1/30/2025-In this AANEM podcast, Dr. Stino interviews Dr. Allen on the groundbreaking ADHERE study, published in Lancet Neurology in 2024, which investigated efgartigimod for treating Chronic Inflammatory Demyelinating Polyneuropathy (CIDP). As the largest CIDP trial to date with 322 patients across 146 sites, it marked the first major study of a targeted biologic therapy in CIDP. The trial featured a unique two-stage design: an open-label response phase followed by a randomized controlled phase for responders. Dr. Allen explains the rationale behind targeting IgG in CIDP, despite its less clear antibody-mediated mechanism compared to myasthenia gravis. The study demonstrated a 66-70% response rate in the open-label phase, with significantly lower relapse rates compared to placebo in the randomized phase. This research represents a significant advancement in CIDP treatment options, offering a weekly subcutaneous administration that could reduce treatment burden compared to traditional therapies. 31 min.
1/15/2025- In this AANEM podcast, Dr. Andrés De León interviews neuromuscular pathology experts Dr. Aziz Shaibani and Dr. Marcus Pinto about the current state and value of muscle and nerve biopsies in clinical practice. The discussion covers essential topics including proper indications for biopsies, technical considerations in choosing biopsy sites, staining techniques, and the impact of advancing genetic testing on diagnostic approaches. Dr. Shaibani emphasizes that while genetic testing has reduced some muscle biopsy indications, biopsies remain crucial for certain conditions like inflammatory myopathies and mitochondrial disorders. Dr. Pinto details specific scenarios where nerve biopsies are invaluable, particularly in diagnosing vasculitic neuropathy and amyloidosis. Both experts share insights on the complementary role of muscle and nerve biopsies in conditions like systemic vasculitis and discuss how modern diagnostic tools like myositis antibody testing and genetic panels are changing but not eliminating the need for tissue diagnosis. 33 min.
12/15/2024- In this AANEM podcast, Carrie Ford, a CNCT and R.NCS.T. from the University of Utah's Jack Petajan EMG Lab, interviews Dr. Kyle Mahoney, an associate professor at the University of Utah, who provides a comprehensive explanation of neuromuscular junction transmission and the critical concept of the "safety factor." He breaks down complex neurophysiological concepts using accessible analogies, explaining how the safety factor serves as a built-in buffer that ensures reliable nerve-to-muscle signal transmission. The discussion covers normal neuromuscular junction function, the impact of various pathological conditions such as Lambert-Eaton Myasthenic Syndrome, myasthenia gravis, and ALS on neuromuscular transmission, and the clinical significance of repetitive nerve stimulation testing. Dr. Mahoney's clear explanations make these technically challenging concepts more approachable for healthcare professionals, particularly EMG technicians who may be less familiar with the underlying mechanisms of neuromuscular transmission. 24 min.
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