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4. Parkinsonism Associated with Anti‐B‐Cell Maturation Antigen Chimeric Antigen Receptor T‐Cell Therapy.

Author

Schneider, Sabine, Aamodt, Whitley W., Pruitt, Amy A., and Berger, Joseph R.

Subjects
SINGLE-photon emission computed tomography, PARKINSON'S disease, CYTOKINE release syndrome, CHIMERIC antigen receptors, GAIT disorders
Abstract

The article discusses the emergence of movement and neurocognitive treatment-emergent adverse events (MNT) associated with chimeric antigen receptor T-cell (CAR-T) therapy targeting B-cell maturation antigen (BCMA) in multiple myeloma patients. It highlights cases of parkinsonism and cognitive dysfunction following CAR-T therapy, with limited treatment options and unclear pathophysiology. The study emphasizes the need for movement disorders specialists to recognize and manage these dopamine-unresponsive adverse events to avoid unnecessary diagnostic testing and harmful treatments. [Extracted from the article]

Published
2024
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30. The CLARION study: first report on safety findings in patients newly initiating treatment with cladribine tablets or fingolimod for multiple sclerosis.

Author

Butzkueven, Helmut, Hillert, Jan, Soilu-Hänninen, Merja, Ziemssen, Tjalf, Kuhle, Jens, Wergeland, Stig, Magyari, Melinda, Berger, Joseph R., Moore, Nicholas, Aydemir, Aida, Bezemer, Irene, and Sabidó, Meritxell

Subjects
PROGRESSIVE multifocal leukoencephalopathy, MULTIPLE sclerosis, PATIENT safety, JOHN Cunningham virus, LYMPHOPENIA, FINGOLIMOD, HERPES zoster
Abstract

As part of the CLARION study: (1) characterize the incidence of severe infections, herpes zoster, and malignancies in patients newly initiating cladribine or fingolimod for relapsing multiple sclerosis (MS); (2) estimate the incidence of severe lymphopenia among cladribine users; and (3) describe prior/subsequent disease-modifying therapy (DMT) in both cohorts. Patients were identified from seven participating MS registries/data sources. The incidence rate (IR) of each outcome per 1000 patient-years and its 95% confidence interval (95%CI) were estimated for cohorts using Poisson regression. By cut-off date (01-April-2020), 742 cladribine and 867 fingolimod users were included. Mean follow-up was ∼1 year. The IR for severe infections from all contributing sources (except Denmark) was: cladribine, 7.37 (2.76,19.6); fingolimod, 6.55 (2.46,17.4). The corresponding IR for herpes zoster was 5.51 (1.78,17.1) and 3.27 (0.82,13.1), respectively, while values for opportunistic infections were 0 (0,6.76) and 1.63 (0.23,11.6), respectively. There were no events of progressive multifocal leukoencephalopathy in either cohort. The IR of severe lymphopenia was 63.9 (40.7,100.1) in 349 cladribine users from contributing sources. The IR of malignancies (cut-off date 01-April-2022) was 3.55 (1.59,7.90) for the cladribine cohort (n = 1035) and 3.55 (1.48,8.52) for the fingolimod cohort (n = 843) from three MS registries/data sources. In the combined data sources, 36.8% of cladribine and 27.4% of fingolimod users were DMT-naïve; after initiation of study treatment, 2.5% and 20.2% switched to another DMT, respectively. No new safety signal was observed in patients treated with cladribine tablets, although results are limited by a relatively short duration of follow-up. [ABSTRACT FROM AUTHOR]

Published
2023
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45. Contrast-associated acute kidney injury: How can we do better?

Author

Berger, Joseph R. and Vazquez, Miguel A.

Abstract

The article focuses on the challenges and considerations surrounding contrast-associated acute kidney injury (CA-AKI) in clinical practice. Topics include the pathophysiology and risks associated with CA-AKI, the impact of physician attitudes on the use of radiocontrast materials, and the need for improved risk assessment and educational strategies to enhance patient care.

Published
2024
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