nach oben

Journal of Neurology

Erschienen in:

01.09.2010 | Review

Neurological adverse events associated with anti-tumor necrosis factor alpha treatment

verfasst von: Antonio G. Tristano

Erschienen in: Journal of Neurology | Ausgabe 9/2010

Einloggen, um Zugang zu erhalten

Abstract

Anti-tumor necrosis factor alpha (TNF-α) drugs have been successfully used for the treatment of rheumatic autoimmune diseases including rheumatoid arthritis (RA), psoriatic arthritis, psoriasis, ankylosing spondylitis (AS), juvenile chronic arthritis, and Crohn’s disease. However, they have been associated with different neurological disorders, including alterations of peripheral nerves, multiple sclerosis (MS), optic neuritis (ON) and acute transverse myelitis (ATM). This article reviews the most current aspect regarding neurological adverse events associated with anti-TNF-α drugs with emphasis on the possible explanations for this relation and the pathogenic mechanism of TNF-α in neurological disorders.

Kollias G, Douni E, Kassiotis G, Kontoyiannis D (1999) The function of tumour necrosis factor and receptors in models of multi-organ inflammation, rheumatoid arthritis, multiple sclerosis and inflammatory bowel disease. Ann Rheum Dis 58(Suppl. 1):I32–I39CrossRefPubMed

Stubgen JP (2008) Tumor necrosis factor-α antagonists and neuropathy. Muscle Nerve 37:282–292CrossRef

Cope A, Ettinger R, McDevitt H (1997) The role of TNF-α and related cytokines in the development and function of the autoreactive T-cell repertoire. Res Immunol 148:307–312CrossRefPubMed

Kollias G, Douni E, Kassiotis G, Kontoyiannis D (1999) The role of tumor necrosis factor and receptors in models of multi organ inflammation, rheumatoid arthritis, multiple sclerosis, and inflammatory bowel disease. Ann Rheum Dis 58(suppl 1):32–39CrossRef

Robinson WH, Genovese MC, Moreland LW (2001) Demyelinating and neurologic events reported in association with tumor necrosis factor α antagonism. Arthritis Rheum 44:1977–1983CrossRefPubMed

Hohlfeld R (1996) Inhibitors of tumor necrosis factor-alpha: promising agents for the treatment of multiple sclerosis? Mult Scler 1:376–378PubMed

Zheng L, Fisher G, Miller RE, Peschon J, Lynch DH, Lenardo MJ (1995) Induction of apoptosis in mature T cells by tumour necrosis factor. Nature 377:348–351CrossRefPubMed

Alldred A (2001) Etanercept in rheumatoid arthritis. Expert Opin Pharmacother 1:1137–1148CrossRef

Enbrel (etanercept) (2007) Current prescribing information. In: Physicians’ desk reference. Thompson, Montvale, pp 584–591

10.

Humira (adalimumab) (2007) Current prescribing information. In: Physicians’ desk reference. Thompson, Montvale, pp 466–471

11.

Remicade (infliximab) (2007) Current prescribing information. In: Physicians’ desk reference. Thompson, Montvale, pp 971–979

12.

Ramos-Casals M, Roberto-Perez-Alvarez, Diaz-Lagares C, Cuadrado MJ, Khamashta MA et al (2010) Autoimmune diseases induced by biological agents: a double-edged sword? Autoimmun Rev 9(3):188–193CrossRefPubMed

13.

Wetter DA, Davis MD (2009) Lupus-like syndrome attributable to anti-tumor necrosis factor alpha therapy in 14 patients during an 8-year period at Mayo Clinic. Mayo Clin Proc 84(11):979–984CrossRefPubMed

14.

Borrás-Blasco J, Navarro-Ruiz A, Borrás C, Casterá E (2009) Adverse cutaneous reactions induced by TNF-alpha antagonist therapy. South Med J 102(11):1133–1140PubMed

15.

Ghezzi P, Mennini T (2001) Tumor necrosis factor and motoneural degeneration: an open problem. Neuroimmunomodulation 9(4):178–182CrossRefPubMed

16.

Cope AP, Liblau RS, Yang XD, Congia M, Laudanna C, Schreiber RD (1997) Chronic tumor necrosis factor alter T cell responses by attenuating T cell receptor signaling. J Exp Med 185:1573–1584CrossRefPubMed

17.

Aggarwal BB, Samanta A, Feldmann M (2000) TNFα. In: Oppenheim JJaFM (ed) Cytokine Reference. Academic Press, London, pp 414–434

18.

Idriss HT, Naismith J (2000) TNF alpha and the TNF receptor superfamily: structure-function relationship(s). Microsc Res Tech 50:184–195CrossRefPubMed

19.

MacEwan DJ (2002) TNF receptor subtype signalling: differences and cellular consequences. Cell Signal 14:477–492CrossRefPubMed

20.

McCoy MK, Tansey MG (2008) TNF signaling inhibition in the CNS: implications for normal brain function and neurodegenerative disease. J Neuroinflammation 5:45CrossRefPubMed

21.

Black RA, Rauch CT, Kozlosky CJ, Peschon JJ, Slack JL, Wolfson MF et al (1997) A metalloproteinase disintegrin that releases tumour-necrosis factor-α from cells. Nature 385:729–733CrossRefPubMed

22.

Lieberman AP, Pitha PM, Shin HS, Shin ML (1989) Production of tumor necrosis factor and other cytokines by astrocytes stimulated with lipopolysaccharide or a neurotropic virus. Proc Natl Acad Sci USA 86:6348–6352CrossRefPubMed

23.

Morganti-Kossman MC, Lenzlinger PM, Hans V, Stahel P, Csuka E, Ammann E et al (1997) Production of cytokines following brain injury: beneficial and deleterious for the damaged tissue. Mol Psychiatry 2:133–136CrossRefPubMed

24.

Chung CY, Seo H, Sonntag KC, Brooks A, Lin L, Isacson O (2005) Cell type-specific gene expression of midbrain dopaminergic neurons reveals molecules involved in their vulnerability and protection. Hum Mol Genet 14:1709–1725CrossRefPubMed

25.

Creange A, Lefaucheur JP, Authier FJ, Gherardi RK (1998) Cytokines and peripheral neuropathies. Rev Neurol 154:208–216PubMed

26.

Oka N, Akiguchi I, Kawasaki T, Mizutani K, Satoi H, Kimura J (1998) Tumor necrosis factor-alpha in peripheral nerve lesions. Acta Neuropathol 95:57–62CrossRefPubMed

27.

Grell M, Wajant H, Zimmermann G, Scheurich P (1998) The type 1 receptor (CD1 20a) is the high-affinity receptor for soluble tumor necrosis factor. Proc Natl Acad Sci USA 95:570–575CrossRefPubMed

28.

Grell M (1995) Tumor necrosis factor (TNF) receptors in cellular signaling of soluble and membrane-expressed TNF. J Inflamm 47:8–17PubMed

29.

Balkwill F (2009) Tumor necrosis factor and cancer. Nat Rev Cancer 9(5):361–371CrossRefPubMed

30.

Ihnatko R, Kubes M (2007) TNF signaling: early events and phosphorylation. Gen Physiol Biophys 26(3):159–167PubMed

31.

Haas E, Grell M, Wajant H, Scheurich P (1999) Continuous autotropic signaling by membrane expressed tumor necrosis factor. J Biol Chem 274(25):18107–18112CrossRefPubMed

32.

Weiss T, Grell M, Hessabi B, Bourteele S, Müller G, Scheurich P et al (1997) Enhancement of TNF receptor p60-mediated cytotoxicity by TNF receptor p80: requirement of the TNF receptor-associated factor-2 binding site. J Immunol 158(5):2398–2404PubMed

33.

Holtmann MH, Neurath MF (2004) Differential TNF-signaling in chronic inflammatory disorders. Curr Mol Med 4(4):439–444CrossRefPubMed

34.

Pocsik E, Duda E, Wallach D (1995) Phosphorylation of the 26 kDa TNF precursor in monocytic cells and in transfected HeLa cells. J Inflamm 45:152–160PubMed

35.

Watts AD, Hunt NH, Wanigasekara Y, Bloomfield G, Wallach D, Roufogalis BD et al (1999) A casein kinase I motif present in the cytoplasmic domain of members of the tumour necrosis factor ligand family is implicated in ‘reverse signalling’. EMBO J 18:2119–2126CrossRefPubMed

36.

Kirchner S, Boldt S, Kolch W, Haffner S, Kazak S, Janosch P et al (2004) LPS resistance in monocytic cells caused by reverse signaling through transmembrane TNF (mTNF) is mediated by the MAPK/ERK pathway. J Leukoc Biol 75:324–331CrossRefPubMed

37.

Tansey MG, Wyss-Coray T (2008) Cytokines in CNS inflammation and disease. In: Lane TE, Carson M (eds) Central nervous system diseases and inflammation. Springer, Berlin

38.

Selmaj KW, Farooq M, Norton WT, Raine CS, Brosnan CF (1990) Proliferation of astrocytes in vitro in response to cytokines. A primary role for tumor necrosis factor. J Immunol 144:129–135PubMed

39.

Merrill JE (1991) Effects of interleukin-1 and tumor necrosis factoralpha on astrocytes, microglia, oligodendrocytes, and glial precursors in vitro. Dev Neurosci 13:130–137CrossRefPubMed

40.

Sedgwick JD, Riminton DS, Cyster JG, Korner H (2001) Tumor necrosis factor: a master-regulator of leukocyte movement. Immunol Today 21:110–113CrossRef

41.

Leon LR (2002) Invited review: cytokine regulation of fever: studies using gene knockout mice. J Appl Physiol 92:2648–2655PubMed

42.

Beattie EC, Stellwagen D, Morishita W, Bresnahan JC, Ha BK, Von Zastrow M et al (2002) Control of synaptic strength by glial TNFalpha. Science 295:2282–2285CrossRefPubMed

43.

Pickering M, Cumiskey D, O’Connor JJ (2005) Actions of TNF-alpha on glutamatergic synaptic transmission in the central nervous system. Exp Physiol 90:663–670CrossRefPubMed

44.

Golan H, Levav T, Mendelsohn A, Huleihel M (2004) Involvement of tumor necrosis factor alpha in hippocampal development and function. Cereb Cortex 14:97–105CrossRefPubMed

45.

Zou JY, Crews FT (2005) TNF alpha potentiates glutamate neurotoxicity by inhibiting glutamate uptake in organotypic brain slice cultures: neuroprotection by NF kappa B inhibition. Brain Res 1034:11–24CrossRefPubMed

46.

Choi DW (1988) Glutamate neurotoxicity and diseases of the nervous system. Neuron 1:623–634CrossRefPubMed

47.

Hsu H, Huang J, Shu HB, Baichwal V, Goeddel DV (1996) TNF-dependent recruitment of the protein kinase RIP to the TNF receptor-1 signaling complex. Immunity 4:387–396CrossRefPubMed

48.

Gross A, Yin XM, Wang K, Wei MC, Jockel J, Milliman C et al (1999) Caspase cleaved BID targets mitochondria and is required for cytochrome c release, while BCL-XL prevents this release but not tumor necrosis factor-R1/Fas death. J Biol Chem 274:1156–1163CrossRefPubMed

49.

Goodman JC, Robertson CS, Grossman RG, Narayan RK (1990) Elevation of tumor necrosis factor in head injury. J Neuroimmunol 30:213–217CrossRefPubMed

50.

Hofman FM, Hinton DR, Johnson K, Merrill JE (1989) Tumor necrosis factor identified in multiple sclerosis brain. J Exp Med 170:607–612CrossRefPubMed

51.

Sharief MK, Hentges R (1991) Association between tumor necrosis factor-alpha and disease progression in patients with multiple sclerosis. N Engl J Med 325:467–472CrossRefPubMed

52.

Beck J, Rondot P, Catinot L, Falcoff E, Kirchner H, Wietzerbin J (1988) Increased production of interferon gamma and tumor necrosis factor precedes clinical manifestation in multiple sclerosis: do cytokines trigger off exacerbations? Acta Neurol Scand 78:318–323CrossRefPubMed

53.

Maimone D, Gregory S, Arnason BGW, Reder AT (1991) Cytokine levels in the cerebrospinal fluid and serum of patients with multiple sclerosis. J Neuroimmunol 32:67–74CrossRefPubMed

54.

Selmaj KW, Raine CS (1988) Tumor necrosis factor mediates myelin and oligodendrocyte damage in vitro. Ann Neurol 23:339–346CrossRefPubMed

55.

Cre′ange A, Be′lec L, Clair B, Raphael JC, Gherardi RK (1996) Circulating tumor necrosis factor (TNF)-α and soluble TNF-α receptors in patients with Guillain–Barre′ syndrome. J Neuroimmunol 68:95–99CrossRef

56.

Misawa S, Kuwabara S, Mori M, Kawagushi N, Yoshiyama Y, Hattori T (2001) Serum levels of tumor necrosis factor-α in chronic inflammatory polyneuropathy. Neurology 56:666–669PubMed

57.

Sharief MK, McLean B, Thompson EJ (1993) Elevated serum levels of tumor necrosis factor-α in Guillain–Barre′ syndrome. Ann Neurol 33:591–596CrossRefPubMed

58.

Terenghi F, Allaria S, Nobile-Orazio E (2006) Circulating levels of cytokines and their modulation by intravenous immunoglobulin in multifocal motor neuropathy. J Peripher Nerv Syst 11:67–71CrossRefPubMed

59.

Zhu J, Mix E, Link H (1998) Cytokine production and the pathogenesis of experimental autoimmune neuritis and Guillain–Barre′ syndrome. J Neuroimmunol 84:40–52CrossRefPubMed

60.

Said G, Hontebeyrie-Joskowicz M (1992) Nerve lesions induced by macrophage activation. Res Immunol 143:589–599CrossRefPubMed

61.

Stoll G, Jung S, Jander S, van der Meide P, Hartung HP (1993) Tumor necrosis factor-alpha in immune-mediated demyelination and Wallerian degeneration of the rat peripheral nervous system. J Neuroimmunol 45:175–182CrossRefPubMed

62.

Weishaupt A, Bruck W, Hartung T, Toyka KV, Gold R (2001) Schwann cell apoptosis in experimental autoimmune neuritis of the Lewis rat and the functional role of tumor necrosis factor-α. Neurosci Lett 306:77–80CrossRefPubMed

63.

Magnano MD, Robinson WH, Genovese MC (2004) Demyelination and inhibition of tumor necrosis factor (TNF). Clin Exp Rheumatol 22(suppl. 35):S134–S140PubMed

64.

Selmaj KW, Raine CS (1995) Experimental autoimmune encephalomyelitis: immunotherapy with anti-tumor necrosis factor antibodies and soluble tumor necrosis factor receptors. Neurology 45:S44–S49PubMed

65.

van Oosten BW, Barkhof F, Truyen L, Boringa JB, Bertelsmann FW, von Blomberg BM et al (1996) Increased MRI activity and immune activation in two multiple sclerosis patients treated with the monoclonal antitumor necrosis factor antibody cA2. Neurology 47:1531–1534PubMed

66.

The Lenercept Multiple Sclerosis Study Group and The University of British Columbia MS/MRI Analysis Group (1999) TNF neutralization in MS: results of a randomized, placebo-controlled multicenter study. Neurology 53:457–465

67.

Klinkert WE, Kojima K, Lesslauer W, Rinner W, Lassmann H, Wekerle H (1997) TNFa receptor fusion protein prevents experimental autoimmune encephalomyelitis and demyelination in Lewis rats: an overview. J Neuroimmunol 72:163–168CrossRefPubMed

68.

Mohan N, Edwards ET, Cupps TR, Oliverio PJ, Sandberg G, Crayton H et al (2001) Demyelination occurring during anti-tumor necrosis factor alpha therapy for inflammatory arthritides. Arthritis Rheum 44(12):2862–2869CrossRefPubMed

69.

Shin IS, Baer AN, Kwon HJ, Papadopoulos EJ, Siegel JN (2006) Guillain-Barré and Miller Fisher syndromes occurring with tumor necrosis factor alpha antagonist therapy. Arthritis Rheum 54(5):1429–1434CrossRefPubMed

70.

Simsek I, Erdem H, Pay S, Sobaci G, Dinc A (2007) Optic neuritis occurring with anti-tumour necrosis factor alpha therapy. Ann Rheum Dis 66(9):1255–1258CrossRefPubMed

71.

Lees CW, Ali AI, Thompson AI, Ho GT, Forsythe RO, Marquez L et al (2009) The safety profile of anti-tumour necrosis factor therapy in inflammatory bowel disease in clinical practice: analysis of 620 patient-years follow-up. Aliment Pharmacol Ther 29(3):286–297CrossRefPubMed

72.

Bernatsky S, Renoux C, Suissa S. Demyelinating events in rheumatoid arthritis after drug exposures. Ann Rheum Dis published online 23 Jul 2009; doi:10.1136/ard.2009.111500

73.

Lozeron P, Denier C, Lacroix C, Adams D (2009) Long-term course of demyelinating neuropathies occurring during tumor necrosis factor-alpha-blocker therapy. Arch Neurol 66(4):490–497CrossRefPubMed

74.

Sicotte NL, Voskuhl RR (2001) Onset of multiple sclerosis associated with anti-TNF therapy. Neurology 57(10):1885–1888PubMed

75.

Muteis-Olivas E, Pérez-García C, Roquer-González J, Maymo-Guarch J (2005) Esclerosis múltiple tras el tratamiento con anticuerpo anti-TNF-α. Med Clin (Barc) 125:756–759

76.

Dubcenco E, Ottaway CA, Chen DL, Baker JP (2006) Neurological symptoms suggestive of demyelination in Crohn’s disease after infliximab therapy. Eur J Gastroenterol Hepatol 18(5):565–566CrossRefPubMed

77.

Enayati PJ, Papadakis KA (2005) Association of anti-tumor necrosis factor therapy with the development of multiple sclerosis. J Clin Gastroenterol 39(4):303–306CrossRefPubMed

78.

Richez C, Blanco P, Lagueny A, Schaeverbeke T, Dehais J (2005) Neuropathy resembling CIDP in patients receiving tumor necrosis factor-alpha blockers. Neurology 64(8):1468–1470PubMed

79.

Richette P, Dieudé P, Damiano J, Lioté F, Orcel P, Bardin T (2004) Sensory neuropathy revealing necrotizing vasculitis during infliximab therapy for rheumatoid arthritis. J Rheumatol 31(10):2079–2081PubMed

80.

Thomas CW Jr, Weinshenker BG, Sandborn WJ (2004) Demyelination during anti-tumor necrosis factor alpha therapy with infliximab for Crohn’s disease. Inflamm Bowel Dis 10(1):28–31CrossRefPubMed

81.

Vadikolias K, Kouklakis G, Heliopoulos I, Argyropoulou P, Papanas N, Tzilonidou M et al (2007) Acute paraplegia after the initiation of anti-tumour necrosis factor-alpha therapy for Crohn’s disease. Eur J Gastroenterol Hepatol 19(2):159–162CrossRefPubMed

82.

Cay HF, Gungor HA, Sezer I, Kacar C, Balci N (2006) Adverse effect of TNF-alpha blocker? Demyelination in an ankylosing spondylitis patient: a case report. J Clin Pharm Ther 31(6):645–648CrossRefPubMed

83.

Jarand J, Zochodne DW, Martin LO, Voll C (2006) Neurological complications of infliximab. J Rheumatol 33(5):1018–1020PubMed

84.

Tanno M, Nakamura I, Kobayashi S, Kurihara K, Ito K (2006) New-onset demyelination induced by infliximab therapy in two rheumatoid arthritis patients. Clin Rheumatol 25(6):929–933CrossRefPubMed

85.

Winkelmann A, Patejdl R, Wagner S, Benecke R, Zettl UK (2008) Cerebral MRI lesions and anti-tumor necrosis factor-alpha therapy. J Neurol 255(Suppl 6):109–114CrossRefPubMed

86.

Fromont A, De Seze J, Fleury MC, Maillefert JF, Moreau T (2009) Inflammatory demyelinating events following treatment with anti-tumor necrosis factor. Cytokine 45(2):55–57CrossRefPubMed

87.

Freeman HJ, Flak B (2005) Demyelination-like syndrome in Crohn’s disease after infliximab therapy. Can J Gastroenterol 19(5):313–316PubMed

88.

Hooper DR, Tarnopolsky MA, Baker SK (2008) Lewis-Sumner syndrome associated with infliximab therapy in rheumatoid arthritis. Muscle Nerve 38(4):1318–1325CrossRefPubMed

89.

Tektonidou MG, Serelis J, Skopouli FN (2007) Peripheral neuropathy in two patients with rheumatoid arthritis receiving infliximab treatment. Clin Rheumatol 26(2):258–260CrossRefPubMed

90.

Sukal SA, Nadiminti L, Granstein RD (2006) Etanercept and demyelinating disease in a patient with psoriasis. J Am Acad Dermatol 54(1):160–164CrossRefPubMed

91.

Berthelot CN, George SJ, Hsu S (2005) Distal lower extremity paresthesia and foot drop developing during adalimumab therapy. J Am Acad Dermatol 53(5 Suppl 1):S260–S262CrossRefPubMed

92.

Cocito D, Bergamasco B, Tavella A, Poglio F, Paolasso I, Costa PC et al (2005) Multifocal motor neuropathy during treatment with infliximab. J Peripher Nerv Syst 10(4):386–387CrossRefPubMed

93.

Rodriguez-Escalera C, Belzunegui J, Lopez-Dominguez L, Gonzalez C, Figueroa M (2005) Multifocal motor neuropathy with conduction block in a patient with rheumatoid arthritis on infliximab therapy. Rheumatology (Oxford) 44(1):132–133CrossRef

94.

Singer OC, Otto B, Steinmetz H, Ziemann U (2004) Acute neuropathy with multiple conduction blocks after TNF alpha monoclonal antibody therapy. Neurology 63(9):1754PubMed

95.

Jarrett SJ, Cunnane G, Conaghan PG, Bingham SJ, Buch MH, Quinn MA et al (2003) Anti-tumor necrosis factor-alpha therapy-induced vasculitis: case series. J Rheumatol 30(10):2287–2291PubMed

96.

FDA Arthritis Advisory Committee Briefing Document (2003) Efficacy and safety review: infliximab. FDA

97.

Schiff MH, Burmester GR, Kent JD, Pangan AL, Kupper H, Fitzpatrick SB et al (2006) Safety analyses of adalimumab (HUMIRA) in global clinical trials and US postmarketing surveillance of patients with rheumatoid arthritis. Ann Rheum Dis 65:889–894CrossRefPubMed

98.

Khanna D, McMahon M, Furst DE (2004) Safety of tumour necrosis factor-alpha antagonists. Drug Saf 27(5):307–324CrossRefPubMed

99.

Midgard R, Grønning M, Riise T, Kvåle G, Nyland H (1996) Multiple sclerosis and chronic inflammatory diseases. A case-control study. Acta Neurol Scand 93(5):322–328CrossRefPubMed

100.

Nielsen NM, Frisch M, Rostgaard K, Wohlfahrt J, Hjalgrim H, Koch-Henriksen N et al (2008) Autoimmune diseases in patients with multiple sclerosis and their first-degree relatives: a nationwide cohort study in Denmark. Mult Scler 14(6):823–829CrossRefPubMed

101.

Sadovnick AD, Armstrong H, Rice GP, Bulman D, Hashimoto L, Paty DW et al (1993) A population-based study of multiple sclerosis in twins: update. Ann Neurol 33(3):281–285CrossRefPubMed

Titel: Neurological adverse events associated with anti-tumor necrosis factor alpha treatment
verfasst von: Antonio G. Tristano
Publikationsdatum: 01.09.2010
Verlag: Springer-Verlag
Erschienen in: Journal of Neurology / Ausgabe 9/2010
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-010-5591-7

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Neurologie

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Frühe Alzheimertherapie lohnt sich

25.04.2024 AAN-Jahrestagung 2024 Nachrichten

Ist die Tau-Last noch gering, scheint der Vorteil von Lecanemab besonders groß zu sein. Und beginnen Erkrankte verzögert mit der Behandlung, erreichen sie nicht mehr die kognitive Leistung wie bei einem früheren Start. Darauf deuten neue Analysen der Phase-3-Studie Clarity AD.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 9/2010

Communications of the European Neurological Society

Bernhard Pollack (1865–1928)

Paraoxonase 1 (PON1) polymorphisms and risk for migraine

Facioscapulohumeral muscular dystrophy: a prospective study of weakness and functional impairment

Advances in multiple sclerosis research in 2009