Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Multiple sclerosis (MS) patients initiating IFN beta-1a, Avonex, therapy (Group 1, n = 30) or experiencing side effects after 6 months on therapy (Group 2, n = 30) were randomized for 5 weeks open label adjunct therapy to naproxen (Aleve), acetaminophen (Tylenol) or ibuprofen (Advil). Our hypothesis was that non-prescription pain medications are effective in decreasing or alleviating the side effects associated with IFN beta-1a therapy. Contrary to the hypothesis, most patients in both groups continued to report side effects on all pain medications. After 5 weeks, headache, fever, chills and injection site pain were low in < or = 50% of patients. Moderate to significant fatigue, muscle or joint pain continued in most patients. As a quality of life measure, the Modified Fatigue Impact Scale (mFIS) improved for Group 1 on naproxen or ibuprofen with greatest improvement in physical subset (P = 0.002 for naproxen and P<0.01 for ibuprofen). Total mFIS for Group 1 on acetaminophen improved (P = 0.04) due to improved cognitive subset rather than physical subset. Group 2, with side effects initially, reported less significant fatigue (severity 5-10) but more moderate fatigue (severity 2-4) at study end for all three medications. All medications improved cognitive subset (P = 0.05). Physical mFIS subset did not improve for Group 2 on acetaminophen, but did with naproxen (P = 0.05) or ibuprofen (P = 0.03). Naproxen and ibuprofen were more effective than acetaminophen in minimizing physical side effects of IFN beta-1a. None of the three pain medications tested were as effective as hypothesized for minimizing fatigue or muscle and joint pain.
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PMID:A randomized open label study of pain medications (naproxen, acetaminophen and ibuprofen) for controlling side effects during initiation of IFN beta-1a therapy and during its ongoing use for relapsing-remitting multiple sclerosis. 1558 88

There is much evidence of the importance of the preclinical phase of multiple sclerosis (MS). However, apart from a recent report of the incidental discovery of a case of primary progressive MS, there are no data on the sequential magnetic resonance imaging (MRI) follow-up of patients before the clinical phase. We report the incidental discovery of white matter changes on MRI and their follow-up in a patient three years before the first neurological event (optic neuritis). A 34-year-old woman presented with headaches and depression after her young daughter had been involved in a car accident and spent two weeks in intensive care. The woman's general practitioner performed a brain MRI, which revealed multiple T2-weighted hypersignals suggesting MS. During the next three years, clinical examination remained normal but we observed new T2 lesions and/or new enhanced T1 lesions after gadolinium infusion on the four successive MRIs. Thirty-seven months after the first MRI, the patient developed a right optic neuritis. The diagnosis of MS was made according to space and time dissemination on MRI criteria. We proposed a treatment with Interferon Beta 1a (Avonex).
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PMID:Sequential magnetic resonance imaging follow-up of multiple sclerosis before the clinical phase. 1604 20

The ITEM study group was organised in Italy to evaluate the effectiveness and safety of interferon-beta (IFNbeta) and glatiramer acetate (GA) in multiple sclerosis (MS) patients treated before 16 years of age. Eighty-six patients (58 females) were included in our database: as subjects with pre- and treatment duration <3 months were excluded, the data of 81 subjects were analysed: 51 were treated with IFNbeta-1a 6 million once weekly (Avonex), 19 with IFNbeta three times weekly (16 with Rebif, 3 with Betaferon) and 11 with GA (Copaxone). The mean age at onset was 12.4 (SD 2.4) years and the mean pre-treatment duration was 19.7 (SD 25.5) months. After a treatment duration of 36.1 (SD 24.2) months, the mean annualised relapse rate decreased from 2.8 (SD 2.6) to 0.5 (SD 0.7). The EDSS score remained unchanged (basal=1.4, final=1,4). Clinical side effects were recorded in 46 subjects of the IFNB group, transient in 35 (flu-like syndrome in 24, headache in 12, myalgia in 10, injection reaction in 5, fever in 3) and persistent in 11 (headache in 5, fever in 4, flu-like syndrome in 3, myalgia in 3, injection reaction in 1). In the GA-treated group, side effects were recorded in 3 cases: injection reaction in 2 and transient chest pain in 1. Abnormal laboratory findings (mainly reduction of WBC) were observed in 24 subjects (transient in 22). Nine subjects treated with Avonex discontinued the treatment: 7 shifted to Rebif, 2 stopped the therapy. Four subjects treated with INFbeta three times weekly shifted to other medications and 2 increased the dose. Four subjects treated with GA discontinued the treatment: 3 shifted to other medications and 1 stopped GA because of injection reaction. On the whole, 3 cases stopped the treatment definitively. To conclude 81, clinically definite MS subjects were treated during childhood or adolescence with immunomodulatory drugs. The treatment was generally well tolerated. It reduced the relapse rate and the progression of the disease in most cases.
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PMID:Immunomodulatory treatment of early onset multiple sclerosis: results of an Italian Co-operative Study. 1638 55

The objective was to evaluate the safety, tolerability and effectiveness of intramuscular (IM) interferon beta-1a (IFNbeta-1a; Avonex, Biogen) 30 mg once a week in patients with onset of symptoms of multiple sclerosis (MS) in childhood or adolescence. Patients with a diagnosis of definite MS according to McDonald's criteria, relapsing course according to Lublin's criteria, onset of symptoms of MS before 16 years of age, and who had received IM IFNbeta-1a therapy before 16 years of age were eligible for the study if they had a pretreatment and treatment duration of at least 6 months. Clinical and laboratory evaluations were performed every 3 months. A total of 52 patients were identified as receiving treatment with IM IFNbeta-1a 30 mg once a week before 16 years of age. Mean age at onset of symptoms of MS was 11.7+/-2.7 years, mean disease duration was 25.9+/-30.3 months, mean annualised relapse rate was 1.9+/-1.1 and mean Expanded Disability Status Scale (EDSS) score was 1.5+/-1.1. After a mean (+/-SD) treatment duration of 42.9+/-19.9 months, annualised relapse rate decreased to 0.4+/-0.5. Final EDSS score was 1.3+/-1.1. Adverse events were recorded for 35 (67%) patients (flulike syndrome, 33%; headache, 29%; myalgia, 21%; fever, 11%; fatigue, 6%; nausea and vomiting, 6%; and skin reaction, 4%); most were transient. IM IFNbeta-1a was effective and well tolerated in these paediatric patients with MS.
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PMID:Treatment of early-onset multiple sclerosis with intramuscular interferonbeta-1a: long-term results. 1760 63