Giacomo Lus

Researcher of Neurology

Name Giacomo
Surname Lus
Institution Università degli Studi della Campania Luigi Vanvitelli
Address II Division of Neurology & Center fo Rare Diseases Department of Medical Surgical, Neurological, Metabolic Sciences, and Aging, University of Campania Luigi Vanvitelli, Edificio 10 Via Sergio Pansini, 580131 Naples, Italy
Giacomo Lus


  • Epstein Barr virus infection reactivation as a possible trigger of primary biliary cirrhosis-like syndrome in a patient with multiple sclerosis in the course of fingolimod treatment.

    Publication Date: 01/12/2014 on Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive
    by Marrone A, Signoriello E, Alfieri G, Dalla Mora L, Rinaldi L, Rainone I, Adinolfi LE, Lus G

    Primary biliary cirrhosis (PBC) and multiple sclerosis (MS) are considered autoimmune diseases with a multifactorial aetiology which is thought to be due to a combination of genetic predisposition and environmental triggers. An association of both diseases has been previously described in sporadic case reports. Fingolimod, an antagonist of the sphingosine 1 phosphate receptor family (S1P1/3/4/5), is a promising and effective drug in the treatment of MS. Here we describe a case of PBC like syndrome that was unmasked, concomitantly or consequently to Epstein Barr virus (EBV) infection reactivation, in a 34 year old male patient with relapsing remitting multiple sclerosis who was receiving fingolimod treatment.

  • Natalizumab treatment in multiple sclerosis patients: a multicenter experience in clinical practice in Italy.

    Publication Date: 01/04/2014 on International journal of immunopathology and pharmacology
    by Totaro R, Lugaresi A, Bellantonio P, Danni M, Costantino G, Gasperini C, Florio C, Pucci E, Maddestra M, Spitaleri D, Lus G, Ardito B, Farina D, Rossi M, Di Carmine C, Altobelli E, Maccarone B, Casalena A, De Luca G, Travaglini D, Di Ioia M, Di Tommaso V, Fantozzi R, Ruggieri S, Provinciali L, De Riso S, Mundi C, Fuiani A, Galgani S, Ruggieri S, Maniscalco GT, Giuliani G, Cartechini E, Petretta V, Fratta M, Alfieri G, Gatto M, Carolei A,
    DOI: 10.1177/039463201402700201

    We evaluated efficacy of natalizumab in relapsing-remitting multiple sclerosis patients in a clinical practice setting. We report data on the first consecutive 343 patients receiving natalizumab in 12 multiple sclerosis (MS) Italian centers enrolled between April 2007 and November 2010. The main efficacy endpoints were the proportion of patients free from relapses, disease progression, combined clinical activity, defined as presence of relapse or disease progression, from MRI activity, and from any disease activity defined as the absence of any single or combined activity. At the end of follow-up, the cumulative proportion of patients free from relapses was 68%; the proportion of patients free from Expanded Disability Status Scale (EDSS) progression was 93%; the proportion of patients free from combined clinical activity was 65%; the proportion of patients free from MRI activity was 77%; and the proportion of patients free from any disease activity was 53%. Natalizumab was effective in reducing clinical and neuroradiological disease activity. Its effectiveness in clinical practice is higher than that reported in pivotal trials and was maintained over time.

  • Endovascular treatment of CCSVI in patients with multiple sclerosis: clinical outcome of 462 cases.

    Publication Date: 01/09/2013 on Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
    by Ghezzi A, Annovazzi P, Cocco E, Coarelli G, Lugaresi A, Rovaris M, Patti F, Capello E, Rodegher ME, Moiola L, Malucchi S, Salemi G, De Rossi N, Provinciali L, Perini P, Bergamaschi R, Scarpini E, Lus G, Gallo A, Tola MR, Amato MP, Rottoli MR, Bianchi A, Comi G,
    DOI: 10.1007/s10072-013-1300-5

    Although it is still debated whether chronic cerebro-spinal venous insufficiency (CCSVI) plays a role in multiple sclerosis (MS) development, many patients underwent endovascular treatment (ET) of CCSVI. The objective of the study is to evaluate the outcome and safety of ET in Italian MS patients. Italian MS centers that are part of the Italian MS Study Group were all invited to participate to this retrospective study. A structured questionnaire was used to collect detailed clinical data before and after the ET. Data from 462 patients were collected in 33 centers. ET consisted of balloon dilatation (93 % of cases) or stent application. The mean follow-up duration after ET was 31 weeks. Mean EDSS remained unchanged after ET (5.2 vs. 4.9), 144 relapses occurred in 98/462 cases (21 %), mainly in RR-MS patients. Fifteen severe adverse events were recorded in 3.2 % of cases. Given the risk of severe adverse events and the lack of objective beneficial effects, our findings confirm that at present ET should not be recommended to patients with MS.

  • Natalizumab in pediatric multiple sclerosis: results of a cohort of 55 cases.

    Publication Date: 01/07/2013 on Multiple sclerosis (Houndmills, Basingstoke, England)
    by Ghezzi A, Pozzilli C, Grimaldi LM, Moiola L, Brescia-Morra V, Lugaresi A, Lus G, Rinaldi F, Rocca MA, Trojano M, Bianchi A, Comi G, Filippi M,
    DOI: 10.1177/1352458512471878

    Limited information is available on the use of natalizumab (NA) in pediatric multiple sclerosis (ped-MS) patients.

  • Fluctuations of MS births and UV-light exposure.

    Publication Date: 01/05/2013 on Acta neurologica Scandinavica
    by Verheul F, Smolders J, Trojano M, Lepore V, Zwanikken C, Amato MP, Grand'maison F, Butzkueven H, Marrosu M, Duquette P, Comi G, Izquierdo G, Grammond P, Lus G, Petersen T, Bergamaschi R, Giuliani G, Boz C, Coniglio G, Van Pesch V, Lechner-Scott J, Cavalla P, Granella F, Avolio C, Fiol M, Poehlau D, Saladino ML, Gallo P, Deri N, Oleschko Arruda W, Paine M, Ferro M, Barnett M, Cabrera-Gomez JA, Slee M, Moore F, Shaw C, Petkovska-Boskova T, Rutherford M, Engelsen O, Damoiseaux J, Hupperts R
    DOI: 10.1111/ane.12007

    Patients with multiple sclerosis (MS) are more frequently born in spring when compared to autumn. Fluctuation of UV-light has been hypothesized to drive this phenomenon.

  • Natalizumab is effective in multiple sclerosis patients switching from other disease modifying therapies in clinical practice.

    Publication Date: 01/04/2013 on Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
    by Lanzillo R, Bonavita S, Quarantelli M, Vacca G, Lus G, Amato L, Carotenuto A, Tedeschi G, Orefice G, Brescia Morra V
    DOI: 10.1007/s10072-012-1088-8

    Natalizumab is one option for multiple sclerosis patients responding poorly to classical immunomodulators, but pilot studies did not point to its effectiveness as a second-line therapy. Aim of this study was to assess the efficacy of natalizumab as second-line therapy in patients switching from disease modifying therapies (DMTs) in a clinical setting. We retrospectively selected patients who had been treated with natalizumab for at least 12 months after switching from one or more DMTs. We collected clinical and neuroradiological data and we analysed the reduction in annualised relapse rate (ARR), the change of Expanded Disability Status Scale (EDSS) and the reduction of contrast-enhancing lesions (CELs) at magnetic resonance imaging (MRI) of the brain at 12 months of natalizumab and of previous DMT therapy. Fifty patients were included in the analysis (11 males, 39 females).We observed a reduction of ARR on natalizumab (p = 0.000) and a statistically significant different trend of relapse event between the two treatments (p = 0.0149). EDSS was stable during natalizumab therapy whilst it showed an increase on DMTs (p = 0.0244). The number of CELs decreased significantly (p = 0.006) during the 12 months of treatment with natalizumab, whilst it was stable on DMTs. Natalizumab showed to decrease ARR, stabilize EDSS, increase the percentage of CELs free patients and decrease the number of CELs in a group of 50 poor responders to classical DMT, after the first 12 months of therapy.

  • Natalizumab vs interferon beta 1a in relapsing-remitting multiple sclerosis: a head-to-head retrospective study.

    Publication Date: 01/11/2012 on Acta neurologica Scandinavica
    by Lanzillo R, Quarantelli M, Bonavita S, Ventrella G, Lus G, Vacca G, Prinster A, Orefice G, Tedeschi G, Brescia Morra V
    DOI: 10.1111/j.1600-0404.2011.01622.x

    No head-to-head study has been performed yet to assess whether natalizumab is more effective than classical immunomodulators in multiple sclerosis (MS).

  • Atorvastatin combined to interferon to verify the efficacy (ACTIVE) in relapsing-remitting active multiple sclerosis patients: a longitudinal controlled trial of combination therapy.

    Publication Date: 01/04/2010 on Multiple sclerosis (Houndmills, Basingstoke, England)
    by Lanzillo R, Orefice G, Quarantelli M, Rinaldi C, Prinster A, Ventrella G, Spitaleri D, Lus G, Vacca G, Carotenuto B, Salvatore E, Brunetti A, Tedeschi G, Brescia Morra V
    DOI: 10.1177/1352458509358909

    A large body of evidence suggests that, besides their cholesterol-lowering effect, statins exert anti-inflammatory action. Consequently, statins may have therapeutic potential in immune-mediated disorders such as multiple sclerosis. Our objectives were to determine safety, tolerability and efficacy of low-dose atorvastatin plus high-dose interferon beta-1a in multiple sclerosis patients responding poorly to interferon beta-1a alone. Relapsing-remitting multiple sclerosis patients, aged 18-50 years, with contrast-enhanced lesions or relapses while on therapy with interferon beta-1a 44 microg (three times weekly) for 12 months, were randomized to combination therapy (interferon + atorvastatin 20 mg per day; group A) or interferon alone (group B) for 24 months. Patients underwent blood analysis and clinical assessment with the Expanded Disability Status Scale every 3 months, and brain gadolinium-enhanced magnetic resonance imaging at screening, and 12 and 24 months thereafter. Primary outcome measure was contrast-enhanced lesion number. Secondary outcome measures were number of relapses, EDSS variation and safety laboratory data. Forty-five patients were randomized to group A (n = 21) or B (n = 24). At 24 months, group A had significantly fewer contrast-enhanced lesions versus baseline (p = 0.007) and significantly fewer relapses versus the two pre-randomization years (p < 0.001). At survival analysis, the risk for a 1-point EDSS increase was slightly higher in group B than in group A (p = 0.053). Low-dose atorvastatin may be beneficial, as add-on therapy, in poor responders to high-dose interferon beta-1a alone.

  • Post-marketing of disease modifying drugs in multiple sclerosis: an exploratory analysis of gender effect in interferon beta treatment.

    Publication Date: 15/11/2009 on Journal of the neurological sciences
    by Trojano M, Pellegrini F, Paolicelli D, Fuiani A, Zimatore GB, Tortorella C, Simone IL, Patti F, Ghezzi A, Portaccio E, Rossi P, Pozzilli C, Salemi G, Lugaresi A, Bergamaschi R, Millefiorini E, Clerico M, Lus G, Vianello M, Avolio C, Cavalla P, Iaffaldano P, Direnzo V, D'Onghia M, Lepore V, Livrea P, Comi G, Amato MP,
    DOI: 10.1016/j.jns.2009.06.036

    There are a few and conflicting results from randomised controlled trials (RCTs) pertaining to the influence of gender in response to currently used disease modifying drugs in Multiple Sclerosis (MS). Observational studies may be especially valuable for answering effectiveness questions in subgroups not studied in RCTs.

  • Real-life impact of early interferon beta therapy in relapsing multiple sclerosis.

    Publication Date: 01/10/2009 on Annals of neurology
    by Trojano M, Pellegrini F, Paolicelli D, Fuiani A, Zimatore GB, Tortorella C, Simone IL, Patti F, Ghezzi A, Zipoli V, Rossi P, Pozzilli C, Salemi G, Lugaresi A, Bergamaschi R, Millefiorini E, Clerico M, Lus G, Vianello M, Avolio C, Cavalla P, Lepore V, Livrea P, Comi G, Amato MP,
    DOI: 10.1002/ana.21757

    Recent findings support greater efficacy of early vs. delayed interferon beta (IFNbeta) treatment in patients with a first clinical event suggestive of multiple sclerosis (MS). We aimed to evaluate the effectiveness of early IFNbeta treatment in definite relapsing-remitting MS (RRMS) and to assess the optimal time to initiate IFNbeta treatment with regard to the greatest benefits on disability progression.