Michael R. Page, PharmD, RPh

In patients with chronic HBV, the immune system may have very low levels of the virus. When reactivation occurs due to immunosuppression, these viruses begin to replicate again. Common symptoms of this event include inflammation of the liver and elevations of liver enzyme levels in the blood. In some cases, bilirubin levels may rise in response to reactivation of infection.

Lemtrada (alemtuzumab) injection is approved for the management of relapsing forms of multiple sclerosis (MS). In general, use of Lemtrada should be limited to patients with MS who have not had therapeutic success with 2 or more prior treatments.

For the first time, an oral therapy has been proved to reduce the risk of developing clinically definite multiple sclerosis in patients with a clinically isolated syndrome.

Increased salt intake may magnify the risk of relapses in patients with multiple sclerosis (MS). According to researchers, excess dietary sodium intake is associated with a higher level of disease activity in patients with relapsing-remitting MS.

In April 2010, Provenge became the first dendritic cell vaccine in cancer treatment to be approved by the US Food and Drug Administration, and the agent is now used in the treatment of metastatic castration-resistant prostate cancer. Insights gleaned from this research are now being applied in the study of a potential vaccine for multiple sclerosis treatment and prevention.

In a study published in the journal Clinical Chemistry and Laboratory Medicine, investigators identified uric acid as a potential biomarker in the progression of multiple sclerosis disability.

Although multiple sclerosis is likely a result of multifactorial influences, there is some evidence that viruses play a role in the disease.

Patients with multiple sclerosis (MS) often seek information from the Internet. Researchers in Italy interviewed 3 focus groups of patients with MS and 3 focus groups of family members of patients with MS to determine how physicians might improve access to the right type of information.

Although 10 disease-modifying agents are available for patients with relapsing-remitting multiple sclerosis (RRMS), and more than 20 years have elapsed since the approval in the United States of the first traditional injectable agents for RRMS, until 2012 only 6 large head-to-head trials had evaluated these treatments directly.

Last year, Copaxone received US Food and Drug Administration (FDA) approval for a new 40-mg/mL subcutaneous injection used 3 times weekly, allowing for less frequent administration of the medication than the original 20-mg/mL daily subcutaneous injection.

Recent drug approvals and continuing breakthroughs in research are creating additional treatment options for patients with hepatitis C.

Treatment for hepatitis C should be offered to the sickest patients first, according to updated guidelines from the Infectious Diseases Society of America and the American Association for the Study of Liver Diseases.

In 2 recent studies, statins and aspirin have been associated with lower rates of progression of liver fibrosis in patients with hepatitis C.

Although some meta-analyses have called into question the efficacy of antiviral treatment, the Centers for Disease Control recommends empirical use of antiviral medications patients with symptoms suggestive of influenza.

Fumaric acid esters (FAEs) are a known component of a centuries-old herbal medicine, have been used for over 50 years as a topical treatment for psoriasis, and most recently, have demonstrated efficacy in treating relapsing- remitting multiple sclerosis.

Psoriatic arthritis may be difficult to distinguish from other types of arthritis. According to results of a new study, assessing a patient's sense of balance and hearing ability may be an aid in the diagnosis.

Opexa Therapeutics is initiating a phase IIb trial of a novel therapy that targets T-cells in patients with secondary progressive multiple sclerosis.

Isotretinoin, a treatment for severe acne, has been linked to inflammatory bowel disease (IBD) in some case reports and 1 study. To investigate whether isotretinoin can induce IBD, French researchers conducted a 2-year nationwide registry study.

Researchers in the United Kingdom have shown a reduction in the rate of brain atrophy progression with use of 80-mg simvastatin daily in patients with secondary-progressive multiple sclerosis over a 2-year period.

Of the 3 to 4 million Americans with chronic HCV infection, only 13% to 18% have received treatment. Understanding the current guidelines in HCV treatment and understanding the current role of direct-acting antiviral agents is an important priority for clinicians.

With the approval of several new therapies in hepatitis C, by late 2013, the 2011 hepatitis C treatment guidelines were well out of date. A multidisciplinary group of infectious disease specialists and hepatology specialists have changed that with a website offering treatment guideline updates at unprecedented speed.

Bristol-Myers Squibb's investigational combination of daclatasvir and asunaprevir for type-1b hepatitis C virus infection has received breakthrough therapy designation by the FDA.

In addition to its recognized anti-inflammatory effects, dimethyl fumarate also produces antioxidative effects that may be neuroprotective.

Combination therapy using daclatasvir and sofosbuvir has attained a sustained viral response 12 weeks after the end of treatment (SVR12) in more than 90% of patients with hepatitis C, regardless of prior treatment.