseline plasma HIV-1 RNA concentration (pVL) ≥100 000 copies/ml and a decline in pVL (per log 10 ) were independently associated with an increase of PHS. An increase of MHS was only associated with pVL decline. Patients experiencing an adverse event during follow-up had a comparable change in PHS but a significantly smaller change in MHS, compared with those without an adverse event. Conclusions First-line ART containing NVP and/or EFV leads to an improvement in HRQoL. The gain in HRQoL was similar for NVP and EFV, but slightly lower for the combination of these drugs.
    Type of Medium: Online Resource
    ISSN: 1359-6535 , 2040-2058
    URL: Article
    DOI: 10.1177/135965350400900512
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2004
    detail.hit.zdb_id: 2118396-X
    SSG: 15,3
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