Hospital de la Santa Creu i Sant Pau

Less than four months after the European Medicines Agency recommended in July not to grant marketing authorisation for Leqembi™ (lecanemab) for the treatment of Alzheimer's disease, the EMA's Committee for Medicinal Products for Human Use (CHMP) has reassessed the available evidence to conclude that the benefits outweigh the risks.

Rituximab and ocrelizumab are two antibodies with a similar mechanism of action that are used in the treatment of multiple sclerosis. Although the former had not shown benefits in primary progressive multiple sclerosis — which affects between 10% and 15% of patients — the latter is approved for this form of the disease. Now, a study conducted in France with more than 1,000 patients has found no benefits with either treatment, as they did not slow the progression of disability in these individuals. The results are published in the journal Neurology.

An international team of researchers has conducted a meta-analysis of 137 clinical trials involving nearly 90,000 people to assess the migraine efficacy of 17 available drugs. Their conclusions are that four drugs in the triptan group are more effective and cheaper than newer drugs such as gepants or lasmiditan, and that the efficacy of the latter is comparable to that of paracetamol and most anti-inflammatory drugs. The results are published in The BMJ.

Vision loss and having high cholesterol - the so-called ‘bad’ cholesterol - are risk factors for developing dementia, according to a meta-analysis published in The Lancet. Eliminating these risk factors could reduce dementia cases by 2% and 7% respectively, the study says. Both factors are in addition to 12 others previously mentioned in a 2020 report such as less education, physical inactivity, hearing loss, excessive alcohol consumption, obesity or poor social contact, among others. According to the research, almost half of all dementia cases could be prevented or delayed if these risk factors were controlled.

A family of more than 1,000 members with origins in Colombia has a mutation called "paisa" that leads to the development of Alzheimer's disease. In 2019, an added mutation in the apoE gene called "Christchurch" was described as conferring strong protection to an individual carrying two copies of it. Now, a study has found that 27 family members carry a single copy and that it is also associated with some degree of protection. According to the authors, who publish their findings in the journal NEJM, the discovery could be used to develop new treatments for the disease. 

The number of patients who suffered harm associated with medical procedures, treatments and contact with healthcare systems increased by 59% worldwide between 1990 and 2019, according to a study published in the journal BMJ Quality & Safety. This is higher than the population growth of 45 % over the same time period. Older people suffer the most adverse effects, with the main increase occurring in those aged 65-69 years.  

Researchers have found specific antibodies in the blood of patients years before they showed symptoms of multiple sclerosis. This group of antibodies was present in 10% of the 250 people who later developed the disease, and were part of a sample of over 10 million US military personnel. The finding could have potential for early detection of multiple sclerosis, says the research team in a paper published in Nature Medicine. 

An antibody therapy is able to restore the immune system of elderly mice to a more youthful state. The method, published in the journal Nature, rebalances blood cell production and reduces age-related immune decline. Preclinical and clinical studies are needed to determine whether this approach could be feasible in humans. 
 

A study has analysed more than 100 environmental factors and their impact on the immune response. After studying about a thousand volunteers, its conclusions are that smoking is the factor that causes the most alterations in defences. While some changes are transient, others may remain for years after quitting. The results are published in the journal Nature.

An international team, involving researchers from Hospital Clínic-IDIBAPS and the Multiple Sclerosis Centre of Catalonia (Cemcat), has identified for the first time a genetic variant related to the progression of multiple sclerosis. It is located near two genes that had not previously been linked to multiple sclerosis. According to Stephen Sawcer, co-lead author of the study, "understanding how the variant exerts its effects on the severity of multiple sclerosis will pave the way for a new generation of treatments that can prevent disease progression". The results are published in the journal Nature.