Digest

Abstract News New DH report on mental health promotion The Department of Health has published an economic evaluation of the benefits of mental health promotion and preventing mental illness ( www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_126386.pdf ). Edited by Professor Martin Knapp and colleagues from the London School of Economics and Political Science, with contributions from researchers based largely in the south east of England, the 43‐page report summarises the financial burden and cost effectiveness of interventions to tackle a range of mental health issues in the home, school and workplace. It concludes that many interventions offer outstanding value for money and several are cost‐saving, though the pay‐off period can be several years. Safinamide helps worst cases of dyskinesia in PD Merck‐Serono's investigational compound safinamide failed to show significant benefit on the primary endpoint in a two‐year placebo‐controlled trial to evaluate its efficacy against dyskinesia in patients with Parkinson's disease. However, a post hoc analysis presented at the American Academy of Neurology (AAN) Annual Meeting showed that, compared with placebo, safinamide 100mg daily added to levo dopa improved dyskinesia scores in the worst affected patients but not overall. Laquinimod improves outcomes in MS The AAN meeting also heard that laquinimod, a once‐daily oral immunomodulator that reduces demyelination and axonal damage, improves outcomes for people with relapsing‐remitting multiple sclerosis (MS). Announcing the results of the ALLEGRO study, a two‐year Phase III trial involving 1106 patients, manu facturer Teva said laquinimod reduced the annualised relapse rate by 23 per cent and disability progression by 36 per cent. Treatment was also associated with a 33 per cent reduction in progression of brain atrophy. Dimethyl fumarate reduces relapse rate in MS Biogen has announced that monotherapy with its oral antiinflammatory agent dimethyl fumarate (340mg twice or three times daily) reduced relapse rate and rate of disability progression compared with placebo in the two‐year DEFINE Phase III trial in patients with relapsing‐remitting MS. A comparative trial against glatiramer acetate is now underway. Fingolimod launched in the UK Fingolimod (Gilenya) is now available in the UK for the treatment of adults with highly active relapsing‐remitting multiple sclerosis despite treatment with beta‐interferon and for rapidly evolving severe (RES) relapsing‐remitting multiple sclerosis. The recommended dosage is 0.5mg orally once daily. A month's treatment costs £1470. Perampanel reduces seizures Adjunctive treatment with the glutamate antagonist perampanel significantly reduces seizures in patients with refractory epilepsy, the AAN meeting heard. A 19week trial in 387 people with seizures despite treatment with one to three antiepileptic drugs showed that perampanel 8 or 12mg daily reduced seizure frequency over a 28‐day period by 6 and 14 per cent respectively compared with placebo. Adverse effects included dizziness, drowsiness, irritability, headache, falls and ataxia. Latrepirdine disappoints in Huntington's disease Disappointing results from the Phase III HORIZON trial, involving 403 patients with Huntington's disease, show that the novel compound latrepirdine (Dimebon) does not improve cognitive function or global function. Pfizer and Medivation have now discontinued development for this indication but are continuing a trial in patients with mild to moderate Alzheimer's disease. New guideline for diabetic neuropathy The AAN has published a new evidence‐based guideline on the treatment of painful diabetic neuro pathy ( Neurology 2011;76: published online April 11. doi:10.1212/WNL.0b013e3182166ebe). It recommends pregabalin as first‐line therapy, with weaker evidence for venlafaxine, duloxetine, amitriptyline, gabapentin, valproate, opioids (morphine sulfate, tramadol, and oxycodone controlled‐release) and capsaicin. However, the AAN notes that adverse effects limit the usefulness of treatment and there is insufficient information about the impact of treatment functioning and quality of life. Antiepileptic retigabine launched The antiepileptic drug retigabine (Trobalt) has been launched in the UK for the adjunctive treatment of adults with partial‐onset seizures. Retigabine is the first in a new class that targets neuronal potassium channels, which are involved in inhibitory mechanisms in the brain, and are thought to have a role in seizure control. The efficacy and safety of retigabine was demonstrated in two trials: RESTORE 1 and 2 (Retigabine Efficacy and Safety Trials for Partial Onset Epilepsy), which included treatment‐resistant patients. Neurodigest: a new event for primary and community healthcare professionals Neurodigest, run in association with the Primary Care Neurology Society and the Community Therapist's Network, is a new event for those with a general interest in neurology but who are finding it increasingly difficult to keep up with the latest guidelines, literature and research. The event will feature key developments and advances in neurology that are likely to impact on practice as well as providing a chance to network with like‐minded professionals from primary and community healthcare. Neurodigest 2011 will be held on 17 November at The Banqueting Suite, Birmingham. For more information about the line up of speakers and the headline areas covered in this year's inaugural event, visit www.neurodigest.co.uk . The conference organisers, Innervate Limited, are offering readers of Progress a 5 per cent discount. If you are interested in registering for this event at the discounted rate, please enter the promotional code PGS05. New parliamentary group report on mental health A new report from the All‐Party Parliamentary Group on Mental Health (APPGMH), Implementation of NICE Guideline on Schizophrenia , supported by Janssen and written and researched by the Institute of Psychiatry, highlights key areas in which Mental Health Trusts are struggling to achieve best practice. Mental Health Trusts in England were surveyed about the treatment of schizophrenia (68 per cent response rate) and based on the findings, the APPGMH has called for the following: Assurance to be provided to Trusts about the nature of mental health funding in light of the new commissioning arrangements for mental health. Increased clarity regarding the best way to implement psychological therapies. Guidelines to rectify the reported inconsistencies in the procedures for the monitoring of medication adherence. More research on the role of cannabis in both the onset of serious mental illness and in relapse.The report also reveals a number of differences across the country in the provision of NHS services for people with schizophrenia. Copyright © 2011 Wiley Interface Ltd