18 results on '"Susana Liwacki"'
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2. Aggressive multiple sclerosis in Argentina: Data from the nationwide registry RelevarEM
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Fatima Pagani Cassara, Verónica Tkachuk, María C. Ysrraelit, Patricio Blaya, Santiago Tizio, Andrés Barboza, Alejandro Caride, Matías Kohler, Gustavo Jose, Jimena Miguez, Jorge Blanche, Luciana Lazaro, Cecilia Pita, Liliana Patrucco, María. L. Doldan, Vladimiro Sinay, Guido Vazquez, Lorena M. Cabrera, Gabriel Volman, Judith Steinberg, Felisa Leguizamon, Ruben Manzi, María Laura Menichini, Jorge Correale, Gustavo Sgrilli, Eduardo Knorre, Emanuel Silva, Marcos Burgos, María I. Gaitán, Edgardo Reich, Carlos Vrech, Raúl Piedrabuena, Ivan Martos, Mariano Marrodan, Maria Laura Saladino, Adriana Carrá, Leila Cohen, Juan Pablo Viglione, Amelia Alvez Pinheiro, Norma Deri, Nora Fernández Liguori, Santiago Bestoso, Marina Alonso Serena, Juan Pablo Pettinicchi, Mariano Coppola, Edgardo Cristiano, Ricardo Alonso, Fernando Caceres, Alejandra D. Martinez, Agustín Pappolla, Maria E. Fracaro, Geraldine Luetic, Dario Tavolini, Carolina Mainella, Marcela Parada Marcilla, Laura Negrotto, Luciano Recchia, Juan Ignacio Rojas, María Eugenia Balbuena, Pablo Divi, Orlando Garcea, María Celeste Curbelo, Berenice Silva, Miguel Jacobo, Eduardo Kohler, Gisela Zanga, Edgar Carnero Contentti, Susana Liwacki, Pablo A. López, Marcela Fiol, Diego Giunta, Javier Pablo Hryb, and Pedro Nofal
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Adult ,Male ,medicine.medical_specialty ,Multiple Sclerosis ,Adolescent ,Population ,Argentina ,Continuous variable ,03 medical and health sciences ,0302 clinical medicine ,Physiology (medical) ,Internal medicine ,medicine ,Humans ,Registries ,Symptom onset ,education ,education.field_of_study ,business.industry ,Multiple sclerosis ,General Medicine ,Middle Aged ,Stepwise regression ,medicine.disease ,Magnetic Resonance Imaging ,Neurology ,030220 oncology & carcinogenesis ,Baseline characteristics ,Radiological weapon ,Cohort ,Disease Progression ,Female ,Surgery ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
The objectives of the present study were to describe the frequency of aggressive multiple sclerosis (aMS) as well as to compare clinical and radiological characteristics in aMS and non-aMS patients included in RelevarEM (NCT03375177).The eligible study population and cohort selection included adult-onset patients (≥18 years) with definite MS. AMS were defined as those reaching confirmed EDSS ≥ 6 within 5 years from symptom onset. Confirmation was achieved when a subsequent EDSS ≥ 6 was recorded at least six months later but within 5 years of the first clinical presentation. AMS and non-aMS were compared using the χ2 test for categorical and the Mann-Whitney for continuous variables at MS onset and multivariable analysis was performed using forward stepwise logistic regression with baseline characteristics at disease onset.A total of 2158 patients with MS were included: 74 aMS and 2084 non-aMS. The prevalence of aMS in our cohort was 3.4% (95%CI 2.7-4.2). AMS were more likely to be male (p = 0.003), older at MS onset (p 0.001), have primary progressive MS (PPMS) phenotype (p = 0.03), multifocal presentation (p 0.001), and spinal cord as well as infratentorial lesions at MRI during disease onset (p = 0.004 and p = 0.002, respectively).3.4% of our patient population could be considered aMS. Men, patients older at symptom onset, multifocal presentation, PPMS phenotype, and spinal cord as well as brainstem lesions on MRI at clinical presentation all had higher odds of having aMS.
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- 2021
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3. Guías de práctica para indicación y contraindicaciones de vacunación de pacientes con esclerosis múltiple
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Fatima Pagani Cassara, María C. Ysrraelit, Santiago Tizio, Alejandra D. Martinez, Dario Tavolini, Carolina Mainella, Geraldine Luetic, Laura Negrotto, Miguel Jacobo, Edgardo Cristiano, Ricardo Alonso, Liliana Patrucco, Marcela Parada Marcilla, Judith Steinberg, Roberto Rotta Escalante, Berenice Silva, Javier Pablo Hryb, Andrés Barboza, Jimena Miguez, Juan Ignacio Rojas, Santiago Bestoso, Norma Deri, Pablo López, Susana Liwacki, Vladimiro Sinay, Gisela Zanga, Lorena M. Cabrera, María Laura Menichini, Edgar Carnero Contentti, Carlos Vrech, Raúl Piedrabuena, Celia Pérez, María I. Gaitán, and Verónica Tkachuk
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03 medical and health sciences ,0302 clinical medicine ,Neurology ,030212 general & internal medicine ,Neurology (clinical) ,030217 neurology & neurosurgery - Abstract
Resumen Introduccion La esclerosis multiple es una enfermedad con componente autoinmune, y un numero significativo de pacientes se encuentra bajo tratamiento inmunomodulador e inmunosupresor. Frecuentemente los medicos tratantes se preguntan si la vacunacion podra tener un impacto en el desarrollo de la enfermedad, y si existen indicaciones o contraindicaciones para la vacunacion de acuerdo a las terapias indicadas. Objetivo Elaborar una guia de referencia sobre indicaciones y contraindicaciones de vacunacion para neurologos que participan en el manejo de pacientes con esclerosis multiple con o sin terapias modificadoras de la enfermedad. Desarrollo Se conformo un equipo de elaboracion de las guias entre los miembros del Grupo de Trabajo de Enfermedades Desmielinizantes de la Sociedad Neurologica Argentina (SNA). La metodologia implementada fue de acuerdo a recomendaciones establecidas por la SNA, basadas en evidencia, con clasificacion de la misma y elaboracion de las recomendaciones segun el formato GRADE. Conclusiones Se detallan las vacunas disponibles en Argentina, el impacto potencial que podrian tener en el curso de la enfermedad, las indicaciones de vacunacion previas al inicio de cada tratamiento y las contraindicaciones para cada vacuna de acuerdo a la terapia indicada.
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- 2021
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4. Disability outcomes in NMOSD and MOGAD patients: data from a nationwide registry in Argentina
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Juan I. Rojas, Agustín Pappolla, Liliana Patrucco, Edgardo Cristiano, Jimena Miguez, Susana Liwacki, Verónica Tkachuk, María E. Balbuena, Carlos Vrech, Norma Deri, Jorge Correale, Mariano Marrodan, María C. Ysrraelit, Marcela Fiol, Felisa Leguizamon, Geraldine Luetic, María L. Menichini, Pablo A. Lopez, Juan Pablo Pettinicchi, Juan Criniti, Alejandro Caride, Darío Tavolini, Carolina Mainella, Gisela Zanga, Marcos Burgos, Javier Hryb, Andrés Barboza, Luciana Lazaro, Ricardo Alonso, Berenice Silva, Nora Fernández Liguori, Débora Nadur, Aníbal Chercoff, Alejandra Martinez, Judith Steinberg, Orlando Garcea, Adriana Carrá, Marina Alonso Serena, and Edgar Carnero Contentti
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Psychiatry and Mental health ,Neurology (clinical) ,Dermatology ,General Medicine - Abstract
The objective was to evaluate time to reach an EDSS of 4, 6, and 7 in NMOSD and MOGAD patients included in the Argentinean MS and NMOSD registry (RelevarEM, NCT 03,375,177).NMOSD patients diagnosed according to 2015 criteria and with MOGAD were identified. Patients with at least 3 years of follow-up and periodic clinical evaluations with EDSS outcomes were included. AQP4-antibody and MOG-antibody status was recorded, and patients were stratified as seropositive and seronegative for AQP4-antibody. EDSS of 4, 6, and 7 were defined as dependent variables. Log rank test was used to identify differences between groups.Registry data was provided for a total of 137 patients. Of these, seventy-five presented AQP4-ab-positive NMOSD, 45 AQP4-ab-negative NMOSD, and 11 MOGAD. AQP4-ab status was determined by cell-based assay (CBA) in 72% of NMOSD patients. MOG-ab status was tested by CBA in all cases. Mean time to EDSS of 4 was 53.6 ± 24.5 vs. 63.1 ± 32.2 vs. 44.7 ± 32 months in seropositive, seronegative NMOSD, and MOGAD, respectively (p = 0.76). Mean time to EDSS of 6 was 79.2 ± 44.3 vs. 75.7 ± 48.6 vs. 54.7 ± 50 months in seropositive, seronegative NMOSD, and MOGAD (p = 0.23), while mean time to EDSS of 7 was 86.8 ± 54 vs. 80.4 ± 51 vs. 58.5 ± 47 months in seropositive, seronegative NMOSD, and MOGAD (p = 0.39).No differences were observed between NMOSD (seropositive and seronegative) and MOGAD in survival curves.
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- 2022
5. Achieving no evidence of disease activity-3 in highly active multiple sclerosis patients treated with cladribine and monoclonal antibodies
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Ricardo Alonso, Magdalena Casas, Luciana Lazaro, Nora Fernandez Liguori, Cecilia Pita, Leila Cohen, Juan Ignacio Rojas, Agustín Pappolla, Liliana Patrucco, Edgardo Cristiano, Marcos Burgos, Carlos Vrech, Raul Piedrabuena, Lopez Pablo, Norma Deri, Geraldine Luetic, Jimena Miguez, Mariela Cabrera, Alejandra Martinez, Gisela Zanga, Verónica Tkachuk, Santiago Tizio, Edgar Carnero Contentti, Eduardo Knorre, Felisa Leguizamon, Carolina Mainella, Pedro Nofal, Susana Liwacki, Javier Hryb, Maria Menichini, Claudia Pestchanker, Marina Alonso, Orlando Garcea, and Berenice Silva
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Cellular and Molecular Neuroscience ,Neurology (clinical) - Abstract
Background We aimed to determine the proportion of highly active multiple sclerosis patients under high-efficacy therapies (HETs) achieve no evidence of disease activity-3 (NEDA-3) at 1 and 2 years, and to identify factors associated with failing to meet no evidence of disease activity 3 at 2 years. Methods This retrospective cohort study based on Argentina Multiple Sclerosis patient registry (RelevarEM), includes highly active multiple sclerosis patients who received HETs. Results In total, 254 (78.51%) achieved NEDA-3 at year 1 and 220 (68.12%) achieved NEDA-3 at year 2. Patients who achieved NEDA-3 at 2 years had a shorter duration of multiple sclerosis ( p Conclusion We found a high proportion of patients who achieved NEDA-3 at 1 and 2 years. Early high-efficacy strategy patients had a higher probability of achieving NEDA-3 at 2 years.
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- 2023
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6. Incidence of COVID-19 after vaccination in people with multiple sclerosis in Argentina: Data from the nationwide registry RelevarEM
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Juan I, Rojas, Geraldine G, Luetic, Carlos, Vrech, Agustín, Pappolla, Liliana, Patrucco, Edgardo, Cristiano, Mariano, Marrodan, María C, Ysrraelit, Marcela, Fiol, Jorge, Correale, Leila, Cohen, Ricardo, Alonso, Berenice, Silva, Magdalena, Casas, Orlando, Garcea, Norma, Deri, Marcos, Burgos, Susana, Liwacki, Verónica, Tkachuk, Andres, Barboza, Raúl, Piedrabuena, Patricio, Blaya, Judith, Steinberg, Alejandra, Martínez, Adriana, Carra, Darío, Tavolini, Pablo, López, Eduardo, Knorre, Pedro, Nofal, Edgar, Carnero Contentti, Amelia, Alves Pinheiro, Felisa, Leguizamon, Emanuel, Silva, Javier, Hryb, María Eugenia, Balbuena, Gisela, Zanga, Matías, Kohler, Luciana, Lazaro, Santiago, Tizio, Carolina, Mainella, Jorge, Blanche, Marcela, Parada Marcilla, María Eugenia, Fracaro, María Laura, Menichini, Gustavo, Sgrilli, Pablo, Divi, Miguel, Jacobo, Mariela, Cabrera, Jimena, Míguez, Nora, Fernandez Liguori, Juan Pablo, Viglione, Debora, Nadur, Marina, Alonso Serena, and Sebastián, Nuñez
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Neurology ,Neurology (clinical) ,General Medicine - Abstract
The objective of the study was to evaluate the incidence of COVID-19 after complete vaccination in people with multiple sclerosis (PwMS) included in the Argentinean MS and NMOSD registry (RelevarEM, NCT03375177).cohort study conducted between May 2021 and December 2021. The primary outcome was the appearance of infection during the follow-up time (at least three months after complete vaccination (second dose)). Data was collected through the contact between the treating physician and the patient. Specific information was requested (date, symptoms, need for hospitalization, ventilatory assistance, treatment, and evolution). The contact was made every 30 days during the period of 3 months after the full dose vaccination. A positive COVID-19 case was defined according to the definition established by the Ministry of Health in Argentina. Cumulative incidence was reported by Kaplan Meier survival curves as well as incidence density.A total of 576 PwMS were included, mean age 45.2 ± 13 years, 432 (75%) RRMS, 403 (70%) were female. The mean and median time of follow-up after the second dose was 91 ± 17 and 94 ± 21 days respectively. Most frequent first and second dose received was Astra-Zeneca vaccine, followed by Sputnik V vaccine. During follow-up a total of twenty COVID-19 cases were observed for a total exposure time of 39,557 days. The overall cumulative incidence for the observed period was 3.4% (SE 0.4%) with an overall incidence density of 5 × 10.000 patients/day (95%CI 0.7-12). We observed more cases in woman than men with an incidence density of 6 × 10.000 patients/day (95%CI 0.9-9) vs. 3 × 10.000 patients/day (95%CI 0.2-6) respectively, but not significantly different (IRR 1.7 95% CI 0.56-7.37 p = 0.15).we found an incidence density of breakthrough COVID-19 infection of 5 × 10.000 patients/day (95%CI 0.7-12) after vaccination in Argentina.
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- 2022
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7. Ofatumumab versus Teriflunomide in Multiple Sclerosis
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Hauser S. L., Bar-Or A., Cohen J. A., Comi G., Correale J., Coyle P. K., Cross A. H., de Seze J., Leppert D., Montalban X., Selmaj K., Wiendl H., Kerloeguen C., Willi R., Li B., Kakarieka A., Tomic D., Goodyear A., Pingili R., Haring D. A., Ramanathan K., Merschhemke M., Kappos L., Stephen L Hauser, Ludwig Kappos, Amit Bar-Or, Jeffrey A Cohen, Giancarlo Comi, Jorge Correale, Patricia K Coyle, Anne Cross, Jerome de Seze, Xavier Montalban, Krzysztof Selmaj, Heinz Wiendl, Stephen C Reingold, Garry R Cutter, Thomas Doerner, Hans-Peter Hartung, Per Soelberg Sørensen, Israel Steiner, Jerry S Wolinsky, Carlos Ballario, Christian Calvo Vildoso, Jorge Gustavo Jose, Norma Haydee Deri, Susana Liwacki, Jeannette Lechner-Scott, John Parratt, Suzanne Hodgkinson, Eva-Maria Maida, Fritz Leutmezer, Barbara Willekens, Bart Van Wijmeersch, Guy Laureys, Jo Caekebeke, Karine Geens, Ludo Vanopdenbosch, Olivier Deryck, Valerie Delvaux, Vincent Van Pesch, Ivan Milanov, Ivaylo Tarnev, Lyubomir Haralanov, Maria Manova Slavova, Penko Shotekov, Francois Emond, Francois Grandmaison, Francois Jacques, Liesly Lee, Marie Sarah Gagne Brosseau, Mark Freedman, Martin Cloutier, Robert Carruthers, Sarah Morrow, Yves Lapierre, Anton Vladic, Hana Bokun, Igor Antoncic, Marija Bosnjak Pasic, Mario Habek, Silva Butkovic Soldo, Vladimira Vuletic, Alena Martinkova, Eva Meluzinova, Ivana Stetkarova, Jan Mares, Jolana Markova, Marta Vachova, Martin Valis, Michaela Tyblova, Michal Dufek, Ondrej Skoda, Pavel Hradilek, Ana Voldsgaard Jensen, Helle Hvilsted Nielsen, Kristina Svendsen, Mads Ravnborg, Peter Vestergaard Rasmussen, Katrin Gross-Paju, Sulev Haldre, Juha Pekka Eralinna, Marja-Liisa Sumelahti, Bruno Brochet, Celine Louapre, Christine Lebrun-Frenay, David Axel Laplaud, Gilles Edan, Giovanni Castelnovo, Marc Debouverie, Patrick Vermersch, Pierre Clavelou, Pierre Labauge, Achim Berthele, Aiden Haghikia, Anselm Kornhuber, Arnfin Bergmann, Benedikt Frank, Birte Elias-Hamp, Bjoern Tackenberg, Brigitte Wildemann, Erik Strauss, Eugen Schlegel, Florian Then Bergh, Gereon Nelles, Hayrettin Tumani, Karl-Otto Sigel, Martin Stangel, Matthias Boehringer, Olaf Martin Hoffmann, Patrick Oschmann, Reinhard Hohlfeld, Silke Walter, Sylvia Menck, Till Sprenger, Tjalf Ziemssen, Veit Ulrich Becker, Vera Straeten, Konstantinos Kilidireas, Konstantinos Voumvourakis, Nikolaos Fakas, Nikolaos Grigoriadis, Agnes Koves, Csilla Rozsa, Krisztina Kovacs, Laszlo Vecsei, Satori Maria, Zita Biro, Anshu Rohatgi, Dheeraj Khurana, Jeyaraj Durai Pandian, Joy Dev Mukherji, Lekha Pandit, Meena Angamuthu Kanikannan, Pahari Ghosh, Rahul Chakor, Rahul Kulkarni, Roopkumar Gursahani, Sangeeta Ravat, Srinivasa Rangasetty, Suresh Kumar, Alla Shifrin, Arnon Karni, Radi Shahien, Ron Milo, Antonio Uccelli, Carlo Pozzilli, Francesco Sacca, Giacomo Lus, Girolama Alessandra Marfia, Laura Brambilla, Marco Salvetti, Massimo Filippi, Mauro Zaffaroni, Paolo Gallo, Silvia Rossi, Simona Bonavita, Valeria Studer, Andrejs Millers, Guntis Karelis, Jolanta Kalnina, Dalia Mickeviciene, Rasa Kizlaitiene, Angelica Carbajal Ramirez, Juan Jose Lopez Prieto, Beatrijs Wokke, Bob W Van Oosten, Peter Van Domburg, Raymond Hupperts, Rogier Q Hintzen, Astrid Edland, Cesar Castaneda, Julio Perez, Martin Gavidia, Andrzej Wiak, Bartosz Karaszewski, Elzbieta Jasinska, Halina Bartosik Psujek, Iwona Jastrzebska, Jaroslaw Slawek, Maciej Maciejowski, Miroslaw Dziki, Monika Adamczyk Sowa, Robert Bonek, Waldemar Fryze, Ana Martins Da Silva, Angela Timoteo, Antonio Vasco Salgado, Carlos Capela, Carlos Veira, Filipe Correia, Joao Cerqueira, Joao De Sa, Livia De Sousa, Raquel Gouveia, Alina Sergeevna Agafina, Anna Naumovna Belova, Denis Viktorovich Sazonov, Dmitry Pokhabov, Ekaterina Igorevna Kairbekova, Elena Gennadievna Arefieva, Farit Axatovich Khabirov, Igor Vyacheslavovich Litvinenko, Igor Stolyarov, Irina Aleksandrovna Sokolova, Larisa Ivanovna Volkova, Maria Vafaevna Davydovskaya, Maria Nikolaevna Zaharova, Nadezhda Alekseevna Malkova, Natalia Agafonovna Totolyan, Nikolay Vasilievich Dorogov, Stella Anatolievna Sivertseva, Egon Kurca, Georgi Krastev, Miroslav Brozman, Peter Koleda, Peter Turcani, Peter Valkovic, Viera Hancinova, Vladimir Donath, Chris Retief, Michael Isaacs, Albert Saiz Hinarejos, Alfredo Rodriguez Antigüedad, Bonaventura Casanova Estruch, Celia Oreja-Guevara, Gemma Reig Rosello, Jose Carlos Alvarez Cermeño, Jose Martinez Rodriguez, Jose Meca Lallana, Juan Antonio Garcia Merino, Lucia Forero Diaz, Lucienne Costa Frossard Franca, Luis Querol Gutierrez, Lluis Ramio Torrenta, Pedro Serrano Castro, Rafael Arroyo Gonzalez, Sara Eichau Madueño, Sergio Martinez Yelamos, Tamara Castillo Trivino, Virgina Meca Lallana, Xaviere Montalban Gairin, Fredrik Piehl, Jan Lycke, Chiara Zecca, Tobias Derfuss, Thy-Sheng Lin, Somsak Tiamkao, Ayse Nur Yuceyar, Aysun Soysal, Belgin Petek Balci, Cavit Boz, Husnu Efendi, Murat Terzi, Serhan Sevim, Serkan Ozakbas, Andrew Gale, Ben Turner, David Barnes, David Paling, Eli Silber, James Overell, Matthew Craner, Aaron Carlson, Adam Wolff, Adaeze Onuoha, Adnan Subei, Ahmad Ata, Aimee Borazanci, Akram Dastagir, Alberto Vasquez, Alison Brooke Allen, Andrew P Keegan, Angel Carrasco, Angel R Chinea Martinez, Ann Bass, Annette Okai, April Erwin, Ariel Antezana-Antezana, Barbara Green, Bharathy E Sundaram, Bhupendra Khatri, Bhupesh Dihenia, Bogdan Gheorghiu, Brian Costell, Brian Steingo, Bruce L Hughes, Carrie M Hersh, Christopher Laganke, Christopher Luzzio, Corey Ford, Craig Edward Herrman, Craig Senzon, Cynthia Huffman, Daniel R Wynn, David D O Bear, David Lesch, David H Mattson, David Weisman, Deborah A Burke, Dennis W Dietrich, Deren Huang, Derrick Robertson, Djamchid Lotfi, Don Joseph Alfonso, Dusan Stefoski, Edward J Fox, Emily Pharr, Enrique Alvarez, Evanthia Bernitsas, Faria Amjad, Gabriel Pardo, Geoffrey Eubank, Gerald Mcintosh, Giles F Crowell, Hemanth Rao, J Michael Hemphill, Jack H Florin, Jacqueline Nicholas, James Napier, James Scott, Jason M Silversteen, Javier Vasallo, Jean-Raphael Schneider, Jeanette Wendt, Jeffrey Cohen, Jeffrey Gross, Jeffrey Groves, Jeffrey Kaplan, Jessica Stulc, Joanna A Cooper, John Foley, John Scagnelli, Jonathan C Calkwood, Jose Pizarro Otero, Jose Rafecas, Joshua Katz, Juliette S Saad, Katherine Standley, Keith Edwards, Kenneth Sharlin, Khurram Bashir, Kimberly Wagner, Kore Liow, Larry Lee Blankenship Jr, Laszlo Mate, Liliana Montoya, Lon D Lynn, Mark Agius, Mark Cascione, Mark Allan Goldstein, Mark Janicki, Martin R Bialow, Mary Denise Hughes, Matthew J Baker, Michelle Apperson, Michelle B Kuczma, M Mateo Paz Soldan, Mirela Cerghet, Nathaniel Robb Whaley, Paul K Winner, Pavle Repovic, Praful Kelkar, Romero Rekha Pillai, Ricardo Ayala, Richard Sater, Randall Trudell, Robert Fairborn Armstrong, Robert Thomas Nahouraii, Robert Naismith, Ronald S Murray, Samuel Hunter, Sara Qureshi, Sharon Lynch, Sibyl Wray, Silvia R Delgado, Stacy Donlon, Stanley Cohan, Stanya Smith, Stuart James Shafer, Susan Azalone, Susan Hibbs, Tamara A Miller, Thomas Giancarlo, Troy Desai, Varun K Saxena, Virginia Simnad, William David Honeycutt, William Logan, William E McElveen, William Wagner, University of California [San Francisco] (UCSF), University of California, Perelman School of Medicine, University of Pennsylvania [Philadelphia], Cleveland Clinic, IRCCS Ospedale San Raffaele [Milan, Italy], Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia [Buenos Aires] (FLENI), FLENI, Stony Brook University [SUNY] (SBU), State University of New York (SUNY), Washington University School of Medicine in St. Louis, Washington University in Saint Louis (WUSTL), CIC Strasbourg (Centre d’Investigation Clinique Plurithématique (CIC - P) ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Strasbourg (UNISTRA)-Hôpital de Hautepierre [Strasbourg]-Nouvel Hôpital Civil de Strasbourg, University Hospital Basel [Basel], Vall d'Hebron University Hospital [Barcelona], University of Warmia and Mazury [Olsztyn], University of Münster, Novartis Pharma S.A.S., Novartis Pharmaceuticals, University of Basel (Unibas), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), Willekens, Barbara, ASCLEPIOS I and ASCLEPIOS II Trial Groups, Hauser, S. L., Bar-Or, A., Cohen, J. A., Comi, G., Correale, J., Coyle, P. K., Cross, A. H., de Seze, J., Leppert, D., Montalban, X., Selmaj, K., Wiendl, H., Kerloeguen, C., Willi, R., Li, B., Kakarieka, A., Tomic, D., Goodyear, A., Pingili, R., Haring, D. A., Ramanathan, K., Merschhemke, M., Kappos, L., Asclepios, I and ASCLEPIOS II Trial Group, Filippi, M, L Hauser, Stephen, Kappos, Ludwig, Bar-Or, Amit, A Cohen, Jeffrey, Comi, Giancarlo, Correale, Jorge, K Coyle, Patricia, Cross, Anne, de Seze, Jerome, Montalban, Xavier, Selmaj, Krzysztof, Wiendl, Heinz, C Reingold, Stephen, R Cutter, Garry, Doerner, Thoma, Hartung, Hans-Peter, Soelberg Sørensen, Per, Steiner, Israel, S Wolinsky, Jerry, Ballario, Carlo, Calvo Vildoso, Christian, Gustavo Jose, Jorge, Haydee Deri, Norma, Liwacki, Susana, Lechner-Scott, Jeannette, Parratt, John, Hodgkinson, Suzanne, Maida, Eva-Maria, Leutmezer, Fritz, Van Wijmeersch, Bart, Laureys, Guy, Caekebeke, Jo, Geens, Karine, Vanopdenbosch, Ludo, Deryck, Olivier, Delvaux, Valerie, Van Pesch, Vincent, Milanov, Ivan, Tarnev, Ivaylo, Haralanov, Lyubomir, Manova Slavova, Maria, Shotekov, Penko, Emond, Francoi, Grandmaison, Francoi, Jacques, Francoi, Lee, Liesly, Sarah Gagne Brosseau, Marie, Freedman, Mark, Cloutier, Martin, Carruthers, Robert, Morrow, Sarah, Lapierre, Yve, Vladic, Anton, Bokun, Hana, Antoncic, Igor, Bosnjak Pasic, Marija, Habek, Mario, Butkovic Soldo, Silva, Vuletic, Vladimira, Martinkova, Alena, Meluzinova, Eva, Stetkarova, Ivana, Mares, Jan, Markova, Jolana, Vachova, Marta, Valis, Martin, Tyblova, Michaela, Dufek, Michal, Skoda, Ondrej, Hradilek, Pavel, Voldsgaard Jensen, Ana, Hvilsted Nielsen, Helle, Svendsen, Kristina, Ravnborg, Mad, Vestergaard Rasmussen, Peter, Gross-Paju, Katrin, Haldre, Sulev, Pekka Eralinna, Juha, Sumelahti, Marja-Liisa, Brochet, Bruno, Louapre, Celine, Lebrun-Frenay, Christine, Axel Laplaud, David, Edan, Gille, Castelnovo, Giovanni, Debouverie, Marc, Vermersch, Patrick, Clavelou, Pierre, Labauge, Pierre, Berthele, Achim, Haghikia, Aiden, Kornhuber, Anselm, Bergmann, Arnfin, Frank, Benedikt, Elias-Hamp, Birte, Tackenberg, Bjoern, Wildemann, Brigitte, Strauss, Erik, Schlegel, Eugen, Then Bergh, Florian, Nelles, Gereon, Tumani, Hayrettin, Sigel, Karl-Otto, Stangel, Martin, Boehringer, Matthia, Martin Hoffmann, Olaf, Oschmann, Patrick, Hohlfeld, Reinhard, Walter, Silke, Menck, Sylvia, Sprenger, Till, Ziemssen, Tjalf, Ulrich Becker, Veit, Straeten, Vera, Kilidireas, Konstantino, Voumvourakis, Konstantino, Fakas, Nikolao, Grigoriadis, Nikolao, Koves, Agne, Rozsa, Csilla, Kovacs, Krisztina, Vecsei, Laszlo, Maria, Satori, Biro, Zita, Rohatgi, Anshu, Khurana, Dheeraj, Durai Pandian, Jeyaraj, Dev Mukherji, Joy, Pandit, Lekha, Angamuthu Kanikannan, Meena, Ghosh, Pahari, Chakor, Rahul, Kulkarni, Rahul, Gursahani, Roopkumar, Ravat, Sangeeta, Rangasetty, Srinivasa, Kumar, Suresh, Shifrin, Alla, Karni, Arnon, Shahien, Radi, Milo, Ron, Uccelli, Antonio, Pozzilli, Carlo, Sacca, Francesco, Lus, Giacomo, Alessandra Marfia, Girolama, Brambilla, Laura, Salvetti, Marco, Filippi, Massimo, Zaffaroni, Mauro, Gallo, Paolo, Rossi, Silvia, Bonavita, Simona, Studer, Valeria, Millers, Andrej, Karelis, Gunti, Kalnina, Jolanta, Mickeviciene, Dalia, Kizlaitiene, Rasa, Carbajal Ramirez, Angelica, Jose Lopez Prieto, Juan, Wokke, Beatrij, W Van Oosten, Bob, Van Domburg, Peter, Hupperts, Raymond, Q Hintzen, Rogier, Edland, Astrid, Castaneda, Cesar, Perez, Julio, Gavidia, Martin, Wiak, Andrzej, Karaszewski, Bartosz, Jasinska, Elzbieta, Bartosik Psujek, Halina, Jastrzebska, Iwona, Slawek, Jaroslaw, Maciejowski, Maciej, Dziki, Miroslaw, Adamczyk Sowa, Monika, Bonek, Robert, Fryze, Waldemar, Martins Da Silva, Ana, Timoteo, Angela, Vasco Salgado, Antonio, Capela, Carlo, Veira, Carlo, Correia, Filipe, Cerqueira, Joao, De Sa, Joao, De Sousa, Livia, Gouveia, Raquel, Sergeevna Agafina, Alina, Naumovna Belova, Anna, Viktorovich Sazonov, Deni, Pokhabov, Dmitry, Igorevna Kairbekova, Ekaterina, Gennadievna Arefieva, Elena, Axatovich Khabirov, Farit, Vyacheslavovich Litvinenko, Igor, Stolyarov, Igor, Aleksandrovna Sokolova, Irina, Ivanovna Volkova, Larisa, Vafaevna Davydovskaya, Maria, Nikolaevna Zaharova, Maria, Alekseevna Malkova, Nadezhda, Agafonovna Totolyan, Natalia, Vasilievich Dorogov, Nikolay, Anatolievna Sivertseva, Stella, Kurca, Egon, Krastev, Georgi, Brozman, Miroslav, Koleda, Peter, Turcani, Peter, Valkovic, Peter, Hancinova, Viera, Donath, Vladimir, Retief, Chri, Isaacs, Michael, Saiz Hinarejos, Albert, Rodriguez Antigüedad, Alfredo, Casanova Estruch, Bonaventura, Oreja-Guevara, Celia, Reig Rosello, Gemma, Carlos Alvarez Cermeño, Jose, Martinez Rodriguez, Jose, Meca Lallana, Jose, Antonio Garcia Merino, Juan, Forero Diaz, Lucia, Costa Frossard Franca, Lucienne, Querol Gutierrez, Lui, Ramio Torrenta, Llui, Serrano Castro, Pedro, Arroyo Gonzalez, Rafael, Eichau Madueño, Sara, Martinez Yelamos, Sergio, Castillo Trivino, Tamara, Meca Lallana, Virgina, Montalban Gairin, Xaviere, Piehl, Fredrik, Lycke, Jan, Zecca, Chiara, Derfuss, Tobia, Lin, Thy-Sheng, Tiamkao, Somsak, Nur Yuceyar, Ayse, Soysal, Aysun, Petek Balci, Belgin, Boz, Cavit, Efendi, Husnu, Terzi, Murat, Sevim, Serhan, Ozakbas, Serkan, Gale, Andrew, Turner, Ben, Barnes, David, Paling, David, Silber, Eli, Overell, Jame, Craner, Matthew, Carlson, Aaron, Wolff, Adam, Onuoha, Adaeze, Subei, Adnan, Ata, Ahmad, Borazanci, Aimee, Dastagir, Akram, Vasquez, Alberto, Brooke Allen, Alison, P Keegan, Andrew, Carrasco, Angel, R Chinea Martinez, Angel, Bass, Ann, Okai, Annette, Erwin, April, Antezana-Antezana, Ariel, Green, Barbara, E Sundaram, Bharathy, Khatri, Bhupendra, Dihenia, Bhupesh, Gheorghiu, Bogdan, Costell, Brian, Steingo, Brian, L Hughes, Bruce, M Hersh, Carrie, Laganke, Christopher, Luzzio, Christopher, Ford, Corey, Edward Herrman, Craig, Senzon, Craig, Huffman, Cynthia, R Wynn, Daniel, O Bear, David D, Lesch, David, H Mattson, David, Weisman, David, A Burke, Deborah, W Dietrich, Denni, Huang, Deren, Robertson, Derrick, Lotfi, Djamchid, Joseph Alfonso, Don, Stefoski, Dusan, J Fox, Edward, Pharr, Emily, Alvarez, Enrique, Bernitsas, Evanthia, Amjad, Faria, Pardo, Gabriel, Eubank, Geoffrey, Mcintosh, Gerald, F Crowell, Gile, Rao, Hemanth, Michael Hemphill, J, H Florin, Jack, Nicholas, Jacqueline, Napier, Jame, Scott, Jame, M Silversteen, Jason, Vasallo, Javier, Schneider, Jean-Raphael, Wendt, Jeanette, Cohen, Jeffrey, Gross, Jeffrey, Groves, Jeffrey, Kaplan, Jeffrey, Stulc, Jessica, A Cooper, Joanna, Foley, John, Scagnelli, John, C Calkwood, Jonathan, Pizarro Otero, Jose, Rafecas, Jose, Katz, Joshua, S Saad, Juliette, Standley, Katherine, Edwards, Keith, Sharlin, Kenneth, Bashir, Khurram, Wagner, Kimberly, Liow, Kore, Lee Blankenship Jr, Larry, Mate, Laszlo, Montoya, Liliana, D Lynn, Lon, Agius, Mark, Cascione, Mark, Allan Goldstein, Mark, Janicki, Mark, R Bialow, Martin, Denise Hughes, Mary, J Baker, Matthew, Apperson, Michelle, B Kuczma, Michelle, Mateo Paz Soldan, M, Cerghet, Mirela, Robb Whaley, Nathaniel, K Winner, Paul, Repovic, Pavle, Kelkar, Praful, Rekha Pillai, Romero, Ayala, Ricardo, Sater, Richard, Trudell, Randall, Fairborn Armstrong, Robert, Thomas Nahouraii, Robert, Naismith, Robert, S Murray, Ronald, Hunter, Samuel, Qureshi, Sara, Lynch, Sharon, Wray, Sibyl, R Delgado, Silvia, Donlon, Stacy, Cohan, Stanley, Smith, Stanya, James Shafer, Stuart, Azalone, Susan, Hibbs, Susan, A Miller, Tamara, Giancarlo, Thoma, Desai, Troy, K Saxena, Varun, Simnad, Virginia, David Honeycutt, William, Logan, William, E McElveen, William, Wagner, William, Stephen, L Hauser, Ludwig, Kappo, Amit, Bar-Or, Jeffrey, A Cohen, Giancarlo, Comi, Jorge, Correale, Patricia, K Coyle, Anne, Cro, Jerome de Seze, Xavier, Montalban, Krzysztof, Selmaj, Heinz, Wiendl, Stephen, C Reingold, Garry, R Cutter, Thomas, Doerner, Hans-Peter, Hartung, Per Soelberg Sørensen, Israel, Steiner, Jerry, S Wolinsky, Carlos, Ballario, Christian Calvo Vildoso, Jorge Gustavo Jose, Norma Haydee Deri, Susana, Liwacki, Jeannette, Lechner-Scott, John, Parratt, Suzanne, Hodgkinson, Eva-Maria, Maida, Fritz, Leutmezer, Barbara, Willeken, Bart Van Wijmeersch, Guy, Laurey, Karine, Geen, Ludo, Vanopdenbosch, Olivier, Deryck, Valerie, Delvaux, Vincent Van Pesch, Ivan, Milanov, Ivaylo, Tarnev, Lyubomir, Haralanov, Maria Manova Slavova, Penko, Shotekov, Francois, Emond, Francois, Grandmaison, Francois, Jacque, Liesly, Lee, Marie Sarah Gagne Brosseau, Mark, Freedman, Martin, Cloutier, Robert, Carruther, Sarah, Morrow, Yves, Lapierre, Anton, Vladic, Hana, Bokun, Igor, Antoncic, Marija Bosnjak Pasic, Mario, Habek, Silva Butkovic Soldo, Vladimira, Vuletic, Alena, Martinkova, Eva, Meluzinova, Ivana, Stetkarova, Jan, Mare, Jolana, Markova, Marta, Vachova, Martin, Vali, Michaela, Tyblova, Michal, Dufek, Ondrej, Skoda, Pavel, Hradilek, Ana Voldsgaard Jensen, Helle Hvilsted Nielsen, Kristina, Svendsen, Mads, Ravnborg, Peter Vestergaard Rasmussen, Katrin, Gross-Paju, Sulev, Haldre, Juha Pekka Eralinna, Marja-Liisa, Sumelahti, Bruno, Brochet, Celine, Louapre, Christine, Lebrun-Frenay, David Axel Laplaud, Gilles, Edan, Giovanni, Castelnovo, Marc, Debouverie, Patrick, Vermersch, Pierre, Clavelou, Pierre, Labauge, Achim, Berthele, Aiden, Haghikia, Anselm, Kornhuber, Arnfin, Bergmann, Benedikt, Frank, Birte, Elias-Hamp, Bjoern, Tackenberg, Brigitte, Wildemann, Erik, Strau, Eugen, Schlegel, Florian Then Bergh, Gereon, Nelle, Hayrettin, Tumani, Karl-Otto, Sigel, Martin, Stangel, Matthias, Boehringer, Olaf Martin Hoffmann, Patrick, Oschmann, Reinhard, Hohlfeld, Silke, Walter, Sylvia, Menck, Till, Sprenger, Tjalf, Ziemssen, Veit Ulrich Becker, Vera, Straeten, Konstantinos, Kilidirea, Konstantinos, Voumvouraki, Nikolaos, Faka, Nikolaos, Grigoriadi, Agnes, Kove, Csilla, Rozsa, Krisztina, Kovac, Laszlo, Vecsei, Satori, Maria, Zita, Biro, Anshu, Rohatgi, Dheeraj, Khurana, Jeyaraj Durai Pandian, Joy Dev Mukherji, Lekha, Pandit, Meena Angamuthu Kanikannan, Pahari, Ghosh, Rahul, Chakor, Rahul, Kulkarni, Roopkumar, Gursahani, Sangeeta, Ravat, Srinivasa, Rangasetty, Suresh, Kumar, Alla, Shifrin, Arnon, Karni, Radi, Shahien, Ron, Milo, Antonio, Uccelli, Carlo, Pozzilli, Sacca', Francesco, Giacomo, Lu, Girolama Alessandra Marfia, Laura, Brambilla, Marco, Salvetti, Massimo, Filippi, Mauro, Zaffaroni, Paolo, Gallo, Silvia, Rossi, Simona, Bonavita, Valeria, Studer, Andrejs, Miller, Guntis, Kareli, Jolanta, Kalnina, Dalia, Mickeviciene, Rasa, Kizlaitiene, Angelica Carbajal Ramirez, Juan Jose Lopez Prieto, Beatrijs, Wokke, Bob, W Van Oosten, Peter Van Domburg, Raymond, Huppert, Rogier, Q Hintzen, Astrid, Edland, Cesar, Castaneda, Julio, Perez, Martin, Gavidia, Andrzej, Wiak, Bartosz, Karaszewski, Elzbieta, Jasinska, Halina Bartosik Psujek, Iwona, Jastrzebska, Jaroslaw, Slawek, Maciej, Maciejowski, Miroslaw, Dziki, Monika Adamczyk Sowa, Robert, Bonek, Waldemar, Fryze, Ana Martins Da Silva, Angela, Timoteo, Antonio Vasco Salgado, Carlos, Capela, Carlos, Veira, Filipe, Correia, Joao, Cerqueira, Joao De Sa, Livia De Sousa, Raquel, Gouveia, Alina Sergeevna Agafina, Anna Naumovna Belova, Denis Viktorovich Sazonov, Dmitry, Pokhabov, Ekaterina Igorevna Kairbekova, Elena Gennadievna Arefieva, Farit Axatovich Khabirov, Igor Vyacheslavovich Litvinenko, Igor, Stolyarov, Irina Aleksandrovna Sokolova, Larisa Ivanovna Volkova, Maria Vafaevna Davydovskaya, Maria Nikolaevna Zaharova, Nadezhda Alekseevna Malkova, Natalia Agafonovna Totolyan, Nikolay Vasilievich Dorogov, Stella Anatolievna Sivertseva, Egon, Kurca, Georgi, Krastev, Miroslav, Brozman, Peter, Koleda, Peter, Turcani, Peter, Valkovic, Viera, Hancinova, Vladimir, Donath, Chris, Retief, Michael, Isaac, Albert Saiz Hinarejos, Alfredo Rodriguez Antigüedad, Bonaventura Casanova Estruch, Celia, Oreja-Guevara, Gemma Reig Rosello, Jose Carlos Alvarez Cermeño, Jose Martinez Rodriguez, Jose Meca Lallana, Juan Antonio Garcia Merino, Lucia Forero Diaz, Lucienne Costa Frossard Franca, Luis Querol Gutierrez, Lluis Ramio Torrenta, Pedro Serrano Castro, Rafael Arroyo Gonzalez, Sara Eichau Madueño, Sergio Martinez Yelamos, Tamara Castillo Trivino, Virgina Meca Lallana, Xaviere Montalban Gairin, Fredrik, Piehl, Jan, Lycke, Chiara, Zecca, Tobias, Derfu, Thy-Sheng, Lin, Somsak, Tiamkao, Ayse Nur Yuceyar, Aysun, Soysal, Belgin Petek Balci, Cavit, Boz, Husnu, Efendi, Murat, Terzi, Serhan, Sevim, Serkan, Ozakba, Andrew, Gale, Ben, Turner, David, Barne, David, Paling, Eli, Silber, James, Overell, Matthew, Craner, Aaron, Carlson, Adam, Wolff, Adaeze, Onuoha, Adnan, Subei, Ahmad, Ata, Aimee, Borazanci, Akram, Dastagir, Alberto, Vasquez, Alison Brooke Allen, Andrew, P Keegan, Angel, Carrasco, Angel, R Chinea Martinez, Ann, Ba, Annette, Okai, April, Erwin, Ariel, Antezana-Antezana, Barbara, Green, Bharathy, E Sundaram, Bhupendra, Khatri, Bhupesh, Dihenia, Bogdan, Gheorghiu, Brian, Costell, Brian, Steingo, Bruce, L Hughe, Carrie, M Hersh, Christopher, Laganke, Christopher, Luzzio, Corey, Ford, Craig Edward Herrman, Craig, Senzon, Cynthia, Huffman, Daniel, R Wynn, David D, O Bear, David, Lesch, David, H Mattson, David, Weisman, Deborah, A Burke, Dennis, W Dietrich, Deren, Huang, Derrick, Robertson, Djamchid, Lotfi, Don Joseph Alfonso, Dusan, Stefoski, Edward, J Fox, Emily, Pharr, Enrique, Alvarez, Evanthia, Bernitsa, Faria, Amjad, Gabriel, Pardo, Geoffrey, Eubank, Gerald, Mcintosh, Giles, F Crowell, Hemanth, Rao, J Michael Hemphill, Jack, H Florin, Jacqueline, Nichola, James, Napier, James, Scott, Jason, M Silversteen, Javier, Vasallo, Jean-Raphael, Schneider, Jeanette, Wendt, Jeffrey, Cohen, Jeffrey, Gro, Jeffrey, Grove, Jeffrey, Kaplan, Jessica, Stulc, Joanna, A Cooper, John, Foley, John, Scagnelli, Jonathan, C Calkwood, Jose Pizarro Otero, Jose, Rafeca, Joshua, Katz, Juliette, S Saad, Katherine, Standley, Keith, Edward, Kenneth, Sharlin, Khurram, Bashir, Kimberly, Wagner, Kore, Liow, Larry Lee Blankenship Jr, Laszlo, Mate, Liliana, Montoya, Lon, D Lynn, Mark, Agiu, Mark, Cascione, Mark Allan Goldstein, Mark, Janicki, Martin, R Bialow, Mary Denise Hughes, Matthew, J Baker, Michelle, Apperson, Michelle, B Kuczma, M Mateo Paz Soldan, Mirela, Cerghet, Nathaniel Robb Whaley, Paul, K Winner, Pavle, Repovic, Praful, Kelkar, Romero Rekha Pillai, Ricardo, Ayala, Richard, Sater, Randall, Trudell, Robert Fairborn Armstrong, Robert Thomas Nahouraii, Robert, Naismith, Ronald, S Murray, Samuel, Hunter, Sara, Qureshi, Sharon, Lynch, Sibyl, Wray, Silvia, R Delgado, Stacy, Donlon, Stanley, Cohan, Stanya, Smith, Stuart James Shafer, Susan, Azalone, Susan, Hibb, Tamara, A Miller, Thomas, Giancarlo, Troy, Desai, Varun, K Saxena, Virginia, Simnad, William David Honeycutt, William, Logan, William, E McElveen, William, Wagner, University of California [San Francisco] (UC San Francisco), University of California (UC), University of Pennsylvania, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Nouvel Hôpital Civil de Strasbourg-Hôpital de Hautepierre [Strasbourg], Westfälische Wilhelms-Universität Münster = University of Münster (WWU), Herrada, Anthony, and UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire
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Male ,MESH: Multiple Sclerosis, Relapsing-Remitting ,T-Lymphocytes ,Hydroxybutyrates ,Kaplan-Meier Estimate ,030204 cardiovascular system & hematology ,Pharmacology ,Relapsing-Remitting ,MESH: Magnetic Resonance Imaging ,chemistry.chemical_compound ,0302 clinical medicine ,Teriflunomide ,Monoclonal ,MESH: Double-Blind Method ,030212 general & internal medicine ,Humanized ,MESH: Toluidines ,B-Lymphocytes ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,biology ,Subcutaneous ,B-Lymphocyte ,Brain ,General Medicine ,Magnetic Resonance Imaging ,MESH: Crotonates ,Crotonates ,Pyrimidine metabolism ,Disease Progression ,Female ,MESH: Disease Progression ,Antibody ,Human ,Adult ,Multiple Sclerosis ,Toluidines ,medicine.drug_class ,Injections, Subcutaneous ,Injections, Subcutaneou ,Monoclonal antibody ,Ofatumumab ,Settore MED/26 ,Antibodies, Monoclonal, Humanized ,Crotonate ,Antibodies ,Injections ,03 medical and health sciences ,MESH: Brain ,Multiple Sclerosis, Relapsing-Remitting ,Double-Blind Method ,MESH: B-Lymphocytes ,Nitriles ,medicine ,Humans ,MESH: Kaplan-Meier Estimate ,MESH: Humans ,business.industry ,Multiple sclerosis ,MESH: Injections, Subcutaneous ,MESH: Adult ,medicine.disease ,MESH: Male ,MESH: T-Lymphocytes ,T-Lymphocyte ,Multicenter study ,chemistry ,MESH: Antibodies, Monoclonal, Humanized ,biology.protein ,Human medicine ,business ,MESH: Female ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience; Background: Ofatumumab, a subcutaneous anti-CD20 monoclonal antibody, selectively depletes B cells. Teriflunomide, an oral inhibitor of pyrimidine synthesis, reduces T-cell and B-cell activation. The relative effects of these two drugs in patients with multiple sclerosis are not known.Methods: In two double-blind, double-dummy, phase 3 trials, we randomly assigned patients with relapsing multiple sclerosis to receive subcutaneous ofatumumab (20 mg every 4 weeks after 20-mg loading doses at days 1, 7, and 14) or oral teriflunomide (14 mg daily) for up to 30 months. The primary end point was the annualized relapse rate. Secondary end points included disability worsening confirmed at 3 months or 6 months, disability improvement confirmed at 6 months, the number of gadolinium-enhancing lesions per T1-weighted magnetic resonance imaging (MRI) scan, the annualized rate of new or enlarging lesions on T2-weighted MRI, serum neurofilament light chain levels at month 3, and change in brain volume.Results: Overall, 946 patients were assigned to receive ofatumumab and 936 to receive teriflunomide; the median follow-up was 1.6 years. The annualized relapse rates in the ofatumumab and teriflunomide groups were 0.11 and 0.22, respectively, in trial 1 (difference, -0.11; 95% confidence interval [CI], -0.16 to -0.06; P
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- 2020
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8. Multiple sclerosis and neuromyelitis optica spectrum disorders in Argentina: comparing baseline data from the Argentinean MS Registry (RelevarEM)
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Fatima Pagani Cassara, Celeste Curbelo, María C. Ysrraelit, Ivan Martos, Fernando Caceres, Jimena Miguez, Alejandra D. Martinez, Guido Vazquez, Geraldine Luetic, Nora Fernández Liguori, Patricio Blaya, Juan Pablo Pettinicchi, Felisa Leguizamon, Laura Negrotto, Judith Steinberg, Alejandro Caride, Maria E. Fracaro, Carlos Vrech, Raúl Piedrabuena, Vladimiro Sinay, on behalf RelevarEM investigators, Edgardo Reich, Agustín Pappolla, Leila Cohen, Maria Laura Saladino, María Laura Menichini, María Eugenia Balbuena, Adriana Carrá, Andrés Barboza, Santiago Bestoso, Verónica Tkachuk, Gisela Zanga, Cecilia Pita, Luciana Lazaro, Norma Deri, Matías Kohler, Dario Tavolini, Carolina Mainella, Amelia Alvez Pinheiro, Edgar Carnero Contentti, María. L. Doldan, Edgardo Cristiano, Ricardo Alonso, Marina Alonso Serena, Marcos Burgos, Liliana Patrucco, Marcela Parada Marcilla, Santiago Tizio, Gabriel Volman, Mariano Marrodan, Ruben Manzi, Gustavo Jose, Lorena M. Cabrera, Juan Ignacio Rojas, Jorge Correale, Gustavo Sgrilli, María I. Gaitán, Juan Pablo Viglione, Eduardo Knorre, Jorge Blanche, Susana Liwacki, Pablo A. López, Marcela Fiol, Diego Giunta, Berenice Silva, Pablo Divi, Orlando Garcea, Javier Pablo Hryb, Facundo Silveira, Pedro Nofal, Emanuel Silva, Miguel Jacobo, and Eduardo Kohler
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medicine.medical_specialty ,Neurology ,Neuromyelitis optica ,business.industry ,Multiple sclerosis ,Dermatology ,General Medicine ,medicine.disease ,Comorbidity ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,Internal medicine ,Epidemiology ,Cohort ,medicine ,Spectrum disorder ,030212 general & internal medicine ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Neuroradiology - Abstract
The objective of this study was to describe and compare the baseline epidemiological data of multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) patients included in RelevarEM (Clinical Trials registry number NCT03375177). RelevarEM is a longitudinal, strictly observational MS and NMOSD registry in Argentina. Epidemiological and comorbidity data from MS and NMOSD patients were described and compared. For comorbidities, the Charlson comorbidity index (CCI) was used to calculate the burden at entry. CCI was stratified in 0 and ≥ 1 and described for the entire cohort. A total of 1588 and 75 MS and NMOSD patients (respectively) were included. For MS patients, the mean age was 42 ± 7 years, female sex 65.3%, mean EDSS 2, and mean disease duration 8 ± 6 years. In NMOSD, the mean age was 40 ± 7 years, female sex 78.7%, mean disease duration 5 ± 3.5 years, and mean EDSS 2.5. The most frequent MS phenotype was RRMS in 82.4%. In MS, the CCI was 0 in 85.8.2% while ≥ 1 was in 14.2% of patients. Regarding phenotype stratification, CCI ≥ 1 was 3.9% in CIS, 13.5% in RRMS, 28.7% in SPMS, and 17.4% in PPMS (p
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- 2020
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9. The Argentinean multiple sclerosis registry (RelevarEM): Methodological aspects and directions
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Patricio Blaya, Alejandro Caride, Celeste Curbelo, María Eugenia Balbuena, Alejandra D. Martinez, María. L. Doldan, Geraldine Luetic, Laura Negrotto, Maria E. Fracaro, Felisa Leguizamon, Amelia Alvez Pinheiro, Gisela Zanga, Eduardo Knorre, Marcos Burgos, Carlos Vrech, Miguel Jacobo, María C. Ysrraelit, Marina Alonso Serena, Susana Liwacki, Liliana Patrucco, Adriana Carrá, Mariano Marrodan, Edgar Carnero Contentti, Jimena Miguez, Marcela Parada Marcilla, Juan Ignacio Rojas, Pablo A. López, Berenice Silva, Marcela Fiol, Nora Fernández Liguori, Javier Pablo Hryb, Leila Cohen, Diego Giunta, Guillermo F. De Lio, Pablo Divi, Jorge Correale, Santiago Bestoso, Verónica Tkachuk, Orlando Garcea, Dario Tavolini, Norma Deri, Carolina Mainella, Facundo Silveira, Judith Steinberg, Pedro Nofal, Emanuel Silva, María I. Gaitán, Edgardo Cristiano, Ricardo Alonso, Andrés Barboza, Juan Pablo Pettinicchi, Guido Vazquez, Santiago Tizio, Lorena M. Cabrera, Gabriel Volman, and Ruben Manzi
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medicine.medical_specialty ,Multiple Sclerosis ,Latin Americans ,business.industry ,Multiple sclerosis ,Argentina ,General Medicine ,medicine.disease ,Clinical trial ,03 medical and health sciences ,0302 clinical medicine ,Neurology ,Physicians ,Family medicine ,parasitic diseases ,Epidemiology ,medicine ,Humans ,Longitudinal Studies ,Registries ,030212 general & internal medicine ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
Despite that different registries already exist in various countries in Europe and North America, no ongoing nationwide registry exists in Latin America (LATAM), a region where the disease behaves differently than in other regions. The objective of this document is to describe the methodology behind RelevarEM, the first nationwide MS registry in Argentina and LATAM. METHODS: In this article, we described the creation, implementation and data management of the nationwide MS registry in Argentina. The registry contains information on the structure, ethical aspects, implementation and variables of the registry (Clinical Trials registry number NCT NCT03375177). CONCLUSION: RelevarEM is the first MS nationwide registry in Argentina, as well as in LATAM, with the objective of providing reliable real-world data of MS in the country.
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- 2019
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10. Seasonal variation in attacks of neuromyelitis optica spectrum disorders and multiple sclerosis: Evaluation of 794 attacks from a nationwide registry in Argentina
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Edgar Carnero Contentti, Pablo A. Lopez, Juan Pablo Pettinicchi, Juan Criniti, Agustín Pappolla, Jimena Miguez, Liliana Patrucco, Edgardo Cristiano, Susana Liwacki, Verónica Tkachuk, María E. Balbuena, Carlos Vrech, Norma Deri, Jorge Correale, Mariano Marrodan, María C. Ysrraelit, Felisa Leguizamon, Geraldine Luetic, María L. Menichini, Darío Tavolini, Carolina Mainella, Gisela Zanga, Marcos Burgos, Javier Hryb, Andrés Barboza, Luciana Lazaro, Ricardo Alonso, Nora Fernández Liguori, Débora Nadur, Aníbal Chercoff, Marina Alonso Serena, Alejandro Caride, Friedemann Paul, and Juan I. Rojas
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Multiple Sclerosis ,Neurology ,Neuromyelitis Optica ,Argentina ,Humans ,Female ,Neurology (clinical) ,General Medicine ,Registries ,Seasons ,Retrospective Studies - Abstract
Identification of triggers that potentially instigate attacks in neuromyelitis optica spectrum disorders (NMOSD) and multiple sclerosis (MS) has remained challenging. We aimed to analyze the seasonality of NMOSD and MS attacks in an Argentinean cohort seeking differences between the two disorders.A retrospective study was conducted in a cohort of NMOSD and MS patients followed in specialized centers from Argentina and enrolled in RelevarEM, a nationwide, longitudinal, observational, non-mandatory registry of MS/NMOSD patients. Patients with complete relapse data (date, month and year) at onset and during follow-up were included. Attack counts were analyzed by month using a Poisson regression model with the median monthly attack count used as reference.A total of 551 patients (431 MS and 120 NMOSD), experiencing 236 NMOSD-related attacks and 558 MS-related attacks were enrolled. The mean age at disease onset in NMOSD was 39.5 ± 5.8 vs. 31.2 ± 9.6 years in MS (p 0.01). Mean follow-up time was 6.1 ± 3.0 vs. 7.4 ± 2.4 years (p 0.01), respectively. Most of the included patients were female in both groups (79% vs. 60%, p 0.01). We found a peak of number of attacks in June (NMOSD: 28 attacks (11.8%) vs MS: 33 attacks (5.9%), incidence rate ratio 1.82, 95%CI 1.15-2.12, p = 0.03), but no differences were found across the months in both disorders when evaluated separately. Strikingly, we observed a significant difference in the incidence rate ratio of attacks during the winter season when comparing NMOSD vs. MS (NMOSD: 75 attacks (31.7%) vs MS: 96 attacks (17.2%), incidence rate ratio 1.82, 95%CI 1.21-2.01, p = 0.02) after applying Poisson regression model. Similar results were observed when comparing the seropositive NMOSD (n = 75) subgroup vs. MS.Lack of seasonal variation in MS and NMOSD attacks was observed when evaluated separately. Future epidemiological studies about the effect of different environmental factors on MS and NMOSD attacks should be evaluated prospectively in Latin America population.
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- 2021
11. Accumulative risk of clinical event in high-risk radiologically isolated syndrome in Argentina: data from the nationwide registry RelevarEM
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Liliana Patrucco, Pedro Nofal, Andrés Barboza, Leila Cohen, Dario Tavolini, Carolina Mainella, Juan Ignacio Rojas, Edgardo Cristiano, Ricardo Alonso, Agustín Pappolla, María I. Gaitán, Jorge Correale, Nora Fernández Liguori, María C. Ysrraelit, Susana Liwacki, Marcos Burgos, Verónica Tkachuk, Marcela Fiol, María Laura Menichini, Felisa Lequizamon, Adriana Carrá, Eduardo Knorre, Orlando Garcea, Marina Alonso Serena, Jimena Miguez, Mariano Marrodan, Patricio Blaya, Berenice Silva, Geraldine Luetic, Gisela Zanga, Pablo H.H. Lopez, and Edgar Carnero Contentti
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medicine.medical_specialty ,Neurology ,Multiple Sclerosis ,Proportional hazards model ,Clinical events ,business.industry ,Multiple sclerosis ,Argentina ,medicine.disease ,Predictive value ,Magnetic Resonance Imaging ,Lesion ,Increased risk ,Internal medicine ,medicine ,Disease Progression ,Humans ,Neurology (clinical) ,Registries ,medicine.symptom ,business ,Neuroradiology ,Demyelinating Diseases - Abstract
We aimed to analyze the accumulative risk of MRI and OB factors for evolution from RIS to MS in subjects included in the Argentinean MS registry (NCT03375177). RIS subjects were identified according to RIS diagnosis criteria. Subjects were longitudinally followed with clinical and MRI at intervals of 6 months. Time from RIS identification to the first clinical event was estimated using Kaplan–Meier. Multivariable Cox regression models were created to assess the independent predictive value of demographic characteristics, as well as clinical, OB and MRI data on time to the first clinical event. The single and increased risk factor of evolution of RIS was quantified. A total of 88 RIS subjects, mean follow-up time 42 ± 4 months were included. 39 (44.3%) and 23 (26.1%) had a new MRI lesion or a clinical event, respectively, during the follow-up. OB (HR 5.9, 95% CI 1.29–10.1, p = 0.004), infratentorial lesions (HR 3.7, 95% CI 1.09–7.5) and spinal cord lesions (HR 5.3, 95% CI 1.4–8.2, p = 0.01) at RIS identification were independent predictors associated with a subsequent clinical event. The accumulative risk showed that when two of the three factors (OB, infratentorial or spinal cord lesions) were present the HR was 10.4, 95% CI 4.4–22, p
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- 2021
12. Rebound activity after fingolimod cessation: A case - control study
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María Laura Menichini, Berenice Silva, Cacilia Pita, Nora Fernández Liguori, Geraldine Luetic, Anibal Chertcoff, Raul Pierdabuena, Alfredo Palavecino, Adriana Carrá, Gisela Zanga, Luciano Recchia, Ricardo Alonso, Marcos Burgos, Agustín Pappolla, Gabriela Orzuza, María C. Ysrraelit, Mario Javier Halfon, Susana Liwacki, Jimena Miguez, María I. Gaitán, Carolina Mainella, Emiliano Ruiz, Judith Steinberg, Verónica Tkachuk, Guillermo Zentil, Andrés Barboza, Liliana Patrucco, Santiago Pigretti, and Luciana Lazaro
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medicine.medical_specialty ,Multiple Sclerosis ,Severe disease ,Disease ,Natalizumab ,Multiple Sclerosis, Relapsing-Remitting ,Internal medicine ,Medicine ,Humans ,Prospective Studies ,Retrospective Studies ,business.industry ,Fingolimod Hydrochloride ,Multiple sclerosis ,Case-control study ,General Medicine ,medicine.disease ,Fingolimod ,Discontinuation ,Neurology ,Case-Control Studies ,Neurology (clinical) ,business ,Mri findings ,Immunosuppressive Agents ,medicine.drug - Abstract
Background There has been an increase in the number of reports of multiple sclerosis (MS) rebound activity (RA), which is usually defined as a severe disease reactivation after natalizumab or fingolimod withdrawal that exceeds pre-treatment baseline inflammatory activity. The frequency and risk factors that could predict RA remain unknown. Fingolimod is currently the most frequently prescribed disease modifying therapy for MS in Argentina, so that there is a need to determine possible predictors of RA. Objectives To identify risk factors for developing RA after fingolimod cessation; to describe RA characteristics, management and evolution. Methods The study was a multicenter, retrospective, case-control study of patients with MS who had discontinued fingolimod and were followed up to nine months after discontinuation. Demographic, clinical and paraclinical data was extracted, including age, gender, MS phenotype, reason for discontinuation, number of relapses during the year prior to suspension, time treated with fingolimod, EDSS before, during and after rebound, MRI findings. Results 26 cases of RA were matched 1:1 with patients without RA. The median time elapsed to RA was 50 days. 68% showed worsening of the EDSS in the evaluation at 3 months of RA. When compared with the control group, no difference was found in terms of age, gender, phenotype, EDSS at the moment of suspension, reason for discontinuation, number of relapses in the previous year, and time on therapy. Conclusion In this case-controlled study, no risk factors could be identified to predict RA after fingolimod cessation. Further controlled, prospective, better powered studies are needed to confirm these findings.
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- 2021
13. Clinical and demographic characteristics of male MS patients included in the national registry-RelevarEM. Does sex or phenotype make the difference in the association with poor prognosis?
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Agustín Pappolla, Leila Cohen, Luciana Lazaro, Jorge Blanche, Alejandra N. Martinez, Felisa Leguizamon, Eduardo Knorre, Adriana Carrá, Pedro Nofal, Marcos Burgos, Juan Pablo Pettinicchi, María Eugenia Balbuena, Edgardo Cristiano, Ricardo Alonso, Fatima Pagani Cassara, Dario Tavolini, Carolina Mainela, María C. Ysrraelit, Vladimiro Sinay, Susana Liwacki, Javier Pablo Hryb, Mariano Marrodan, Gustavo Sgrilli, Carlos Vrech, Raúl Piedrabuena, Patricio Blaya, Celeste Curbelo, Marcela Fiol, Pablo Divi, Andrés Barboza, Orlando Garcea, Edgardo Reich, Jimena Miguez, Gabriel Volman, Ruben Manzi, Jorge Correale, María Laura Menichini, Matías Kohler, Norma Deri, Anibal Chertcoff, Magdalena Casas, Geraldine Luetic, Emanuel Silva, Miguel Jacobo, Marina Alonso Serena, Juan Pablo Viglione, Marcela Parada Marcilla, Guido Vazquez, Maria E. Fracaro, Judith Steinberg, Luciano Recchia, Liliana Patrucco, Santiago Bestoso, Berenice Silva, Mariela Cabrera, Debora Nadur, Gisela Zanga, Pablo H.H. Lopez, Amelia Alves Pinheiro, Santiago Tizio, Juan Ignacio Rojas, Edgar Carnero Contentti, Gustavo Jose, Carlos Fernando Martínez, Ivan Martos, Nora Fernández Liguori, Verónica Tkachuk, and Mariano Coppola
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Male ,medicine.medical_specialty ,Multiple Sclerosis ,Disease ,Multiple Sclerosis, Relapsing-Remitting ,Internal medicine ,medicine ,Humans ,Registries ,Association (psychology) ,Demography ,Retrospective Studies ,Expanded Disability Status Scale ,business.industry ,Multiple sclerosis ,Confounding ,General Medicine ,Odds ratio ,Prognosis ,medicine.disease ,Phenotype ,Neurology ,Disease Progression ,Female ,Observational study ,Neurology (clinical) ,business - Abstract
Background : In multiple sclerosis demographics there is a well-known female prevalence and male patients have been less specifically evaluated in clinical studies, though some clinical differences have been reported between sexes. Objective : The objective of this study was to assess clinical and demographic differences between male and female patients included in the national Argentine MS Registry – RelevarEM. Material and methods : This study was observational, retrospective, and was based on the data of 3,099 MS patients included as of 04 April 2021. The statistical analysis plan included bivariate analyses with the crude data and also after adjustment for the MS phenotype, further categorized as progressive-onset MS or relapsing-onset MS. In the adjusted analysis, the Mantel-Haenszel odds ratio was compared to the crude odds ratio, to account for the phenotype as a confounder. Results : The data from 1,074 (34.7%) men and 2,025 (65.3%) women with MS diagnosis were analysed. Males presented primary progressive disease two times more often than women (11% and 5%, respectively). In the crude analyses by sex, the presence of exclusively infratentorial lesions in the magnetic resonance imaging studies was more frequent in males than in females, but after adjustment by MS onset phenotype, such difference was only present in males with relapsing-onset MS (p = 0.00006). Similarly, worse Expanded Disability Status Scale scores were confirmed only in men with relapsing-onset disease after phenotype adjustment (p = 0.02). Conclusion : We did not find any statistically significant clinical or demographic difference between sexes when the progressive or remitting MS phenotype was specifically considered. However, the differences we found between the clinical phenotypes are in line with the literature and highlight the importance of stratifying the analyses by sex and phenotype when designing MS studies.
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- 2022
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14. Assessing attacks and treatment response rates among adult patients with NMOSD and MOGAD: Data from a nationwide registry in Argentina
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Nora Fernández Liguori, Carlos Vrech, María Eugenia Balbuena, María C. Ysrraelit, Susana Liwacki, Jimena Miguez, Juan Pablo Pettinicchi, Dario Tavolini, Carolina Mainella, Agustín Pappolla, Geraldine Luetic, Aníbal Chercoff, Debora Nadur, Juan Criniti, María Laura Menichini, Luciana Lazaro, Andrés Barboza, Pablo López, Friedemann Paul, Marina Alonso Serena, Liliana Patrucco, Javier Pablo Hryb, Ricardo Alonso, Norma Deri, Alejandro Caride, Marcos Burgos, Mariano Marrodan, J. Correale, Verónica Tkachuk, Edgardo Carnero Contentti, Juan Ignacio Rojas, Gisela Zanga, Felisa Leguizamon, and Edgar Carnero Contentti
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Pediatrics ,medicine.medical_specialty ,Treatment response ,Neuromyelitis optica ,biology ,Adult patients ,business.industry ,treatment response ,medicine.disease ,Myelin oligodendrocyte glycoprotein ,Cellular and Molecular Neuroscience ,Treatment intervention ,attacks ,Latin America ,Aquaporin 4 ,disability ,Neuromyelitis Optica Spectrum Disorders ,biology.protein ,Neuromyelitis optica spectrum disorders ,Medicine ,In patient ,Original Research Article ,Neurology (clinical) ,Function and Dysfunction of the Nervous System ,business - Abstract
We aimed to examine treatment interventions implemented in patients experiencing neuromyelitis optica spectrum disorders (NMOSD) attacks (frequency, types, and response). Methods Retrospective study. Data on patient demographic, clinical and radiological findings, and administered treatments were collected. Remission status (complete [CR], partial [PR], no remission [NR]), based on changes in the EDSS score was evaluated before treatment, during attack, and at 6 months. CR was analyzed with a generalized estimating equations (GEEs) model. Results A total of 131 patients (120 NMOSD and 11 myelin oligodendrocyte glycoprotein-antibody-associated diseases [MOGAD]), experiencing 262 NMOSD-related attacks and receiving 270 treatments were included. High-dose steroids (81.4%) was the most frequent treatment followed by plasmapheresis (15.5%). CR from attacks was observed in 47% (105/223) of all treated patients. During the first attack, we observed CR:71.2%, PR:16.3% and NR:12.5% after the first course of treatment. For second, third, fourth, and fifth attacks, CR was observed in 31.1%, 10.7%, 27.3%, and 33.3%, respectively. Remission rates were higher for optic neuritis vs. myelitis (p Conclusions This study suggests individualization of treatment according to age and attack manifestation. The outcome of attacks was generally poor.
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- 2021
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15. What percentage of AQP4-ab-negative NMOSD patients are MOG-ab positive? A study from the Argentinean multiple sclerosis registry (RelevarEM)
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Emanuel Silva, Geraldine Luetic, Liliana Patrucco, Laura Negrotto, Andrés Barboza, Adriana Carrá, Orlando Garcea, Susana Liwacki, Nora Fernández Liguori, Gisela Zanga, María Eugenia Balbuena, Pablo A. López, Juan Pablo Pettinicchi, Pedro Nofal, Marcela Fiol, Dario Tavolini, Carolina Mainella, Edgar Carnero Contentti, Javier Pablo Hryb, Maria E. Fracaro, Patricio Blaya, Felisa Leguizamon, Juan Ignacio Rojas, Jorge Correale, Alejandro Caride, Luciana Lazaro, María I. Gaitán, María Laura Menichini, Carlos Vrech, Marcos Burgos, Mariano Marrodan, María C. Ysrraelit, Ivan Martos, Jimena Miguez, Verónica Tkachuk, Santiago Bestoso, Amelia Alvez Pinheiro, Marina Alonso Serena, Agustín Pappolla, Norma Deri, Edgardo Cristiano, and Ricardo Alonso
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medicine.medical_specialty ,Multiple Sclerosis ,Argentina ,Myelin oligodendrocyte glycoprotein ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Optic neuritis ,Registries ,030212 general & internal medicine ,Autoantibodies ,Aquaporin 4 ,Neuromyelitis optica ,biology ,business.industry ,Multiple sclerosis ,Neuromyelitis Optica ,General Medicine ,medicine.disease ,Clinical trial ,Neurology ,Cohort ,biology.protein ,Optic nerve ,Myelin-Oligodendrocyte Glycoprotein ,sense organs ,Neurology (clinical) ,Antibody ,business ,030217 neurology & neurosurgery - Abstract
Background Myelin oligodendrocyte glycoprotein antibodies (MOG-ab) have been described in aquaporin-4-antibodies(AQP4-ab)-negative neuromyelitis optica spectrum disorder (NMOSD) patients. We aimed to evaluate the percentage of AQP4-ab-negative NMOSD patients who are positive for MOG-ab in a cohort of Argentinean patients included in RelevarEM (Clinical Trials registry number NCT03375177). Methods RelevarEM is a longitudinal, strictly observational multiple sclerosis (MS) and NMOSD registry in Argentina. Of 3031 consecutive patients (until March 2020), 165 patients with phenotype of suspected NMOSD, whose relevant data for the purpose of this study were available, were included. Data on demographic, clinical, paraclinical and treatment in AQP4-ab (positive, negative and unknown) and MOG-ab (positive and negative) patients were evaluated. Results A total of 165 patients (79 AQP4-Ab positive, 67 AQP4-Ab negative and 19 unknown) were included. Of these, 155 patients fulfilled the 2015 NMOSD diagnostic criteria. Of 67 AQP4-Ab-negative patients, 36 (53.7%) were tested for MOG-Ab and 10 of them (27.7%) tested positive. Serum AQP4-ab levels were tested by means of cell-based assay (CBA) in 48 (35.2%), based on tissue-based indirect immunofluorescence assays in 58 (42.6%) and enzyme-linked immunosorbent assay in 4 (2.9%). All MOG-ab were tested by CBA. Optic neuritis (90%) was the most frequent symptom at presentation and optic nerve lesions the most frequent finding (80%) in neuroimaging of MOG-ab-associated disease. Of these, six (60%) patients were under immunosuppressant treatments at latest follow-up. Conclusion We observed that 27.7% (10/36) of the AQP4-ab-negative patients tested for MOG-ab were positive for this antibody, in line with results from other world regions.
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- 2021
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16. Access and unmet needs to multiple sclerosis care in a cohort of Argentinean patients
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Ricardo Alonso, Edgar Carnero Contentti, Surai Mellinger, María Eugenia Balbuena, Orlando Garcea, Vladimiro Sinay, Sebastián Ianardi, Verónica Tkachuk, Leonel Migliacci, Mónica Perassolo, Adriana Carrá, Raúl Piedrabuena, Susana Liwacki, Fatima Pagani Cassara, Santiago Tizio, Emiliano Ruiz Romagnoli, Pablo A. López, Mathias Qüesta Laudani, Emanuel Silva, Carolina Mainella, Mariela Cabrera, Juan Pablo Pettinicchi, Javier Pablo Hryb, José Luis Di Pace, Christian Bortoluzzi, and María Celeste Curbelo
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Adult ,Male ,medicine.medical_specialty ,Pediatrics ,Multiple Sclerosis ,Adolescent ,Argentina ,Health Services Accessibility ,Unmet needs ,Cohort Studies ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Surveys and Questionnaires ,Health care ,medicine ,Humans ,030212 general & internal medicine ,Social determinants of health ,Disease management (health) ,Medical prescription ,Health Services Needs and Demand ,business.industry ,Public health ,Multiple sclerosis ,General Medicine ,Middle Aged ,medicine.disease ,Cross-Sectional Studies ,Neurology ,Cohort ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Background Multiple sclerosis (MS) has a low prevalence in Argentina. However, MS has a high burden of disease, which implies frequent neurological visits, magnetic resonance images (MRI) use and chronic MS medication during follow-up, with a high impact on the healthcare system. Therefore, MS care is essential to optimize disease management and improve patients’ outcome. We aimed to evaluate the access and barriers to MS care and identified differences in treatment and management of MS patients over a period of 12 months in an Argentinean cohort. Methods A cross-sectional study based on a self-administered survey was carried out from August to December 2017 in 13 provinces from Argentina. MS patients (n = 219) were divided into three groups as follows: prepaid health insurance (PHI), social health insurance (SHI) and state-run health insurance (SRHI, Public Health Ministry) and they were assessed in order to detect differences in employment, access and barriers to MS care (neurological visit, MRI use and MS medication). Results A total of 185 (84.5%) MS patients were employed (full-time: 59%), 34 (15.5%) were currently unemployed and 15 (6.8%) retired by MS. In addition, 132 had SHI, 45 PHI and 40 SRHI. No statistical differences were found in disease severity, frequency of neurological visit, waiting time for neurological visit as well as frequency and waiting time for MRI use. MS patients with SRHI experienced a longer waiting time (first prescription and during follow-up) and inappropriate delivery of MS medication during follow-up compared to MS patients with PHI and SHI. A total of 8/45 (17.7%) in PHI, 17/40 (42.5%) in SRHI and 25/132 (18.9%) in SHI did not receive the MS medication as properly as prescribed for their neurologists. PHI was independently associated with appropriate delivery of MS medication (OR = 0.81, p = 0.01). Conclusion This study showed that MS patients had access barriers to receive MS medication properly, especially those with SRHI (public sector).
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- 2018
17. Absence of latitudinal gradient in oligoclonal bands prevalence in argentina
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Susana Liwacki, Edgardo Reich, Marcela Parada Marcilla, Verónica Tkachuk, Patricio Blaya, Geraldine Luetic, Vladimiro Sinay, Gisela Zanga, Fatima Pagani Cassara, Norma Deri, Alejandro Caride, Pablo A. López, Ivan Martos, María C. Ysrraelit, Marcela Fiol, María Laura Menichini, Mariano Coppola, Edgar Carnero Contentti, Nora Fernández Liguori, Edgardo Cristiano, Gustavo Sgrilli, Ricardo Alonso, Andrés Barboza, Laura Negrotto, Luciano Recchia, Javier Pablo Hryb, Carlos Vrech, Raúl Piedrabuena, Jorge Correale, Maria Laura Saladino, Diego Giunta, Pablo Divi, Judith Steinberg, Dario Tavolini, Carolina Mainella, María I. Gaitán, Orlando Garcea, Pedro Nofal, Matías Kohler, Guido Vazquez, Marcos Burgos, María Eugenia Balbuena, Adriana Carrá, Juan Ignacio Rojas, Anibal Chertcoff, Emanuel Silva, Jimena Miguez, Juan Pablo Viglione, Eduardo Knorre, Berenice Silva, Juan Pablo Pettinicchi, Marina Alonso Serena, Liliana Patrucco, Jorge Blanche, Leila Cohen, Agustín Pappolla, Maria E. Fracaro, Mariano Marrodan, Amelia Alves Pinheiro, Santiago Bestoso, Cecilia Pita, María Celeste Curbelo, María. L. Doldan, Felisa Leguizamon, Luciana Lazaro, Gabriel Volman, Lorena M. Cabrera, Ruben Manzi, Santiago Tizio, Gustavo Jose, Fernando Caceres, Alejandra D. Martinez, Miguel Jacobo, and Eduardo Kohler
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Multivariate statistics ,medicine.medical_specialty ,Multiple Sclerosis ,Argentina ,Logistic regression ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Epidemiology ,medicine ,Prevalence ,Humans ,Statistical analysis ,030212 general & internal medicine ,Clinically isolated syndrome ,Isoelectric focusing ,business.industry ,Multiple sclerosis ,Oligoclonal Bands ,General Medicine ,medicine.disease ,Neurology ,Neurology (clinical) ,Linear correlation ,Isoelectric Focusing ,business ,030217 neurology & neurosurgery - Abstract
Like MS prevalence, oligoclonal bands (OCB) frequency seems to follow a latitudinal gradient. Argentina is extensive, latitude-wise, and previous studies have not found an MS prevalence latitudinal gradient. Our aim is to describe OCB prevalence in MS, clinically isolated syndrome (CIS) and radiologically isolated syndrome (RIS) patients included in the Argentinean MS and NMOSD registry (RelevarEM) and to investigate if it follows a latitudinal gradient.For each province, an average latitude was calculated, and OCB frequency was investigated. Multivariate logistical regression analysis and linear correlation were performed. Statistical analysis was repeated after excluding patients from centers using isoelectric focusing (IEF) in less than 95% of patients (CwIEF95).We included 2866 patients. OCB where positive in 73.9% of patients. No association or correlation were found between OCB and latitude of residence, even after excluding patients from (CwIEF95).OCB positivity does not follow a latitudinal gradient in Argentina. Also, OCB positivity is lower than described in other world regions.
18. Disease activity after discontinuation of disease-modifying therapies in patients with multiple sclerosis in Argentina: data from the nationwide registry RelevarEM.
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Gisela Z, Carla P, Josefina B, Tomas I, Lucia B, Pappolla A, Miguez J, Patrucco L, Cristiano E, Norma D, Verónica T, Carlos V, Leila C, Alonso R, Garcea O, Silva B, Celica Y, Marrodan M, Gaitán MI, Correale J, Marcos B, Luciana L, Anibal C, Emanuel S, Eduardo K, Judith S, Dario T, Javier H, Pedro N, Felisa L, Pablo LA, Susana L, Patricio B, Raul P, Adriana C, Alejandra M, María Eugenia B, Contentti Edgar C, Amelia AP, Carolina M, Mariano C, Luciano R, Matias K, Eduardo K, María Celeste C, Maria Laura M, Santiago T, Mariela C, Fatima PC, Andres B, Geraldine L, Alonso Serena M, Juan Ignacio R, and Marcos S
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- Male, Humans, Argentina epidemiology, Registries, Recurrence, Multiple Sclerosis drug therapy, Multiple Sclerosis, Relapsing-Remitting diagnostic imaging, Multiple Sclerosis, Relapsing-Remitting drug therapy, Multiple Sclerosis, Relapsing-Remitting pathology
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Introduction: The discontinuation of disease-modifying therapies (DMTs) in multiple sclerosis (MS) is commonly seen in real-world settings due to several factors., Area Cover: The aim of this study is to describe the frequency of disease activity after discontinuation of DMTs in MS patients included in the Argentinean MS and NMOSD registry., Discusion: Patients with relapsing remitting MS (RRMS) and active secondary progressive MS (SPMS) were included based on the following criteria: they discontinued treatment for more than 6 months, they had been treated with a DMT for ≥2 years, and they had at least 6 months of follow-up in the registry after discontinuation. Demographic and clinical data were collected. Disease activity during follow-up was defined as the presence of a clinical relapse or a new magnetic resonance (MRI) lesion (either new lesions on T2-weighted sequence and/or contrast enhancement). Bivariate analysis was applied to identify clinical and demographic factors related to disease activity., Conclusion: We included 377 patients (75.5% RRMS, 22.5% SPMS) who had discontinued DMTs. The mean (SD) follow-up after discontinuation was 15.7 (7.9) months. After discontinuation, the presence of relapse was detected in 18.8% and 3.5% in RRMS and SPMS, respectively; and new MRI activity in 22% and 3.5%, respectively. We found that higher risk of relapse and MRI activity was associated with younger age (p < 0.001), shorter disease duration (p < 0.001), and RRMS phenotype (p = 0.006). Males showed higher MRI activity (p 0.011). This study provides real-world data that can guide physicians when considering discontinuation of DMTs.
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- 2023
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