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1.

001-es BibID:BIBFORM050853
035-os BibID:PMID:23293933
Első szerző:Bánáti Miklós (neurológus, Pécs)
Cím:Antibody response against gastrointestinal antigens in demyelinating diseases of the central nervous system / M. Banati, P. Csecsei, E. Koszegi, H. H. Nielsen, G. Suto, L. Bors, A. Trauninger, T. Csepany, C. Rozsa, G. Jakab, T. Molnar, A. Berthele, S. R. Kalluri, T. Berki, Z. Illes
Dátum:2013
ISSN:1351-5101
Megjegyzések:Antibodies against gastrointestinal antigens may indicate altered microbiota and immune responses in the gut. Recent experimental data suggest a connection between gastrointestinal immune responses and CNS autoimmunity. METHODS: Antibodies against gliadin, tissue transglutaminase (tTG), intrinsic factor (IF), parietal cells (PC) and Saccharomyces cerevisiae (ASCA) were screened in the sera of 45 patients with AQP4-seropositive neuromyelitis optica (NMO) and NMO spectrum diseases (NMO/NMO-SD), 17 patients with AQP4-seronegative NMO, 85 patients with clinically definite multiple sclerosis (MS), and 48 healthy controls (HC). RESULTS: Thirty-seven percentages of patients with AQP4-seropositive NMO/NMO-SD and 28% of patients with MS had at least one particular antibody in contrast to 8% of HC (P < 0.01, respectively). Antibodies were most common (46%) in AQP4-seropositive myelitis (P = 0.01 versus HS, P = 0.05 versus MS). Anti-gliadin and ASCA were more frequent in the AQP4-seropositive NMO-spectrum compared to controls (P = 0.01 and P < 0.05, respectively). CONCLUSION: Antibody responses against gastrointestinal antigens are common in MS and AQP4-seropositive NMO/NMO-SD, especially in longitudinally extensive myelitis.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
anti-Saccharomyces cerevisiae
aquaporin 4
gliadin
intrinsic factor
multiple sclerosis
myelitis
neuromyelitis optica
optic neuritis
parietal cell
transglutaminase
Megjelenés:European Journal of Neurology. - 20 : 11 (2013), p. 1492-1495. -
További szerzők:Csécsei Péter (1992-) (neurológus) Kőszegi E. (neurológus, Pécs) Nielsen, Helle H. Sütő Gábor Bors László (Neurológus, Pécs) Trauninger Anita (Pécs orvos) Csépány Tünde (1956-) (neurológus, pszichiáter) Rózsa Csilla Jakab Gabriella Molnár T. Berthele, A. Kalluri, Sudhakar Reddy Berki Tímea Illés Zsolt (neurológus, Pécs)
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2.

001-es BibID:BIBFORM032363
Első szerző:Csépány Tünde (neurológus, pszichiáter)
Cím:MRI findings in central nervous system systemic lupus erythematosus are associated with immunoserological parameters and hypertension / Csepany, T., Bereczki, D., Kollar, J., Sikula, J., Kiss, E., Csiba, L.
Dátum:2003
Megjegyzések:Involvement of the brain is one of the most important complications of systemic lupus erythematosus (SLE). To investigate the correlation between abnormal cranial MRI findings and age, duration of SLE, neuropsychiatric (NP) manifestations, hypertensive status, and the presence of antiphospholipid antibodies (PA) in patients with SLE we evaluated the MRI results of 81 SLE patients in nine NP clinical subgroups.Immunoserological status was described by the presence of lupus anticoagulant (LA), and anticardiolipin antibodies (aCL). The MRI findings were categorized as normal [41], cerebral atrophy [15], small subcortical hyperintensity [7], and infarct larger than 10mm [18]. Mean age differed among the clinical subgroups (ANOVA, p = 0.002), whereas there was no age difference among the subgroups based on MRI and immunoserological results. Patients with hypertension (33/81) were a mean of 6 years older at the time of examination (p = 0.033) and had stroke more frequently, than normotensive ones (p = 0.0015). MRI abnormalities were more frequent in patients with LA positivity (p < 0.01) than in those without these antibodies, and in the hypertensive than in the normotensive subgroup (p = 0.00041). The presence of PA was associated with abnormal MRI even after controlling for the effect of age and hypertensive status (p = 0.011). In our study the MRI findings in central nervous system SLE were independent of the age of patients and the age at the diagnosis of SLE, and were not influenced by the duration of SLE; however, they were associated with immunoserological parameters and hypertension.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
multiple sclerosis
autoimmunity
iron
prolactin
ferritin
Megjelenés:Journal of Neurology. - 250 : 11 (2003), p. 1348-1354. -
További szerzők:Bereczki Dániel (1960-) (neurológus) Kollár József (1950-) (radiológus) Sikula Judit (1954-) (radiológus) Kiss Emese (1960-) (belgyógyász, immunológus) Csiba László (1952-) (neurológus, pszichiáter)
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3.

001-es BibID:BIBFORM015606
035-os BibID:15258802
Első szerző:Csépány Tünde (neurológus, pszichiáter)
Cím:Miller Fisher syndrome : a presenting clinical manifestation of lung cancer in apreviously apparently healthy individual / Tunde Csepany, Judit Boczan, Maria T. Magyar, Sandor Molnar, Laszlo Csiba, Judit Decsy, Judit Toth, Szabolcs Felszeghy, Szabolcs Szakall, Zsolt Szentkereszty, Daniel Bereczki
Dátum:2004
ISSN:0340-5354 (Linking)
Tárgyszavak:Orvostudományok Klinikai orvostudományok szerkesztői levél
0 (KRT7 protein, human)
0 (Keratin-7)
0 (Tumor Markers, Biological)
68238-35-7 (Keratins)
Adenocarcinoma/*secondary
Brain/pathology/physiopathology
Brain Neoplasms/*secondary
Cerebrospinal Fluid/cytology
Diagnosis, Differential
Facial Nerve/pathology/physiopathology
Humans
Keratin-7
Keratins/metabolism
Lateral Ventricles/pathology
Lung/pathology/physiopathology
Lung Neoplasms/*pathology
Male
Meningeal Neoplasms/secretion
Middle Aged
Miller Fisher Syndrome/cerebrospinal fluid/*etiology/pathology
egyetemen (Magyarországon) készült közlemény
Oculomotor Nerve/pathology/physiopathology
Tumor Markers, Biological/metabolism
Megjelenés:Journal of Neurology. - 251 : 7 (2004), p. 898-900. -
További szerzők:Boczán Judit (1972-) (neurológus) Magyar Mária Tünde (1970-) (neurológus) Molnár Sándor (1973-) (neurológus) Csiba László (1952-) (neurológus, pszichiáter) Décsy Judit Tóth Judit (1964-) (radiológus) Felszeghy Szabolcs Béla (1972-) (fogorvos, anatómus, kötőszövetbiológus) Szakáll Szabolcs Szentkereszty Zsolt (1961-) (sebész) Bereczki Dániel (1960-) (neurológus)
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4.

001-es BibID:BIBFORM119146
035-os BibID:(scopus)85177103067 (wos)001030569800001
Első szerző:Diouf, Ibrahima
Cím:Effectiveness of multiple disease-modifying therapies in relapsing-remitting multiple sclerosis : causal inference to emulate a multiarm randomised trial / Diouf Ibrahima, Malpas Charles B., Sharmin Sifat, Roos Izanne, Horakova Dana, Kubala Havrdova Eva, Patti Francesco, Shaygannejad Vahid, Ozakbas Serkan, Eichau Sara, Onofrj Marco, Lugaresi Alessandra, Alroughani Raed, Prat Alexandre, Duquette Pierre, Terzi Murat, Boz Cavit, Grand'Maison Francois, Sola Patrizia, Ferraro Diana, Grammond Pierre, Yamout Bassem, Altintas Ayse, Gerlach Oliver, Lechner-Scott Jeannette, Bergamaschi Roberto, Karabudak Rana, Iuliano Gerardo, McGuigan Christopher, Cartechini Elisabetta, Hughes Stella, Sa Maria Jose, Solaro Claudio, Kappos Ludwig, Hodgkinson Suzanne, Slee Mark, Granella Franco, de Gans Koen, McCombe Pamela A., Ampapa Radek, van der Walt Anneke, Butzkueven Helmut, Sánchez-Menoyo José Luis, Vucic Steve, Laureys Guy, Sidhom Youssef, Gouider Riadh, Castillo-Trivino Tamara, Gray Orla, Aguera-Morales Eduardo, Al-Asmi Abdullah, Shaw Cameron, Al-Harbi Talal M., Csepany Tunde, Sempere Angel P., Trevino Frenk Irene, Stuart Elizabeth A., Kalincik Tomas
Dátum:2023
ISSN:0022-3050
Megjegyzések:Background Simultaneous comparisons of multiple disease-modifying therapies for relapsing-remitting multiple sclerosis (RRMS) over an extended follow-up are lacking. Here we emulate a randomised trial simultaneously comparing the effectiveness of six commonly used therapies over 5 years. Methods Data from 74 centres in 35 countries were sourced from MSBase. For each patient, the first eligible intervention was analysed, censoring at change/discontinuation of treatment. The compared interventions included natalizumab, fingolimod, dimethyl fumarate, teriflunomide, interferon beta, glatiramer acetate and no treatment. Marginal structural Cox models (MSMs) were used to estimate the average treatment effects (ATEs) and the average treatment effects among the treated (ATT), rebalancing the compared groups at 6-monthly intervals on age, sex, birth-year, pregnancy status, treatment, relapses, disease duration, disability and disease course. The outcomes analysed were incidence of relapses, 12-month confirmed disability worsening and improvement. Results 23 236 eligible patients were diagnosed with RRMS or clinically isolated syndrome. Compared with glatiramer acetate (reference), several therapies showed a superior ATE in reducing relapses: natalizumab (HR=0.44, 95% CI=0.40 to 0.50), fingolimod (HR=0.60, 95% CI=0.54 to 0.66) and dimethyl fumarate (HR=0.78, 95% CI=0.66 to 0.92). Further, natalizumab (HR=0.43, 95% CI=0.32 to 0.56) showed a superior ATE in reducing disability worsening and in disability improvement (HR=1.32, 95% CI=1.08 to 1.60). The pairwise ATT comparisons also showed superior effects of natalizumab followed by fingolimod on relapses and disability. Conclusions The effectiveness of natalizumab and fingolimod in active RRMS is superior to dimethyl fumarate, teriflunomide, glatiramer acetate and interferon beta. This study demonstrates the utility of MSM in emulating trials to compare clinical effectiveness among multiple interventions simultaneously.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
MULTIPLE SCLEROSIS
STATISTICS
Megjelenés:Journal Of Neurology Neurosurgery And Psychiatry. - 94 : 12 (2023), p. 1004-1011. -
További szerzők:Malpas, Charles B. Sharmin, Sifat Roos, Izanne Horakova, Dana Kubala Havrdova, Eva Patti, Francesco Shaygannejad, Vahid Ozakbas, Serkan Eichau, Sara Onofrj, Marco Lugaresi, Alessandra Alroughani, Raed Prat, Alexandre Duquette, Pierre Terzi, Murat Boz, Cavit Grand'Maison, Francois Sola, Patrizia Ferraro, Diana Grammond, Pierre Yamout, Bassem Altintas, Ayse Gerlach, Oliver Lechner-Scott, Jeannette Bergamaschi, Roberto Karabudak, Rana Iuliano, Gerardo McGuigan, Christopher Cartechini, Elisabetta Hughes, Stella Sá, Maria José Solaro, Claudio Kappos, Ludwig Hodgkinson, Suzanne Slee, Mark Granella, Franco de Gans, Koen McCombe, Pamela Ampapa, Radek Walt, Anneke van der Butzkueven, Helmut Sanchez-Menoyo, Jose Vucic, Steve Laureys, Guy Sidhom, Youssef Gouider, Riadh Castillo Triviño, Tamara Gray, Orla Aguera-Morales, Eduardo Al-Asmi, Abdullah Shaw, Cameron Al-Harbi, Talal Csépány Tünde (1956-) (neurológus, pszichiáter) Sempere, Perez A. Trevino-Frenk, Irene Stuart, Elizabeth A. Kalincik, Tomas
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5.

001-es BibID:BIBFORM107545
035-os BibID:(cikkazonosító)15706 (Scopus)85148460657 (WoS)000952991100026
Első szerző:Diouf, Ibrahima
Cím:Variability of the response to immunotherapy among subgroups of patients with multiple sclerosis / Diouf Ibrahima, Malpas Charles B., Sharmin Sifat, Roos Izanne, Horakova Dana, Havrdova Eva Kubala, Patti Francesco, Shaygannejad Vahid, Ozakbas Serkan, Izquierdo Guillermo, Eichau Sara, Onofrj Marco, Lugaresi Alessandra, Alroughani Raed, Prat Alexandre, Girard Marc, Duquette Pierre, Terzi Murat, Boz Cavit, Grand'Maison Francois, Hamdy Sherif, Sola Patrizia, Ferraro Diana, Grammond Pierre, Turkoglu Recai, Buzzard Katherine, Skibina Olga, Yamout Bassem, Altintas Ayse, Gerlach Oliver, van Pesch Vincent, Blanco Yolanda, Maimone Davide, Lechner-Scott Jeannette, Bergamaschi Roberto, Karabudak Rana, Iuliano Gerardo, McGuigan Chris, Cartechini Elisabetta, Barnett Michael, Hughes Stella, Sa Maria José, Solaro Claudio, Kappos Ludwig, Ramo-Tello Cristina, Cristiano Edgardo, Hodgkinson Suzanne, Spitaleri Daniele, Soysal Aysun, Petersen Thor, Slee Mark, Butler Ernest, Granella Franco, de Gans Koen, McCombe Pamela, Ampapa Radek, Van Wijmeersch Bart, van der Walt Anneke, Butzkueven Helmut, Prevost Julie, Sinnige L. G. F., Sanchez-Menoyo Jose Luis, Vucic Steve, Laureys Guy, Van Hijfte Liesbeth, Khurana Dheeraj, Macdonell Richard, Gouider Riadh, Castillo-Trivino Tamara, Gray Orla, Aguera-Morales Eduardo, Al-Asmi Abdullah, Shaw Cameron, Deri Norma, Al-Harbi Talal, Fragoso Yara, Csepany Tunde, Perez Sempere Angel, Trevino-Frenk Irene, Schepel Jan, Moore Fraser, Kalincik Tomas
Dátum:2023
ISSN:1351-5101
Megjegyzések:Background This study assessed the effect of patient characteristics on the response to disease modifying therapy (DMT) in in multiple sclerosis (MS). Methods We extracted data from 61,810 patients from 135 centres across 35 countries from the MSBase registry. The selection criteria were: clinically isolated syndrome or definite MS; follow-up ?1 year; ?3 EDSS scores; and with ?1 score recorded per year. Marginal structural models with interaction terms were used to compare the hazards of 12-month confirmed worsening and improvement of disability, and the incidence of relapses between treated and untreated patients stratified by their characteristics. Results Among 24,344 patients with relapsing MS, those on DMTs experienced 48% reduction in relapse incidence (hazard ratio (HR)=0.52, 95%CI=0.45-0.60), 46% lower risk of disability worsening (HR=0.54, 95%CI=0.41-0.71) and 32% greater chance of disability improvement (HR=1.32, 95%CI=1.09-1.59). The effect of DMTs on EDSS worsening and improvement and the risk of relapses was attenuated with more severe disability. The magnitude of the effect of DMT on suppressing relapses declined with higher prior relapse rate and prior cerebral MRI activity. We did not find any evidence for the effect of age on the effectiveness of DMT. After inclusion of 1985 participants with progressive MS, the effect of DMT on disability mostly depended on MS phenotype, whereas its effect on relapses was driven mainly by prior relapse activity. Conclusions DMT is generally most effective among patients with lower disability and in relapsing MS phenotypes. There is no evidence attenuation of the effect of DMT with age.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:European Journal Of Neurology. - 30 : 4 (2023), p. 1014-1024. -
További szerzők:Malpas, Charles B. Sharmin, Sifat Roos, Izanne Horakova, Dana Havrdova, Eva Patti, Francesco Shaygannejad, Vahid Ozakbas, Serkan Izquierdo, Guillermo Eichau, Sara Onofrj, Marco Lugaresi, Alessandra Alroughani, Raed Prat, Alexandre Girard, Marc Duquette, Pierre Terzi, Murat Boz, Cavit Grand'Maison, Francois Hamdy, Sherif Sola, Patrizia Ferraro, Diana Grammond, Pierre Turkoglu, Recai Buzzard, Katherine Skibina, Olga Yamout, Bassem Altintas, Ayse Gerlach, Oliver Pesch, Vincent van Blanco, Yolanda Maimone, Davide Lechner-Scott, Jeannette Bergamaschi, Roberto Karabudak, Rana Iuliano, Gerardo McGuigan, Christopher Cartechini, Elisabetta Barnett, Michael Hughes, Stella Sá, Maria José Solaro, Claudio Kappos, Ludwig Ramo-Tello, Cristina Cristiano, Edgardo Hodgkinson, Suzanne Spitaleri, Daniele Soysal, Aysun Petersen, Thor Slee, Mark Butler, Ernest Granella, Franco de Gans, Koen McCombe, Pamela Ampapa, Radek Van Wijmeersch, Bart Walt, Anneke van der Butzkueven, Helmut Prevost, Julie Sinnige, L. G. F. Sanchez-Menoyo, Jose Vucic, Steve Laureys, Guy Van Hijfte, Liesbeth Khurana, Dheeraj Macdonell, Richard Gouider, Riadh Castillo Triviño, Tamara Gray, Orla Aguera-Morales, Eduardo Al-Asmi, Abdullah Shaw, Cameron Deri, Norma Al-Harbi, Talal Fragoso, Yara Csépány Tünde (1956-) (neurológus, pszichiáter) Perez Sempere, Angel Trevino-Frenk, Irene Schepel, Jan Moore, Fraser Kalincik, Tomas
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6.

001-es BibID:BIBFORM079822
Első szerző:Fekete Klára (neurológus)
Cím:Effectiveness and outcome of intravenous (IV) and intra-arterial (IA) thrombolysis in the Eastern Hungarian Stroke Center / K. Fekete, I. Fekete, D. Bereczki, T. Magyar, L. Olah, T. Csepany, L. Csiba
Dátum:2009
ISSN:1351-5101
Megjegyzések:Introduction: IV and IA thrombolysis is an effective treatment in acute ischemic stroke. Effectiveness and side effects were tested in the database. Methods: We treated 208 patients with IV/IA (145/63 pts) rt-PA after onset of ischemic stroke. After urgent CT, CTA we administered 0.9 mg/kg rt-PA according to the protocol. At local thrombolysis after 5 mg rt-PA bolus, 1 mg/min infusionwasadministered.GCS,NIHSSwereexaminedon the admission and after 7 days, mRS after 3 months. Risk factors and time window of stroke were estimated, too. Results: 64% of patients were male and 36% female.Time window was within 120min by 28% of patients, 180min 44%, 4.5h 17% and more than 270min 11% (for IA thrombolysis)afterstrokeonset.Averageagewas66.5?13.9 and 67.3?14.7 years.The most important risk factors were: hypertension (68.5%), atrial fibrillation (17%), other heart disorders(20%),smoking18.5%),diabetesmellitus(16%), hypercholesterolemia(19%),previousstrokeorTIA(16%). The average of NIHSS before thrombolysis was 14 (2-25), after 24 hours 11 (0-25). Hemorrhagic transformation was 13% after IA, 4.4% after IV administration of rt-PA. Intracerebral haemorrhage was recognized in 17.6% after IA,4.4%IV .Mortalitywas3%within24hours,21%within 3 months (IA: 27.9%, IV:13%). Large artery re-opening after IA thrombolysis was 46%. The proportion of independent patients was 36.4% (mRS) at 3 months. Conclusion: Beside IV thrombolysis IA administration of rt-PA is effective in acute stroke, but ICH and hemorrhagic transformation rate is more frequent
Tárgyszavak:Orvostudományok Klinikai orvostudományok idézhető absztrakt
thrombolysis
Megjelenés:European Journal of Neurology. - 16 : Suppl. 3 (2009), p. 393. -
További szerzők:Fekete István (1951-) (neurológus, pszichiáter) Bereczki Dániel (1960-) (neurológus) Magyar T. Oláh László (1967-) (neurológus) Csépány Tünde (1956-) (neurológus, pszichiáter) Csiba László (1952-) (neurológus, pszichiáter)
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7.

001-es BibID:BIBFORM050854
035-os BibID:WOS:000324099200017
Első szerző:Mezei Zsolt (neurológus)
Cím:Cerebrovascular hemodynamic changes in multiple sclerosis patients during head-up tilt table test : effect of high-dose intravenous steroid treatment / Zsolt Mezei, Laszlo Olah, Laszlo Kardos, Reka Katalin Kovacs, Laszlo Csiba, Tunde Csepany
Dátum:2013
ISSN:0340-5354
Megjegyzések:Demyelination in multiple sclerosis (MS) may cause damage to the vegetative nervous system. Our objective was to examine cerebral autoregulation assessed via blood pressure and cerebral blood flow velocity fluctuations during head-up tilt table testing. We also investigated the effects of high-dose intravenous corticosteroid treatment. Transcranial Doppler registration of middle cerebral artery blood flow velocity and continuous blood pressure and heart rate monitoring were performed at rest and during tilt table testing in 30 MS patients. Ten age-matched healthy subjects were also examined as controls. Correlations between mean arterial blood pressure (MBP) and cerebral blood flow velocity (CBF) fluctuations were averaged, yielding the correlation coefficient index Mx. For a subgroup of 11 patients with acute exacerbations, results were also evaluated before and after methylprednisolone treatment (1 g/day intravenously for 5 days). No significant differences in the autoregulatory indices were seen between patients and controls, or between pre- and post-steroid results. Modeling CBF velocity changes associated with a 1-mmHg increase in MBP, significant differences (p < 0.05) were detected in patients vs. controls, and also after vs. before steroid administration. We conclude that cerebrovascular autoregulation impairments are detectable in early phase MS. Corticosteroid treatment has a significant effect on hemodynamic changes in acute exacerbations.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Journal of Neurology. - 260 : 9 (2013), p. 2335-2342. -
További szerzők:Oláh László (1967-) (neurológus) Kardos László (1970-) (megelőző orvostan és népegészségtan szakorvos) Czuriga-Kovács Katalin Réka (1981-) (neurológus) Csiba László (1952-) (neurológus, pszichiáter) Csépány Tünde (1956-) (neurológus, pszichiáter)
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8.

001-es BibID:BIBFORM103021
035-os BibID:(Wos)000809732300001 (Scopus)85131507832
Első szerző:Sharmin, Sifat
Cím:Confirmed disability progression as a marker of permanent disability in multiple sclerosis / Sharmin Sifat, Bovis Francesca, Malpas Charles, Horakova Dana, Havrdova Eva Kubala, Izquierdo Guillermo, Eichau Sara, Trojano Maria, Prat Alexandre, Girard Marc, Duquette Pierre, Onofrj Marco, Lugaresi Alessandra, Grand'Maison Francois, Grammond Pierre, Sola Patrizia, Ferraro Diana, Terzi Murat, Gerlach Oliver, Alroughani Raed, Boz Cavit, Shaygannejad Vahid, van Pesch Vincent, Cartechini Elisabetta, Kappos Ludwig, Lechner-Scott Jeannette, Bergamaschi Roberto, Turkoglu Recai, Solaro Claudio, Iuliano Gerardo, Granella Franco, Van Wijmeersch Bart, Spitaleri Daniele, Slee Mark, McCombe Pamela, Prevost Julie, Ampapa Radek, Ozakbas Serkan, Sanchez-Menoyo Jose Luis, Soysal Aysun, Vucic Steve, Petersen Thor, de Gans Koen, Butler Ernest, Hodgkinson Suzanne, Sidhom Youssef, Gouider Riadh, Cristiano Edgardo, Castillo-Trivino Tamara, Saladino Maria Laura, Barnett Michael, Moore Fraser, Rozsa Csilla, Yamout Bassem, Skibina Olga, van der Walt Anneke, Buzzard Katherine, Gray Orla, Hughes Stella, Sempere Angel Perez, Singhal Bhim, Fragoso Yara, Shaw Cameron, Kermode Allan, Taylor Bruce, Simo Magdolna, Shuey Neil, Al-Harbi Talal, Macdonell Richard, Dominguez Jose Andres, Csepany Tunde, Sirbu Carmen-Adella, Sormani Maria Pia, Butzkueven Helmut, Kalincik Tomas
Dátum:2022
ISSN:1351-5101
Megjegyzések:Background and purpose: The prevention of disability over the long term is the main treatment goal in multiple sclerosis (MS); however, randomized clinical trials evaluate only short-term treatment effects on disability. This study aimed to define criteria for 6-month confirmed disability progression events of MS with a high probability of resulting in sustained long-term disability worsening. Methods: In total, 14,802 6- month confirmed disability progression events were identified in 8741 patients from the global MSBase registry. For each 6-month confirmed progression event (13,321 in the development and 1481 in the validation cohort), a sustained progression score was calculated based on the demographic and clinical characteristics at the time of progression that were predictive of long-term disability worsening. The score was externally validated in the Cladribine Tablets Treating Multiple Sclerosis Orally (CLARITY) trial. Results: The score was based on age, sex, MS phenotype, relapse activity, disability score and its change from baseline, number of affected functional system domains and worsening in six of the domains. In the internal validation cohort, a 61% lower chance of improvement was estimated with each unit increase in the score (hazard ratio 0.39, 95% confidence interval 0.29?0.52; discriminatory index 0.89). The proportions of progression events sustained at 5 years stratified by the score were 1: 72%; 2: 88%; 3: 94%; 4: 100%. The results of the CLARITY trial were confirmed for reduction of disability progression that was >88% likely to be sustained (events with score ?1.5).Conclusions: Clinicodemographic characteristics of 6-month confirmed disability progression events identify those at high risk of sustained long-term disability. This knowledge will allow future trials to better assess the effect of therapy on long-term disability accrual.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:European Journal Of Neurology. - 29 : 8 (2022), p. 2321-2334. -
További szerzők:Bovis, Francesca Malpas, Charles Horakova, Dana Havrdova, Eva Izquierdo, Guillermo Eichau, Sara Trojano, Maria Prat, Alexandre Girard, Marc Duquette, Pierre Onofrj, Marco Lugaresi, Alessandra Grand'Maison, Francois Grammond, Pierre Sola, Patrizia Ferraro, Diana Terzi, Murat Gerlach, Oliver Alroughani, Raed Boz, Cavit Shaygannejad, Vahid Pesch, Vincent van Cartechini, Elisabetta Kappos, Ludwig Lechner-Scott, Jeannette Bergamaschi, Roberto Turkoglu, Recai Solaro, Claudio Iuliano, Gerardo Granella, Franco Van Wijmeersch, Bart Spitaleri, Daniele Slee, Mark McCombe, Pamela Prevost, Julie Ampapa, Radek Ozakbas, Serkan Sanchez-Menoyo, Jose Soysal, Aysun Vucic, Steve Petersen, Thor de Gans, Koen Butler, Ernest Hodgkinson, Suzanne Sidhom, Youssef Gouider, Riadh Cristiano, Edgardo Castillo Triviño, Tamara Saladino, Maria Laura Barnett, Michael Moore, Fraser Rózsa Csilla Yamout, Bassem Skibina, Olga Walt, Anneke van der Buzzard, Katherine Gray, Orla Hughes, Stella Sempere, Perez A. Singhal, Bhim Fragoso, Yara Shaw, Cameron Kermode, Allan G. Taylor, Bruce V. Simó Magdolna Shuey, Neil Al-Harbi, Talal Macdonell, Richard Dominguez, Jose Andres Csépány Tünde (1956-) (neurológus, pszichiáter) Sirbu, Carmen-Adella Sormani, Maria Pia Butzkueven, Helmut Kalincik, Tomas
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