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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:BIBFORM103012
035-os BibID:(Scopus)85102939985 (WOS)000631262400001 (cikkazonosító)611597
Első szerző:Hayden Zsófia
Cím:Clinical Characteristics and Outcome of Neuronal Surface Antibody-Mediated Autoimmune Encephalitis Patients in a National Cohort / Hayden Zsófia, Bóné Beáta, Orsi Gergely, Szots Monika, Nagy Ferenc, Csépány Tünde, Mezei Zsolt, Rajda Cecília, Simon Diána, Najbauer József, Illes Zsolt, Berki Timea
Dátum:2021
ISSN:1664-2295
Megjegyzések:Background: In our previous single-center study of autoimmune encephalitis (AE) related autoantibody test results we found positivity in 60 patients out of 1,034 with suspected AE from 2012 through 2018 as part of a Hungarian nationwide program. In our current multicenter retrospective study, we analyzed the clinical characteristics and outcome of AE patients with positive neuronal cell surface autoantibody test results. Methods: A standard online questionnaire was used to collect demographic and clinical characteristics, laboratory and imaging data, therapy and prognosis of 30 definitive AE patients in four major clinical centers of the region. Results: In our study, 19 patients were positive for anti-NMDAR (63%), 6 patients (20%) for anti-LGI1, 3 patients for anti-GABABR (10%) and 3 patients for anti-Caspr2 (10%) autoantibodies. Most common prodromal symptoms were fever or flu-like symptoms (10/30, 33%). Main clinical features included psychiatric symptoms (83%), epileptic seizures (73%) and memory loss (50%). 19 patients (63%) presented with signs of central nervous system (CNS) inflammation, which occurred more frequently in elder individuals (p = 0.024), although no significant differences were observed in sex, tumor association, time to diagnosis, prognosis and immunotherapy compared to AE patients without CNS inflammatory markers. Anti-NMDAR encephalitis patients were in more severe condition at the disease onset (p = 0.028), although no significant correlation between mRS score, age, sex and immunotherapy was found. 27% of patients (n = 8) with associated tumors had worse outcome (p = 0.045) than patients without tumor. In most cases, immunotherapy led to clinical improvement of AE patients (80%) who achieved a good outcome (mRS ? 2; median follow-up 33 months). Conclusion: Our study confirms previous publications describing characteristics of AE patients, however, differences were observed in anti-NMDAR encephalitis that showed no association with ovarian teratoma and occurred more frequently among young males. One-third of AE patients lacked signs of inflammation in both CSF and brain MRI, which emphasizes the importance of clinical symptoms and autoantibody testing in diagnostic workflow for early introduction of immunotherapy, which can lead to favorable outcome in AE patients.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Frontiers in Neurology. - 12 (2021), p. 1-11. -
További szerzők:Bóné Beáta Orsi Gergely Szots Monika Nagy Ferenc (neurológus Kaposvár) Csépány Tünde (1956-) (neurológus, pszichiáter) Mezei Zsolt (1979-) (neurológus) Rajda Cecília Simon Diána Najbauer József Illés Zsolt (neurológus, Pécs) Berki Tímea
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8.

001-es BibID:BIBFORM103011
035-os BibID:(Scopus)85102090793 (Wos)000656637200025
Első szerző:Kalincik, Tomas
Cím:Effect of Disease-Modifying Therapy on Disability in Relapsing-Remitting Multiple Sclerosis Over 15 Years / Kalincik Tomas, Diouf Ibrahima, Sharmin Sifat, Malpas Charles, Spelman Tim, Horakova Dana, Havrdova Eva Kubala, Trojano Maria, Izquierdo Guillermo, Lugaresi Alessandra, Prat Alexandre, Girard Marc, Duquette Pierre, Grammond Pierre, Jokubaitis Vilija, van der Walt Anneke, Grand'Maison Francois, Sola Patrizia, Ferraro Diana, Shaygannejad Vahid, Alroughani Raed, Hupperts Raymond, Terzi Murat, Boz Cavit, Lechner-Scott Jeannette, Pucci Eugenio, Van Pesch Vincent, Granella Franco, Bergamaschi Roberto, Spitaleri Daniele, Slee Mark, Vucic Steve, Ampapa Radek, McCombe Pamela, Ramo-Tello Cristina, Prevost Julie, Olascoaga Javier, Cristiano Edgardo, Barnett Michael, Saladino Maria Laura, Sanchez-Menoyo Jose Luis, Hodgkinson Suzanne, Rozsa Csilla, Hughes Stella, Moore Fraser, Shaw Cameron, Butler Ernest, Skibina Olga, Gray Orla, Kermode Allan, Csepany Tunde, Singhal Bhim, Shuey Neil, Piroska Imre, Taylor Bruce, Simo Magdolna, Sirbu Carmen-Adella, Sas Attila, Butzkueven Helmut, MSBase Study Group
Dátum:2021
ISSN:0028-3878 1526-632X
Megjegyzések:Objective To test the hypothesis that immunotherapy prevents long-term disability in relapsing-remitting multiple sclerosis (MS), we modeled disability outcomes in 14,717 patients. Methods We studied patients from MSBase followed for ?1 year, with ?3 visits, ?1 visit per year, and exposed to MS therapy, and a subset of patients with ?15-year follow-up. Marginal structural models were used to compare the cumulative hazards of 12-month confirmed increase and decrease in disability, Expanded Disability Status Scale (EDSS) step 6, and the incidence of relapses between treated and untreated periods. Marginal structural models were continuously readjusted for patient age, sex, pregnancy, date, disease course, time from first symptom, prior relapse history, disability, and MRI activity. Results A total of 14,717 patients were studied. During the treated periods, patients were less likely to experience relapses (hazard ratio 0.60, 95% confidence interval [CI] 0.43?0.82, p = 0.0016), worsening of disability (0.56, 0.38?0.82, p = 0.0026), and progress to EDSS step 6 (0.33, 0.19?0.59, p = 0.00019). Among 1,085 patients with ?15-year follow-up, the treated patients were less likely to experience relapses (0.59, 0.50?0.70, p = 10?9) and worsening of disability (0.81, 0.67?0.99, p = 0.043). Conclusion Continued treatment with MS immunotherapies reduces disability accrual by 19%?44% (95% CI 1%?62%), the risk of need of a walking aid by 67% (95% CI 41%?81%), and the frequency of relapses by 40?41% (95% CI 18%?57%) over 15 years. This study provides evidence that disease-modifying therapies are effective in improving disability outcomes in relapsing-remitting MS over the long term. Classification of Evidence This study provides Class IV evidence that, for patients with relapsing-remitting MS, long-term exposure to immunotherapy prevents neurologic disability.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Neurology. - 96 : 5 (2021), p. e783-e797. -
További szerzők:Diouf, Ibrahima Sharmin, Sifat Malpas, Charles Spelman, Tim Horakova, Dana Havrdova, Eva Trojano, Maria Izquierdo, Guillermo Lugaresi, Alessandra Prat, Alexandre Girard, Marc Duquette, Pierre Grammond, Pierre Jokubaitis, Vilija Walt, Anneke van der Grand'Maison, Francois Sola, Patrizia Ferraro, Diana Shaygannejad, Vahid Alroughani, Raed Hupperts, Raymond Terzi, Murat Boz, Cavit Lechner-Scott, Jeannette Pucci, Eugenio Pesch, Vincent van Granella, Franco Bergamaschi, Roberto Spitaleri, Daniele Slee, Mark Vucic, Steve Ampapa, Radek McCombe, Pamela Ramo-Tello, Cristina Prevost, Julie Olascoaga, Javier Cristiano, Edgardo Barnett, Michael Saladino, Maria Laura Sanchez-Menoyo, Jose Hodgkinson, Suzanne Rózsa Csilla Hughes, Stella Moore, Fraser Shaw, Cameron Butler, Ernest Skibina, Olga Gray, Orla Kermode, Allan G. Csépány Tünde (1956-) (neurológus, pszichiáter) Singhal, Bhim Shuey, Neil Piroska Imre Taylor, Bruce V. Simó Magdolna Sirbu, Carmen-Adella Sas Attila Butzkueven, Helmut MSBase Study Group
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Intézményi repozitóriumban (DEA) tárolt változat
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9.

001-es BibID:BIBFORM067755
Első szerző:Kalincik, Tomas
Cím:Treatment effectiveness of alemtuzumab compared with natalizumab, fingolimod, and interferon beta in relapsing-remitting multiple sclerosis : a cohort study / Tomas Kalincik, J. William L. Brown, Neil Robertson, Mark Willis, Neil Scolding, Claire M. Rice, Alastair Wilkins, Owen Pearson, Tjalf Ziemssen, Michael Hutchinson, Christopher McGuigan, Vilija Jokubaitis, Tim Spelman, Dana Horakova, Eva Havrdova, Maria Trojano, Guillermo Izquierdo, Alessandra Lugaresi, Alexandre Prat, Marc Girard, Pierre Duquette, Pierre Grammond, Raed Alroughani, Eugenio Pucci, Patrizia Sola, Raymond Hupperts, Jeannette Lechner-Scott, Murat Terzi, Vincent Van Pesch, Csilla Rozsa, François Grand'Maison, Cavit Boz, Franco Granella, Mark Slee, Daniele Spitaleri, Javier Olascoaga, Roberto Bergamaschi, Freek Verheul, Steve Vucic, Pamela McCombe, Suzanne Hodgkinson, Jose Luis Sanchez-Menoyo, Radek Ampapa, Magdolna Simo, Tunde Csepany, Cristina Ramo, Edgardo Cristiano, Michael Barnett, Helmut Butzkueven, Alasdair Coles, MSBase Study Group
Dátum:2017
ISSN:1474-4422
Megjegyzések:BackgroundAlemtuzumab, an anti-CD52 antibody, is proven to be more efficacious than interferon beta-1a in the treatment of relapsing-remitting multiple sclerosis, but its efficacy relative to more potent immunotherapies is unknown. We compared the effectiveness of alemtuzumab with natalizumab, fingolimod, and interferon beta in patients with relapsing-remitting multiple sclerosis treated for up to 5 years.MethodsIn this international cohort study, we used data from propensity-matched patients with relapsing-remitting multiple sclerosis from the MSBase and six other cohorts. Longitudinal clinical data were obtained from 71 MSBase centres in 21 countries and from six non-MSBase centres in the UK and Germany between Nov 1, 2015, and June 30, 2016. Key inclusion criteria were a diagnosis of definite relapsing-remitting multiple sclerosis, exposure to one of the study therapies (alemtuzumab, interferon beta, fingolimod, or natalizumab), age 65 years or younger, Expanded Disability Status Scale (EDSS) score 6?5 or lower, and no more than 10 years since the first multiple sclerosis symptom. The primary endpoint was annualised relapse rate. The secondary endpoints were cumulative hazards of relapses, disability accumulation, and disability improvement events. We compared relapse rates with negative binomial models, and estimated cumulative hazards with conditional proportional hazards models.FindingsPatients were treated between Aug 1, 1994, and June 30, 2016. The cohorts consisted of 189 patients given alemtuzumab, 2155 patients given interferon beta, 828 patients given fingolimod, and 1160 patients given natalizumab. Alemtuzumab was associated with a lower annualised relapse rate than interferon beta (0?19 [95% CI 0?14?0?23] vs 0?53 [0?46?0?61], p<0?0001) and fingolimod (0?15 [0?10?0?20] vs 0?34 [0?26?0?41], p<0?0001), and was associated with a similar annualised relapse rate as natalizumab (0?20 [0?14?0?26] vs 0?19 [0?15?0?23], p=0?78). For the disability outcomes, alemtuzumab was associated with similar probabilities of disability accumulation as interferon beta (hazard ratio [HR] 0?66 [95% CI 0?36?1?22], p=0?37), fingolimod (1?27 [0?60?2?70], p=0?67), and natalizumab (0?81 [0?47?1?39], p=0?60). Alemtuzumab was associated with similar probabilities of disability improvement as interferon beta (0?98 [0?65?1?49], p=0?93) and fingolimod (0?50 [0?25?1?01], p=0?18), and a lower probability of disability improvement than natalizumab (0?35 [0?20?0?59], p=0?0006).InterpretationAlemtuzumab and natalizumab seem to have similar effects on annualised relapse rates in relapsing-remitting multiple sclerosis. Alemtuzumab seems superior to fingolimod and interferon beta in mitigating relapse activity. Natalizumab seems superior to alemtuzumab in enabling recovery from disability. Both natalizumab and alemtuzumab seem highly effective and viable immunotherapies for multiple sclerosis. Treatment decisions between alemtuzumab and natalizumab should be primarily governed by their safety profiles.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Lancet Neurology 16 : 4 (2017), p. 271-281. -
További szerzők:Brown, Jeremy William L. Robertson, Neil Willis, Mark Scolding, Neil Rice, Claire M. Wilkins, Alastair Pearson, Owen Ziemssen, Tjalf Hutchinson, Michael McGuigan, Christopher Jokubaitis, Vilija Spelman, Tim Horakova, Dana Havrdova, Eva Trojano, Maria Izquierdo, Guillermo Lugaresi, Alessandra Prat, Alexandre Girard, Marc Duquette, Pierre Grammond, Pierre Alroughani, Raed Pucci, Eugenio Sola, Patrizia Hupperts, Raymond Lechner-Scott, Jeannette Terzi, Murat Pesch, Vincent van Rózsa Csilla Grand'Maison, Francois Boz, Cavit Granella, Franco Slee, Mark Spitaleri, Daniele Olascoaga, Javier Bergamaschi, Roberto Verheul, Freek Vucic, Steve McCombe, Pamela Hodgkinson, Suzanne Sanchez-Menoyo, Jose Ampapa, Radek Simó Magdolna Csépány Tünde (1956-) (neurológus, pszichiáter) Ramo, Cristina Cristiano, Edgardo Barnett, Michael Butzkueven, Helmut Coles, Alasdair MSBase Study Group
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Intézményi repozitóriumban (DEA) tárolt változat
Borító:

10.

001-es BibID:BIBFORM058152
Első szerző:Kalincik, Tomas
Cím:Switch to natalizumab versus fingolimod in active relapsing-remitting multiple sclerosis / Tomas Kalincik, Dana Horakova, Tim Spelman, Vilija Jokubaitis, Maria Trojano, Alessandra Lugaresi, Guillermo Izquierdo, Csilla Rozsa, Pierre Grammond, Raed Alroughani, Pierre Duquette, Marc Girard, Eugenio Pucci, Jeannette Lechner-Scott, Mark Slee, Ricardo Fernandez-Bolanos, Francois Grand'Maison, Raymond Hupperts, Freek Verheul, Suzanne Hodgkinson, Celia Oreja-Guevara, Daniele Spitaleri, Michael Barnett, Murat Terzi, Roberto Bergamaschi, Pamela McCombe, Jose Sanchez-Menoyo, Magdolna Simo, Tunde Csepany, Gabor Rum, Cavit Boz, Eva Havrdova, Helmut Butzkueven
Dátum:2015
ISSN:0364-5134
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Annals Of Neurology. - 77 : 3 (2015), p. 425-435. -
További szerzők:Horakova, Dana Spelman, Tim Jokubaitis, Vilija Trojano, Maria Lugaresi, Alessandra Izquierdo, Guillermo Rózsa Csilla Grammond, Pierre Alroughani, Raed Duquette, Pierre Girard, Marc Pucci, Eugenio Lechner-Scott, Jeannette Slee, Mark Fernandez-Bolanos, Ricardo Grand'Maison, Francois Hupperts, Raymond Verheul, Freek Hodgkinson, Suzanne Oreja-Guevara, Celia Spitaleri, Daniele Barnett, Michael Terzi, Murat Bergamaschi, Roberto McCombe, Pamela Sanchez-Menoyo, Jose Simó Magdolna Csépány Tünde (1956-) (neurológus, pszichiáter) Rum Gábor Boz, Cavit Havrdova, Eva Butzkueven, Helmut
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Intézményi repozitóriumban (DEA) tárolt változat
Borító:

11.

001-es BibID:BIBFORM067748
Első szerző:Kappos, Ludwig
Cím:The 11-year long-term follow-up study from the randomized BENEFIT CIS trial / Ludwig Kappos, Gilles Edan, Mark S. Freedman, Xavier Montalbán, Hans-Peter Hartung, Bernhard Hemmer, Edward J. Fox, Frederik Barkhof, Sven Schippling, Andrea Schulze, Dirk Pleimes, Christoph Pohl, Rupert Sandbrink, Gustavo Suarez, Eva-Maria Wicklein, BENEFIT Study Group
Dátum:2016
ISSN:0028-3878
Megjegyzések:Objective: To assess outcomes for patients treated with interferon beta-1b immediately after clinically isolated syndrome (CIS) or after a short delay.Methods: Participants in BENEFIT (Betaferon/Betaseron in Newly Emerging MS for Initial Treatment) were randomly assigned to receive interferon beta-1b (early treatment) or placebo (delayed treatment). After conversion to clinically definite multiple sclerosis (CDMS) or 2 years, patients on placebo could switch to interferon beta-1b or another treatment. Eleven years after randomization, patients were reassessed.Results: Two hundred seventy-eight (59.4%) of the original 468 patients (71.3% of those eligible atparticipating sites) were enrolled (early: 167 [57.2%]; delayed: 111 [63.1%]). After 11 years, risk of CDMS remained lower in the early-treatment arm compared with the delayed-treatment arm (p 50.0012), with longer time to first relapse (median [Q1, Q3] days: 1,888 [540, not reached] vs 931 [253, 3,296]; p50.0005) and lower overall annualized relapse rate (0.21 vs 0.26; p50.0018). Only25 patients (5.9%, overall; early, 4.5%; delayed, 8.3%) converted to secondary progressive multiple sclerosis. Expanded Disability Status Scale scores remained low and stable, with no differencebetween treatment arms (median [Q1,Q3]: 2.0 [1.0, 3.0]). The early-treatment group had better Paced Auditory Serial Addition Task?3 total scores (p 5 0.0070). Employment rates remained high, and health resource utilization tended to be low in both groups.MRI metrics did not differ between groups.Conclusions: Although the delay in treatment was relatively short, several clinical outcomes favored earlier treatment. Along with low rates of disability and disease progression in bothgroups, this supports the value of treatment at CIS.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Neurology 87 : 10 (2016), p. 978-987. -
További szerzők:Edan, Gilles Freedman, Mark S. Montalbán, Xavier Hartung, Hans-Peter Hemmer, Bernhard Fox, Edward J. Barkhof, Frederik Schippling, Sven Schulze, Andrea Pleimes, Dirk Pohl, Christoph Sandbrink, Rupert Suarez, Gustavo Wicklein, Eva-Maria Csiba László (1952-) (neurológus, pszichiáter) Csépány Tünde (1956-) (neurológus, pszichiáter) BENEFIT Study Group
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Intézményi repozitóriumban (DEA) tárolt változat
Borító:

12.

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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