scholarly journals Chemokine Receptors as Biomarkers in Multiple Sclerosis

2006 ◽  
Vol 22 (4) ◽  
pp. 227-233 ◽  
Author(s):  
Robert J. Fox ◽  
Pia Kivisäkk ◽  
Jar-Chi Lee ◽  
Barbara Tucky ◽  
Claudia Lucchinetti ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Chemokine Receptors ◽  
Individual Variability ◽  
Response To Treatment ◽  
Considerable Variability ◽  
Set Point ◽  
Disease Modifying Therapies ◽  
Disease Modifying ◽  
Peripheral Leukocytes ◽  
Over Time

Leukocyte infiltrates characterize tissue inflammation and are thought to be integral in the pathogenesis of multiple sclerosis (MS). This attribute underlines the importance of understanding mechanisms of leukocyte migration. Chemokines are secreted proteins which govern leukocyte trafficking into targeted organs. Chemokine receptors (CKR) are differentially expressed on leukocytes and their modulation is a potential target for MS disease modifying therapies. Chemokines and their receptors are also potential biomarkers of both disease activity and response to treatment. We describe the fluctuations in CKR expression on peripheral leukocytes in a group of MS patients followed longitudinally for up to 36 months. We observed little fluctuation in CKR expression within each patient over time, despite considerable variability in CKR expression between patients. These observations suggest that individual patients have a CKR set point, and this set point varies from one patient to another. Evaluation of chemokines or chemokine receptors as biomarkers in MS will need to account for this individual variability in CKR expression.

scholarly journals Predictors of adherence and persistence to disease-modifying therapies in Multiple Sclerosis

2021 ◽  
Vol 14 ◽  
pp. 175628642110310
Author(s):  
Gisela Zanga ◽  
Estefania Drzewiscki ◽  
Paula Tagliani ◽  
Maximiliano Smietniansky ◽  
Maria M. Esnaola y Rojas ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Medication Possession Ratio ◽  
Care Program ◽  
Cross Sectional Study ◽  
Response To Treatment ◽  
Cross Sectional ◽  
National Medical ◽  
Disease Modifying Therapies ◽  
Disease Modifying ◽  
Predictors Of Adherence

Background and Aims: In multiple sclerosis (MS), non-adherence/non-persistence is related to suboptimal response to treatment, including disease relapses and the need for more expensive healthcare. The aim of this study was to identify predictors related to adherence to disease modifying therapies (DMTs) in a cohort of Argentinian MS patients. Methods: We conducted a cross-sectional study at the National Medical Care Program from Argentina. MS patients with at least one claim for a DMT from 1 January 2017 to 1 October 2017 were identified. A telephone survey was performed to assess clinical and demographic factors. The medication possession ratio (MPR) was used to estimate adherence; MPR <80% defined non-adherence. Associations were studied using a logistic regression model. Results: Our database included 648 MS patients. A total of 360 patients (60% females, mean age 55.3 years) accepted to participate. Of these, 308 (85.5%) patients were receiving DMT at the time of the survey. Some 198 (63.7%) were receiving injectable therapies. Optimal adherence was 47.7%. Adherence was associated with oral medication [odds ratio (OR) 1.83 95% confidence interval (CI) 1.13–3.00, p = 0.014]. A factor related to oral drugs was higher educational level (OR 2.86 95%CI 1.41–5.81, p = 0.004). Conclusion: This real-world study showed better adherence and persistence on treatment with oral therapies in MS patients in Argentina.

scholarly journals Ethical use of off-label disease-modifying therapies for multiple sclerosis

2021 ◽  
pp. 135245852110302
Author(s):  
Joanna Laurson-Doube ◽  
Nick Rijke ◽  
Anne Helme ◽  
Peer Baneke ◽  
Brenda Banwell ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
World Health ◽  
World Federation ◽  
Off Label ◽  
Disease Modifying Therapies ◽  
The World ◽  
Disease Modifying ◽  
Health Organization

Background: Off-label disease-modifying therapies (DMTs) for multiple sclerosis (MS) are used in at least 89 countries. There is a need for structured and transparent evidence-based guidelines to support clinical decision-making, pharmaceutical policies and reimbursement decisions for off-label DMTs. Objectives/Results: The authors put forward general principles for the ethical use of off-label DMTs for treating MS and a process to assess existing evidence and develop recommendations for their use. Conclusion: The principles and process are endorsed by the World Federation of Neurology (WFN), American Academy of Neurology (AAN), European Academy of Neurology (EAN), Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS), European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), Middle-East North Africa Committee for Treatment and Research in Multiple Sclerosis (MENACTRIMS) and Pan-Asian Committee for Treatment and Research in Multiple Sclerosis (PACTRIMS), and we have regularly consulted with the Brain Health Unit, Mental Health and Substance Use Department at the World Health Organization (WHO).

scholarly journals Disease‐Modifying Therapies and Coronavirus Disease 2019 Severity in Multiple Sclerosis

2021 ◽  
Author(s):  
Maria P. Sormani ◽  
Nicola De Rossi ◽  
Irene Schiavetti ◽  
Luca Carmisciano ◽  
Cinzia Cordioli ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Disease Modifying Therapies ◽  
Disease Modifying

Human papillomavirus lesions in 16 MS patients treated with fingolimod: Outcomes and vaccination

2021 ◽  
pp. 135245852199143
Author(s):  
Elsa Mhanna ◽  
Agathe Nouchi ◽  
Céline Louapre ◽  
Raphael De Paz ◽  
Olivier Heinzlef ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Human Papillomavirus ◽  
Hpv Vaccination ◽  
Case Series ◽  
Good Tolerance ◽  
Prevalence Studies ◽  
Disease Modifying Therapies ◽  
Disease Modifying ◽  
Hpv Screening

Few cases of human papillomavirus (HPV) diseases have been reported in multiple sclerosis (MS) patients treated with fingolimod. We describe a case series of 16 MS patients (11 women, 5 men) developing HPV lesions after the onset of fingolimod, without previous HPV history. Fingolimod had to be discontinued in six patients. Six patients received vaccination for HPV, with good tolerance. Our report highlights that systematic HPV screening and discussion about HPV vaccination before fingolimod onset are crucial. In case of occurrence of HPV lesions during fingolimod treatment, a comprehensive workup of HPV disease is necessary, with discussion of HPV vaccination to prevent secondary lesions. Prevalence studies of HPV lesions are needed in MS patients with the different disease-modifying therapies.

Sign in / Sign up

Export Citation Format

Share Document