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Article ; Online: Burden of treatment and quality of life in relapsing remitting multiple sclerosis patients under early high efficacy therapy in Argentina: Data from the Argentinean registry.

Rojas, Juan I / Carnero Contentti, Edgar / Alonso, Ricardo / Tavolini, Dario / Burgos, Marcos / Federico, Belén / Patrucco, Liliana / Cristiano, Edgardo

Multiple sclerosis and related disorders

2024 Volume 85, Page(s) 105543

Abstract: The objective of this study was to describe and compare the burden of treatment (BOT) and the quality of life (QoL) in early high efficacy therapy (HET) vs. escalation therapy in relapsing remitting multiple sclerosis (RRMS) patients included in ... ...

Abstract	The objective of this study was to describe and compare the burden of treatment (BOT) and the quality of life (QoL) in early high efficacy therapy (HET) vs. escalation therapy in relapsing remitting multiple sclerosis (RRMS) patients included in RelevarEM, the Argentinean registry of MS (RelevarEM, NCT 03,375,177). Methods: cross sectional study conducted between September and December 2022. Participating patients were adults, RRMS patients who initiated (during the last three years) their treatment with a HET (natalizumab, ocrelizumab, alemtuzumab, cladribine) or with escalation treatment (beta interferon, glatiramer acetate, teriflunomide, dimethyl fumarate or fingolimod). Clinical and demographic aspect were collected. QoL and BOT was measured with the validated to Spanish MusiQol and BOT questionnaire. Propensity score (PS)-based nearest-neighbor matching was applied to homogenize groups. Comparisons were be done using a linear regression analysis model stratified by matched pairs, with BOT and QoL assessments as main outcomes. Results: 269 patients were included in the analysis, mean age 33.7 ± 5.7 years, 193 (71.7 %) were female. A total of 136 patients were on early HET while 133 were on escalation therapy. In the entire group the mean total BOT score (±SD) was 48.5 ± 15.3 while in the group of patients receiving early HET we observed that the mean BOT score (±SD) was 43.5 ± 12.2 vs. 54.3 ± 13.3 in escalation treatment (p < 0.0001). Regarding the score QoL (±SD), in the entire sample we observed a global score of 77.4 ± 11.2. When we stratified groups, in HET (±SD) it was 81.3 ± 14 vs. 74.1 ± 18.3 in escalation therapy (p = 0.0003). Conclusion: in this multicenter study that included 269 patients from Argentina we observed in early HET a significantly lower BOT and higher QoL than patients receiving escalation therapy.
MeSH term(s)	Humans ; Multiple Sclerosis, Relapsing-Remitting/drug therapy ; Female ; Male ; Argentina ; Adult ; Quality of Life ; Cross-Sectional Studies ; Registries ; Immunologic Factors/administration & dosage ; Immunosuppressive Agents/therapeutic use ; Cost of Illness
Chemical Substances	Immunologic Factors ; Immunosuppressive Agents
Language	English
Publishing date	2024-03-16
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2645330-7
ISSN	2211-0356 ; 2211-0348
ISSN (online)	2211-0356
ISSN	2211-0348
DOI	10.1016/j.msard.2024.105543
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Article ; Online: Essential Components of a Public Health Tuberculosis Prevention, Control, and Elimination Program: Recommendations of the Advisory Council for the Elimination of Tuberculosis and the National Tuberculosis Controllers Association.

Cole, Barbara / Nilsen, Diana M / Will, Lorna / Etkind, Sue C / Burgos, Marcos / Chorba, Terence

MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports

2020 Volume 69, Issue 7, Page(s) 1–27

Abstract: This report provides an introduction and reference tool for tuberculosis (TB) controllers regarding the essential components of a public health program to prevent, control, and eliminate TB. The Advisory Council for the Elimination of Tuberculosis and ... ...

Abstract	This report provides an introduction and reference tool for tuberculosis (TB) controllers regarding the essential components of a public health program to prevent, control, and eliminate TB. The Advisory Council for the Elimination of Tuberculosis and the National Tuberculosis Controllers Association recommendations in this report update those previously published (Advisory Council for the Elimination of Tuberculosis. Essential components of a tuberculosis prevention and control program. Recommendations of the Advisory Council for the Elimination of Tuberculosis. MMWR Recomm Rep 1995;44[No. RR-11]). The report has been written collaboratively on the basis of experience and expert opinion on approaches to organizing programs engaged in diagnosis, treatment, prevention, and surveillance for TB at state and local levels.This report reemphasizes the importance of well-established priority strategies for TB prevention and control: identification of and completion of treatment for persons with active TB disease; finding and screening persons who have had contact with TB patients; and screening, testing, and treatment of other selected persons and populations at high risk for latent TB infection (LTBI) and subsequent active TB disease.Health departments are responsible for public safety and population health. To meet their responsibilities, TB control programs should institute or ensure completion of numerous responsibilities and activities described in this report: preparing and maintaining an overall plan and policy for TB control; maintaining a surveillance system; collecting and analyzing data; participating in program evaluation and research; prioritizing TB control efforts; ensuring access to recommended laboratory and radiology tests; identifying, managing, and treating contacts and other persons at high risk for Mycobacterium tuberculosis infection; managing persons who have TB disease or who are being evaluated for TB disease; providing TB training and education; and collaborating in the coordination of patient care and other TB control activities. Descriptions of CDC-funded resources, tests for evaluation of persons with TB or LTBI, and treatment regimens for LTBI are provided (Supplementary Appendices; https://stacks.cdc.gov/view/cdc/90289).
MeSH term(s)	Advisory Committees ; Disease Eradication/organization & administration ; Humans ; Latent Tuberculosis/epidemiology ; Latent Tuberculosis/prevention & control ; Mass Screening ; Program Development ; Public Health ; Tuberculosis/epidemiology ; Tuberculosis/prevention & control ; United States/epidemiology
Language	English
Publishing date	2020-07-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	1020048-4
ISSN	1545-8601 ; 1057-5987
ISSN (online)	1545-8601
ISSN	1057-5987
DOI	10.15585/mmwr.rr6907a1
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Article ; Online: Clinical characterization of long-term multiple sclerosis (COLuMbus) patients in Argentina: A cross-sectional non-interventional study.

Deri, Norma / Barboza, Andres / Vrech, Carlos / Rey, Roberto / Burgos, Marcos / Fiol, Marcela / CalvoVildoso, Cristian / Patrucco, Liliana / Jose, Gustavo / Aliberti, Paula / Chirico, Daniela / Federico, Maria B / Seifer, Gustavo / Piedrabuena, Raul

Multiple sclerosis and related disorders

2023 Volume 83, Page(s) 105421

Abstract: Background: Most Multiple Sclerosis (MS) clinical trials fail to assess the long-term effects of disease-modifying therapies (DMT) or disability.: Methods: COLuMbus was a single-visit, cross-sectional study in Argentina in adult patients with ≥10 ... ...

Abstract	Background: Most Multiple Sclerosis (MS) clinical trials fail to assess the long-term effects of disease-modifying therapies (DMT) or disability. Methods: COLuMbus was a single-visit, cross-sectional study in Argentina in adult patients with ≥10 years of MS since first diagnosis. The primary endpoint was to determine patient disability using the Expanded Disability Status Scale (EDSS). The secondary endpoints were to evaluate the distribution of diagnoses between relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS), patient demographics, disease history, and the risk of disability progression. The relationship between baseline characteristics and the current disability state and the risk of disability progression was assessed. Results: Out of the 210 patients included, 76.7 % had a diagnosis of RRMS and 23.3 % had been diagnosed with SPMS, with a mean disease duration of 17.9 years and 20.5 years, respectively. The mean delay in the initial MS diagnosis was 2.6 years for the RRMS subgroup and 2.8 years for the SPMS subgroups. At the time of cut-off (28May2020), 90.1 % (RRMS) and 75.5 % (SPMS) of patients were receiving a DMT, with a mean of 1.5 and 2.0 prior DMTs, respectively. The median EDSS scores were 2.5 (RRMS) and 6.5 (SPMS). In the RRMS and SPMS subgroups, 23 % and 95.9 % of patients were at high risk of disability, respectively; the time since first diagnosis showed a significant correlation with the degree of disability. Conclusions: This is the first local real-world study in patients with long-term MS that highlights the importance of recognizing early disease progression to treat the disease on time and delay disability.
MeSH term(s)	Adult ; Humans ; Multiple Sclerosis/diagnosis ; Multiple Sclerosis/epidemiology ; Multiple Sclerosis/therapy ; Cross-Sectional Studies ; Argentina/epidemiology ; Disease Progression ; Multiple Sclerosis, Chronic Progressive/diagnosis ; Multiple Sclerosis, Chronic Progressive/epidemiology ; Multiple Sclerosis, Chronic Progressive/drug therapy ; Multiple Sclerosis, Relapsing-Remitting/diagnosis ; Multiple Sclerosis, Relapsing-Remitting/epidemiology ; Multiple Sclerosis, Relapsing-Remitting/therapy
Language	English
Publishing date	2023-12-31
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2645330-7
ISSN	2211-0356 ; 2211-0348
ISSN (online)	2211-0356
ISSN	2211-0348
DOI	10.1016/j.msard.2023.105421
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Article ; Online: COVID-19 in Argentine teriflunomide-treated multiple sclerosis patients: First national case series.

Luetic, Geraldine / Menichini, María L / Burgos, Marcos / Alonso, Ricardo / Carnero Contentti, Edgar / Carrá, Adriana / Deri, Norma / Steinberg, Judith / Rojas, Juan I

Multiple sclerosis and related disorders

2021 Volume 53, Page(s) 103049

Abstract: We report COVID-19 presentation, course and outcomes in teriflunomide-treated MS patients in Argentina.: Methods: descriptive, retrospective, multicentre, study that included MS patients receiving teriflunomide who developed COVID-19, with clinical ... ...

Abstract	We report COVID-19 presentation, course and outcomes in teriflunomide-treated MS patients in Argentina. Methods: descriptive, retrospective, multicentre, study that included MS patients receiving teriflunomide who developed COVID-19, with clinical follow-up at reference MS centres, also listed in a nationwide registry. Results: Eighteen MS patients on teriflunomide treatment, from eight MS centres developed COVID-19. The mean age was 41,2 years and 72% of them were female; 94% had diagnosis of relapsing-remitting MS and 6% presented a radiologically isolated syndrome. Median EDSS was 2 (range 0-5.5). The average time on teriflunomide therapy was 3 years. COVID-19 diagnosis was confirmed with nasal swab in 61%. None required hospitalization and they completely recovered from the acute-phase within 7-14 days. All the patients continued their teriflunomide therapy during COVID-19 course. No MS relapses occurred during or after COVID-19 course. Conclusion: Our report adds to the evidence that COVID-19 is mild in patients receiving teriflunomide therapy and that continuing with teriflunomide therapy during Sars-CoV-2 infection is safe and advisable for MS patients.
MeSH term(s)	Adult ; COVID-19 ; COVID-19 Testing ; Crotonates/adverse effects ; Female ; Humans ; Hydroxybutyrates ; Multiple Sclerosis/drug therapy ; Multiple Sclerosis/epidemiology ; Multiple Sclerosis, Relapsing-Remitting/drug therapy ; Multiple Sclerosis, Relapsing-Remitting/epidemiology ; Nitriles ; Retrospective Studies ; SARS-CoV-2 ; Toluidines/adverse effects
Chemical Substances	Crotonates ; Hydroxybutyrates ; Nitriles ; Toluidines ; teriflunomide (1C058IKG3B)
Language	English
Publishing date	2021-05-30
Publishing country	Netherlands
Document type	Letter
ZDB-ID	2645330-7
ISSN	2211-0356 ; 2211-0348
ISSN (online)	2211-0356
ISSN	2211-0348
DOI	10.1016/j.msard.2021.103049
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Article ; Online: Addressing Latent Tuberculosis Infection Treatment Through a Collaborative Care Model With Community Pharmacies and a Health Department.

Jakeman, Bernadette / Logothetis, Stefanie J / Roberts, Melissa H / Bachyrycz, Amy / Fortune, Diana / Borrego, Matthew E / Ferreira, Julianna / Burgos, Marcos

Preventing chronic disease

2020 Volume 17, Page(s) E14

Abstract: Introduction: The objective of this study was to evaluate a novel collaborative care model using community pharmacies as additional access points for latent tuberculosis infection (LTBI) treatment for patients using combination weekly therapy with ... ...

Abstract	Introduction: The objective of this study was to evaluate a novel collaborative care model using community pharmacies as additional access points for latent tuberculosis infection (LTBI) treatment for patients using combination weekly therapy with isoniazid and rifapentine (3HP) plus directly observed therapy for 12 weeks. Methods: This prospective pilot study included adult patients diagnosed with LTBI. Patients were eligible for study participation if they spoke English or Spanish and were followed by the New Mexico Department of Health (NM DOH). Patients were excluded if they were pregnant, receiving concomitant HIV antiretroviral therapy, or had contraindications to 3HP due to allergy or drug interactions. Community pharmacy sites included chain, independent, and hospital outpatient pharmacies in Albuquerque and Santa Fe, New Mexico. Results: A total of 40 patients initiated treatment with 3HP and were included. Most were female (55%) and had a mean age of 46 years (standard deviation, 12.6 y). A total of 75.0% of patients completed LTBI treatment with 3HP in a community pharmacy site. Individuals of Hispanic ethnicity were more likely to complete treatment (76.7% vs 40.0%, P = .04). Most patients (60%; n = 24) reported experiencing an adverse drug event (ADE) with 3HP therapy. Patients who completed treatment were less likely to experience an ADE than patients who discontinued treatment (50.0% vs 90.0%, P = .03). Pharmacists performed 398 LTBI treatment visits (40 initial visits, 358 follow-up visits), saving the NM DOH approximately 143 hours in patient contact time. Conclusion: High completion rates and safe administration of LTBI treatment can be achieved in the community pharmacy setting.
MeSH term(s)	Adult ; Antibiotics, Antitubercular/administration & dosage ; Drug Therapy, Combination ; Feasibility Studies ; Female ; Humans ; Isoniazid/administration & dosage ; Latent Tuberculosis/drug therapy ; Male ; Middle Aged ; New Mexico ; Pharmacies/organization & administration ; Pilot Projects ; Prospective Studies ; Public Health/methods ; Rifampin/administration & dosage ; Rifampin/analogs & derivatives
Chemical Substances	Antibiotics, Antitubercular ; Isoniazid (V83O1VOZ8L) ; Rifampin (VJT6J7R4TR) ; rifapentine (XJM390A33U)
Language	English
Publishing date	2020-02-13
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2135684-1
ISSN	1545-1151 ; 1545-1151
ISSN (online)	1545-1151
ISSN	1545-1151
DOI	10.5888/pcd17.190263
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Article ; Online: Guidelines for the Treatment of Latent Tuberculosis Infection: Recommendations from the National Tuberculosis Controllers Association and CDC, 2020.

Sterling, Timothy R / Njie, Gibril / Zenner, Dominik / Cohn, David L / Reves, Randall / Ahmed, Amina / Menzies, Dick / Horsburgh, C Robert / Crane, Charles M / Burgos, Marcos / LoBue, Philip / Winston, Carla A / Belknap, Robert

MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports

2020 Volume 69, Issue 1, Page(s) 1–11

Abstract: Comprehensive guidelines for treatment of latent tuberculosis infection (LTBI) among persons living in the United States were last published in 2000 (American Thoracic Society. CDC targeted tuberculin testing and treatment of latent tuberculosis ... ...

Abstract	Comprehensive guidelines for treatment of latent tuberculosis infection (LTBI) among persons living in the United States were last published in 2000 (American Thoracic Society. CDC targeted tuberculin testing and treatment of latent tuberculosis infection. Am J Respir Crit Care Med 2000;161:S221-47). Since then, several new regimens have been evaluated in clinical trials. To update previous guidelines, the National Tuberculosis Controllers Association (NTCA) and CDC convened a committee to conduct a systematic literature review and make new recommendations for the most effective and least toxic regimens for treatment of LTBI among persons who live in the United States.The systematic literature review included clinical trials of regimens to treat LTBI. Quality of evidence (high, moderate, low, or very low) from clinical trial comparisons was appraised using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. In addition, a network meta-analysis evaluated regimens that had not been compared directly in clinical trials. The effectiveness outcome was tuberculosis disease; the toxicity outcome was hepatotoxicity. Strong GRADE recommendations required at least moderate evidence of effectiveness and that the desirable consequences outweighed the undesirable consequences in the majority of patients. Conditional GRADE recommendations were made when determination of whether desirable consequences outweighed undesirable consequences was uncertain (e.g., with low-quality evidence).These updated 2020 LTBI treatment guidelines include the NTCA- and CDC-recommended treatment regimens that comprise three preferred rifamycin-based regimens and two alternative monotherapy regimens with daily isoniazid. All recommended treatment regimens are intended for persons infected with Mycobacterium tuberculosis that is presumed to be susceptible to isoniazid or rifampin. These updated guidelines do not apply when evidence is available that the infecting M. tuberculosis strain is resistant to both isoniazid and rifampin; recommendations for treating contacts exposed to multidrug-resistant tuberculosis were published in 2019 (Nahid P, Mase SR Migliori GB, et al. Treatment of drug-resistant tuberculosis. An official ATS/CDC/ERS/IDSA clinical practice guideline. Am J Respir Crit Care Med 2019;200:e93-e142). The three rifamycin-based preferred regimens are 3 months of once-weekly isoniazid plus rifapentine, 4 months of daily rifampin, or 3 months of daily isoniazid plus rifampin. Prescribing providers or pharmacists who are unfamiliar with rifampin and rifapentine might confuse the two drugs. They are not interchangeable, and caution should be taken to ensure that patients receive the correct medication for the intended regimen. Preference for these rifamycin-based regimens was made on the basis of effectiveness, safety, and high treatment completion rates. The two alternative treatment regimens are daily isoniazid for 6 or 9 months; isoniazid monotherapy is efficacious but has higher toxicity risk and lower treatment completion rates than shorter rifamycin-based regimens.In summary, short-course (3- to 4-month) rifamycin-based treatment regimens are preferred over longer-course (6-9 month) isoniazid monotherapy for treatment of LTBI. These updated guidelines can be used by clinicians, public health officials, policymakers, health care organizations, and other state and local stakeholders who might need to adapt them to fit individual clinical circumstances.
MeSH term(s)	Centers for Disease Control and Prevention, U.S. ; Humans ; Latent Tuberculosis/drug therapy ; Practice Guidelines as Topic ; Randomized Controlled Trials as Topic ; United States
Language	English
Publishing date	2020-02-14
Publishing country	United States
Document type	Journal Article ; Systematic Review
ZDB-ID	1020048-4
ISSN	1545-8601 ; 1057-5987
ISSN (online)	1545-8601
ISSN	1057-5987
DOI	10.15585/mmwr.rr6901a1
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Article: Mortality of neuromyelitis optica spectrum disorder patients in an Argentinean population: A study from the RelevarEM registry.

Carnero Contentti, Edgar / Lopez, Pablo A / Pettinicchi, Juan Pablo / Criniti, Juan / Pappolla, Agustín / Miguez, Jimena / Cristiano, Edgardo / Patrucco, Liliana / Liwacki, Susana / Tkachuk, Verónica / Balbuena, María E / Vrech, Carlos / Deri, Norma / Correale, Jorge / Marrodan, Mariano / Ysrraelit, María C / Leguizamon, Felisa / Luetic, Geraldine / Menichini, María L /

Tavolini, Darío / Mainella, Carolina / Zanga, Gisela / Burgos, Marcos / Hryb, Javier / Barboza, Andrés / Lazaro, Luciana / Alonso, Ricardo / Fernández Liguori, Nora / Nadur, Débora / Alonso Serena, Marina / Caride, Alejandro / Paul, Friedemann / Rojas, Juan I

Multiple sclerosis journal - experimental, translational and clinical

2023 Volume 9, Issue 4, Page(s) 20552173231205444

Abstract: We aimed to evaluate mortality and causes of death among Argentinean neuromyelitis optica spectrum disorder (NMOSD) patients and identify predictors of death. Retrospective study included 158 NMOSD patients and 11 (7%) patients died after 11 years of ... ...

Abstract	We aimed to evaluate mortality and causes of death among Argentinean neuromyelitis optica spectrum disorder (NMOSD) patients and identify predictors of death. Retrospective study included 158 NMOSD patients and 11 (7%) patients died after 11 years of follow-up for a total exposure time of 53,345 days with an overall incidence density of 2.06 × 10.000 patients/day (95% CI 1.75-2.68). Extensive cervical myelitis with respiratory failure (45%) was the most frequent cause of death. Older age (HR = 2.05,
Language	English
Publishing date	2023-10-17
Publishing country	United States
Document type	Case Reports
ZDB-ID	2841884-0
ISSN	2055-2173 ; 2055-2173
ISSN (online)	2055-2173
ISSN	2055-2173
DOI	10.1177/20552173231205444
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Article: Achieving no evidence of disease activity-3 in highly active multiple sclerosis patients treated with cladribine and monoclonal antibodies.

Alonso, Ricardo / Casas, Magdalena / Lazaro, Luciana / Fernandez Liguori, Nora / Pita, Cecilia / Cohen, Leila / Rojas, Juan Ignacio / Pappolla, Agustín / Patrucco, Liliana / Cristiano, Edgardo / Burgos, Marcos / Vrech, Carlos / Piedrabuena, Raul / Pablo, Lopez / Deri, Norma / Luetic, Geraldine / Miguez, Jimena / Cabrera, Mariela / Martinez, Alejandra /

Zanga, Gisela / Tkachuk, Verónica / Tizio, Santiago / Carnero Contentti, Edgar / Knorre, Eduardo / Leguizamon, Felisa / Mainella, Carolina / Nofal, Pedro / Liwacki, Susana / Hryb, Javier / Menichini, Maria / Pestchanker, Claudia / Alonso, Marina / Garcea, Orlando / Silva, Berenice

Multiple sclerosis journal - experimental, translational and clinical

2023 Volume 9, Issue 1, Page(s) 20552173231154712

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 ... ...

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 ( 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.
Language	English
Publishing date	2023-02-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2841884-0
ISSN	2055-2173 ; 2055-2173
ISSN (online)	2055-2173
ISSN	2055-2173
DOI	10.1177/20552173231154712
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Article ; Online: Incidence of SARS-CoV-2 infection in patients with multiple sclerosis who received SARS-CoV-2 vaccines and are under treatment with high-efficacy therapies in Argentina.

Carnero Contentti, Edgar / López, Pablo A / Pappolla, Agustín / Alonso, Ricardo / Silva, Berenice / Deri, Norma / Balbuena, María E / Burgos, Marcos / Luetic, Geraldine / Alvez Pinheiro, Amelia / Cabrera, Mariela / Hryb, Javier / Nofal, Pedro / Pestchanker, Claudia / Vrech, Carlos / Tavolini, Darío / Tkachuk, Verónica / Zanga, Gisela / Marrodan, Mariano /

Ysrraelit, María Célica / Correale, Jorge / Carrá, Adriana / Federico, Belén / Garcea, Orlando / Fernandez Liguori, Nora / Patrucco, Liliana / Cristiano, Edgardo / Giunta, Diego / Alonso Serena, Marina / Rojas, Juan I

Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

2023 Volume 45, Issue 2, Page(s) 379–389

Abstract: We aimed to evaluate the incidence of SARS-CoV-2 breakthrough infection of SARS-CoV-2 vaccines in people with MS (PwMS) on high-efficacy disease-modifying therapies (HET) included in the national MS registry in Argentina (RelevarEM).: Methods: Non- ... ...

Abstract	We aimed to evaluate the incidence of SARS-CoV-2 breakthrough infection of SARS-CoV-2 vaccines in people with MS (PwMS) on high-efficacy disease-modifying therapies (HET) included in the national MS registry in Argentina (RelevarEM). Methods: Non-interventional, retrospective cohort study that collected information directly from RelevarEM. Adult PwMS who had been treated for at least 6 months with a HET (ocrelizumab, natalizumab, alemtuzumab, cladribine) who had received at least two doses of SARS-CoV-2 vaccines available in Argentina were included. Full course of vaccination was considered after the second dose of the corresponding vaccines. Cumulative incidence of SARS-CoV-2 infection was reported for the whole cohort by Kaplan-Meier survival curves (which is expressed in percentage) as well as incidence density (which is expressed per 10.000 patients/day with 95% CI). Results: Two hundred twenty-eight PwMS were included. Most frequent first and second dose received was AstraZeneca vaccine, followed by Sputnik vaccine. Most frequent HETs used in included patients were cladribine in 79 (34.8%). We found an incidence density of breakthrough COVID-19 infection of 3.5 × 10.000 patients/day (95% CI 2.3-6.7) after vaccination in Argentina. We described the incidence rate after vaccination for every HET used, it being significantly higher for ocrelizumab compared with other HETs (p = 0.005). Only five patients presented a relapse during the follow-up period with no differences regarding the pre-vaccination period. Conclusions: We found an incidence density of breakthrough COVID-19 infection of 3.5 × 10.000 patients/day (95% CI 2.3-6.7) after vaccination in Argentina.
MeSH term(s)	Adult ; Humans ; COVID-19 ; COVID-19 Vaccines/therapeutic use ; Incidence ; Multiple Sclerosis ; Cladribine ; Argentina/epidemiology ; Undertreatment ; Retrospective Studies ; SARS-CoV-2 ; Breakthrough Infections
Chemical Substances	COVID-19 Vaccines ; Cladribine (47M74X9YT5)
Language	English
Publishing date	2023-12-30
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2016546-8
ISSN	1590-3478 ; 1590-1874
ISSN (online)	1590-3478
ISSN	1590-1874
DOI	10.1007/s10072-023-07282-x
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Article ; Online: Evaluation of the use of high-efficacy treatments (HETs) in patients with relapsing-remitting multiple sclerosis in Argentina.

Alonso, Ricardo / Casas, Magdalena / Lazaro, Luciana / Liguori, Nora Fernandez / Pita, Cecilia / Cohen, Leila / Rojas, Juan Ignacio / Pappolla, Agustín / Patrucco, Liliana / Cristiano, Edgardo / Burgos, Marcos / Vrech, Carlos / Piedrabuena, Raul / Pablo, Lopez / Deri, Norma / Luetic, Geraldine / Miguez, Jimena / Cabrera, Mariela / Martinez, Alejandra /

Multiple sclerosis and related disorders

2023 Volume 79, Page(s) 104935

Abstract: Background: Disease-modifying therapies (DMTs) in multiple sclerosis (MS) can be classified according to the efficacy in which they prevent inflammatory activity. To date, there are limited data regarding the use of high-efficacy treatments (HETs) in ... ...

Abstract	Background: Disease-modifying therapies (DMTs) in multiple sclerosis (MS) can be classified according to the efficacy in which they prevent inflammatory activity. To date, there are limited data regarding the use of high-efficacy treatments (HETs) in Latin America (LATAM). We aimed to analyze the use of HETs in Argentina, focusing on the clinical and sociodemographic characteristics of the patients who use these treatments and the changes in the trend of use over the years. Methods: A retrospective cohort study was done using the Argentina MS patient registry, RelevarEM. Patients diagnosed with relapsing-remitting MS (RRMS) according to validated diagnostic criteria and under treatment with natalizumab, alemtuzumab, cladribine, rituximab or ocrelizumab were included. Results: Out of 2450 RRMS patients under a DMT, 462 (19%) were on HETs. One third of those patients (35%) received HETs as the first treatment. The most frequent reason for switching to HETs was treatment failure to previous DMT (77%). The time from MS diagnosis to the first HET in treatment-naive patients was less than one year (IQR: 0-1 year) and in treatment-experienced patients it was 5 years (IQR: 3-9 years). Between 2015 and 2017 (P1), 729 patients included in RelevarEM started a new treatment, of which 85 (11.65%) were HETs. Between 2018 and 2020 (P2), 961 patients included in RelevarEM started a new treatment, of which 284 (29.55%) were HETs. When comparing P2 with P1, a significant increase in the use of HETs was observed (p < 0.01). The most frequently used HETs were alemtuzumab (50.59%) in P1, and cladribine (45.20%) in P2. Conclusion: The demographic and clinical characteristics of patients under HET in Argentina were identified. Based on a real-world setting, we found a significant trend towards and a rapid increase in the use of HETs in clinical practice in patients with RRMS.
MeSH term(s)	Humans ; Multiple Sclerosis, Relapsing-Remitting/drug therapy ; Multiple Sclerosis, Relapsing-Remitting/epidemiology ; Cladribine/therapeutic use ; Multiple Sclerosis/drug therapy ; Alemtuzumab/therapeutic use ; Retrospective Studies ; Argentina ; Immunosuppressive Agents/therapeutic use
Chemical Substances	Cladribine (47M74X9YT5) ; Alemtuzumab (3A189DH42V) ; Immunosuppressive Agents
Language	English
Publishing date	2023-08-09
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2645330-7
ISSN	2211-0356 ; 2211-0348
ISSN (online)	2211-0356
ISSN	2211-0348
DOI	10.1016/j.msard.2023.104935
Database	MEDical Literature Analysis and Retrieval System OnLINE

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