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The American Stroke Association (ASA) has published updated recommendations for stroke care systems (Stroke. 2019;50:00-00). The recommendations comprehensively review evidence evaluating stroke care systems and update previous ASA recommendations based upon advances in stroke care systems. Among such advances are stroke center certifications, remarkable improvement in endovascular therapy, neurocritical care, telestroke, mobile stroke units, and other innovations. All of this has occurred while the landscape of health care in the US has undergone large changes. The statement addresses...
Treatment with ubrogepant (Allergan, Madison, NJ) resulted in similar magnitudes of pain relief for participants who had triptan-nonreponsive migraine (n ~1,000), triptan-responsive migraine, or who were naïve to triptan treatment. Individuals in the triptan-nonresponsive group included primarily people for whom triptans had been ineffective (~80%), with some having intolerability to triptans (~17%) and a few having contraindications (~3%). Treatment-emergent adverse events were not serious and were also similar amongst the 3 groups and those who took placebo. In the ACHIEVE II...
Results from multiple trials of SMN1gene-replacement therapy (Zolgensma; Avexis, Bannockburn, IL) show promise for single-dose treatment of spinal muscular atrophy (SMA). In the STRIVE phase 3 study for treatment of spinal muscular atrophy, 22 infants under age 6 months, diagnosed genetically (biallelic SMN1 mutations/deletions, 2 SMN2 copies), were treated. Of the 15 babies treated more than 13.6 months or who discontinued the study before then, 13 (87%) survived without needing permanent ventilation, in contrast to the 25-50% survival rate for children with SMA when untreated....
Gordon H. Baltuch, MD, PhD
Michelle L. Dougherty, MD, FAAN
Katharine Nicholson, MD