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Safety and clinical effectiveness of peginterferon beta-1a for relapsing multiple sclerosis in a real-world setting: Final results from the Plegridy Observational Program. 在真实世界环境中,peginterferon beta-1a 治疗复发性多发性硬化症的安全性和临床有效性:Plegridy 观察项目的最终结果。
IF 2.8 Q2 Medicine Pub Date : 2024-05-23 eCollection Date: 2024-04-01 DOI: 10.1177/20552173241238632
Marco Salvetti, Sibyl Wray, Gereon Nelles, Nicholas Belviso, Achint Kumar, Thijs Koster, Wanda Castro-Borrero, Megan Vignos

Background: Interferon beta-1a remains an important treatment option for multiple sclerosis, particularly when safety or tolerability concerns may outweigh the benefits of higher-efficacy disease-modifying therapies. The five-year phase 4 Plegridy Observational Program (POP) study (NCT02230969) collected data on real-world safety and effectiveness of Plegridy® (peginterferon beta-1a) treatment in patients with relapsing multiple sclerosis.

Objective: To explore the real-world safety and effectiveness of peginterferon beta-1a in patients with relapsing multiple sclerosis, including factors influencing treatment discontinuation.

Methods: Data were collected prospectively from patients ≥ 18 years old with relapsing multiple sclerosis for overall population analysis and for subpopulations including newly/previously diagnosed patients, age, and experience with peginterferon beta-1a. Outcome measures included annualized relapse rates, adverse events, and predictors of time to treatment discontinuation.

Results: Mean (SD) treatment duration in the overall population (N = 1172) was 896.0 (733.15) days. Incidence of adverse events was higher in new than experienced users (79.4% vs. 57.0%). New users were more likely than experienced users to discontinue (hazard ratio = 1.60; P < 0.0001). The adjusted annualized relapse rate was 0.09, and at the end of 5 years, 77.1% of patients were relapse-free.

Conclusions: Peginterferon beta-1a is an effective therapy for managing relapsing multiple sclerosis. The identification of predictors of discontinuation can help inform strategies to enhance treatment persistence.

背景:干扰素β-1a仍然是多发性硬化症的重要治疗选择,尤其是当安全性或耐受性方面的问题可能超过疗效更高的疾病改变疗法的益处时。为期五年的4期Plegridy观察项目(POP)研究(NCT02230969)收集了复发性多发性硬化症患者接受Plegridy®(peginterferon beta-1a)治疗的实际安全性和有效性数据:探讨peginterferon beta-1a在复发性多发性硬化症患者中的实际安全性和有效性,包括影响治疗中止的因素:前瞻性地收集了年龄≥18岁的复发性多发性硬化症患者的数据,用于总体人群分析和亚人群分析,包括新诊断/既往诊断患者、年龄和使用peginterferon beta-1a的经验。结果测量包括年化复发率、不良事件和终止治疗时间的预测因素:总体患者(N = 1172)的平均(标度)治疗时间为 896.0 (733.15) 天。新用药者的不良反应发生率高于老用药者(79.4% 对 57.0%)。新用药者比老用药者更有可能停药(危险比 = 1.60;P 结论:新用药者比老用药者更有可能停药:培根干扰素 beta-1a 是治疗复发性多发性硬化症的有效疗法。识别中断治疗的预测因素有助于制定提高治疗持久性的策略。
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引用次数: 0
Low-intensity repetitive transcranial magnetic stimulation is safe and well tolerated by people living with MS - outcomes of the phase I randomised controlled trial (TAURUS). 低强度重复经颅磁刺激对多发性硬化症患者安全且耐受性良好--第一阶段随机对照试验(TAURUS)的结果。
IF 2.8 Q2 Medicine Pub Date : 2024-05-15 eCollection Date: 2024-04-01 DOI: 10.1177/20552173241252571
Phuong Tram Nguyen, Amin Zarghami, Kalina Makowiecki, Natasha Stevens, Chigozie Ezegbe, Kain Kyle, Chenyu Wang, Linda Ly, Katie De La Rue, Mark R Hinder, Lewis Johnson, Jennifer Rodger, Samantha Cooper, Carlie L Cullen, Michael Barnett, Kaylene M Young, Bruce V Taylor

Background: Low-intensity repetitive transcranial magnetic stimulation (rTMS), delivered as a daily intermittent theta burst stimulation (iTBS) for four consecutive weeks, increased the number of new oligodendrocytes in the adult mouse brain. Therefore, rTMS holds potential as a remyelinating intervention for people with multiple sclerosis (MS).

Objective: Primarily to determine the safety and tolerability of our rTMS protocol in people with MS. Secondary objectives include feasibility, blinding and an exploration of changes in magnetic resonance imaging (MRI) metrics, patient-reported outcome measures (PROMs) and cognitive or motor performance.

Methods: A randomised (2:1), placebo controlled, single blind, parallel group, phase 1 trial of 20 rTMS sessions (600 iTBS pulses per hemisphere; 25% maximum stimulator output), delivered over 4-5 weeks. Twenty participants were randomly assigned to 'sham' (n = 7) or active rTMS (n = 13), with the coil positioned at 90° or 0°, respectively.

Results: Five adverse events (AEs) including one serious AE reported. None were related to treatment. Protocol compliance was high (85%) and blinding successful. Within participant MRI metrics, PROMs and cognitive or motor performance were unchanged over time.

Conclusion: Twenty sessions of rTMS is safe and well tolerated in a small group of people with MS. The study protocol and procedures are feasible. Improvement of sham is warranted before further investigating safety and efficacy.

背景连续四周、每天进行间歇性θ脉冲刺激(iTBS)的低强度重复经颅磁刺激(rTMS)可增加成年小鼠大脑中新生少突胶质细胞的数量。因此,经颅磁刺激有可能成为多发性硬化症(MS)患者的髓鞘再形成干预措施:主要目的:确定我们的经颅磁刺激方案对多发性硬化症患者的安全性和耐受性。次要目标包括可行性、盲法以及探索磁共振成像(MRI)指标、患者报告结果指标(PROMs)和认知或运动表现的变化:随机(2:1)、安慰剂对照、单盲、平行组、第一阶段试验,20 次经颅磁刺激(每个半球 600 iTBS 脉冲;25% 最大刺激器输出),持续 4-5 周。20名参与者被随机分配到 "假"(n = 7)或主动经颅磁刺激(n = 13),线圈位置分别为90°或0°:结果:共报告了五例不良事件(AE),其中包括一例严重不良事件。无一与治疗相关。方案依从性高(85%),盲法成功。参试者的磁共振成像指标、PROMs和认知或运动表现随时间推移没有变化:结论:对一小部分多发性硬化症患者来说,20 次经颅磁刺激治疗是安全且耐受性良好的。研究方案和程序是可行的。在进一步研究安全性和有效性之前,需要对假象进行改进。
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引用次数: 0
Clinical outcomes after use of checkpoint inhibitor immunotherapies in people with multiple sclerosis. 多发性硬化症患者使用检查点抑制剂免疫疗法后的临床疗效。
IF 2.8 Q2 Medicine Pub Date : 2024-05-07 eCollection Date: 2024-04-01 DOI: 10.1177/20552173241252563
Alyssa N Nylander, William Rowles, Shane Poole, Riley Bove

Background: Immune checkpoint inhibitors (ICIs) represent a novel class of agents approved for the treatment of several cancers and progressive multifocal leukoencephalopathy (PML). However, due to the risk of autoimmune side effects, their use in people with autoimmune diseases such as multiple sclerosis (MS) has been limited.

Objective: To characterize outcomes in a cohort of adults with MS who received ICIs.

Methods: A single-center retrospective review of medical record data was performed for people with MS treated with ICIs.

Results: Seven people with MS were identified, with a mean (SD) age at ICI use of 55.4 (13.7) years and a mean MS duration of 18.2 (12.2) years. Six were treated for cancer; 1 was treated for PML. After mean (SD) follow-up of 1.76 (2.15) years after ICI, outcomes are: no evidence of disease (2), residual metastatic disease (1), death due to cancer (1), death due to PML (1), and lost to follow-up (2). Notably, 0 out of 7 patients experienced an MS relapse; two out of six had new asymptomatic demyelinating magnetic resonance imaging lesions. In the three patients with expanded disability status scale (EDSS) scores at baseline and follow-up, EDSS remained stable (mean delta 0.13).

Conclusion: In this cohort, no people with MS experienced clinical relapses and one-third experienced asymptomatic radiological activity following ICI treatment.

背景:免疫检查点抑制剂(ICIs)是一类新型药物,已被批准用于治疗多种癌症和进行性多灶性白质脑病(PML)。然而,由于存在自身免疫副作用的风险,它们在多发性硬化症(MS)等自身免疫性疾病患者中的应用受到了限制:目的:描述一组接受 ICIs 治疗的多发性硬化症成人患者的治疗效果:方法:对接受 ICIs 治疗的 MS 患者的病历数据进行单中心回顾性分析:结果:共发现 7 名多发性硬化症患者,使用 ICIs 时的平均(标清)年龄为 55.4 (13.7) 岁,多发性硬化症的平均病程为 18.2 (12.2) 年。其中 6 人接受过癌症治疗,1 人接受过 PML 治疗。ICI 后平均(标清)随访 1.76(2.15)年,结果为:无疾病证据(2 例)、残留转移性疾病(1 例)、因癌症死亡(1 例)、因 PML 死亡(1 例)和失去随访(2 例)。值得注意的是,7 名患者中有 0 人多发性硬化症复发;6 人中有 2 人出现新的无症状脱髓鞘磁共振成像病变。在基线和随访时有扩大残疾状态量表(EDSS)评分的三名患者中,EDSS保持稳定(平均delta值为0.13):结论:在这组患者中,没有多发性硬化症患者出现临床复发,三分之一的患者在接受 ICI 治疗后出现了无症状的放射性活动。
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引用次数: 0
The patient-reported wearing-off phenomenon with monoclonal antibody treatments for multiple sclerosis. 单克隆抗体治疗多发性硬化症的患者报告磨损现象。
IF 2.8 Q2 Medicine Pub Date : 2024-05-06 eCollection Date: 2024-04-01 DOI: 10.1177/20552173241251707
Lindsey M Marian, Kathleen A Harris, Devon S Conway

Background: Many patients report a wearing-off phenomenon with monoclonal antibody treatment for multiple sclerosis in which perceived benefits wear off before the next dose is due.

Objectives: To determine prevalence of the wearing-off effect, symptoms experienced, impact on treatment satisfaction, and associated patient characteristics.

Methods: Patients receiving natalizumab, ocrelizumab, ofatumumab, or rituximab at a tertiary multiple sclerosis center were invited to take an online survey interrogating their monoclonal antibody experience. Additional history and patient characteristic data were collected. Logistic regression was used to determine if patient characteristics predicted the wearing-off effect and linear regression to evaluate the impact of the wearing-off effect on treatment satisfaction. The models were adjusted for age, disease duration, race, sex, body mass index, education, and depression as measured by the Patient Health Questionnaire-9.

Results: We received 258 qualifying responses and 141 (54.7%) patients reported the wearing-off phenomenon. The most common symptom was fatigue (47.7%). Higher Patient Health Questionnaire-9 scores were significantly associated with the wearing-off phenomenon (OR = 1.02, p = 0.005). The wearing-off effect (β = -0.52, p = 0.04) and higher Patient Health Questionnaire-9 (β = -0.09, p < 0.01) scores were associated with significantly reduced treatment satisfaction.

Conclusion: The wearing-off phenomenon is common, associated with depression, and reduces treatment satisfaction. Research addressing mitigation strategies is needed.

背景:许多患者报告说,在单克隆抗体治疗多发性硬化症的过程中会出现药效消失现象,即在下一次用药到期之前,患者感觉到的疗效就会消失:确定消退效应的发生率、出现的症状、对治疗满意度的影响以及相关的患者特征:方法:邀请在一家三级多发性硬化症治疗中心接受纳妥珠单抗、奥克里珠单抗、ofatumumab或利妥昔单抗治疗的患者进行在线调查,了解他们的单克隆抗体治疗经历。此外还收集了其他病史和患者特征数据。我们使用逻辑回归来确定患者特征是否能预测消退效应,并使用线性回归来评估消退效应对治疗满意度的影响。这些模型根据年龄、病程、种族、性别、体重指数、教育程度和患者健康问卷-9 测量的抑郁程度进行了调整:结果:我们收到了 258 份合格答卷,其中 141 名患者(54.7%)报告了消退现象。最常见的症状是疲劳(47.7%)。患者健康问卷-9 评分越高,磨损现象越明显(OR = 1.02,p = 0.005)。磨损效应(β = -0.52,p = 0.04)和较高的患者健康问卷-9(β = -0.09,p 结论:患者健康问卷-9得分越高,磨损效应越明显:消退现象很常见,与抑郁有关,并会降低治疗满意度。需要对缓解策略进行研究。
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引用次数: 0
High-resolution diffusion tensor imaging of the fornix predicts memory function in multiple sclerosis. 穹窿的高分辨率弥散张量成像可预测多发性硬化症患者的记忆功能。
IF 2.8 Q2 Medicine Pub Date : 2024-05-06 eCollection Date: 2024-04-01 DOI: 10.1177/20552173241240937
Katherine A Koenig, Ken E Sakaie, Daniel Ontaneda, Kedar R Mahajan, Se-Hong Oh, Kunio Nakamura, Stephen E Jones, Stephen M Rao, Mark J Lowe

Background: Cognitive dysfunction is a known symptom of multiple sclerosis (MS), with memory recognized as a frequently impacted domain. Here, we used high-resolution MRI at 7 tesla to build on cross-sectional work by evaluating the longitudinal relationship of diffusion tensor imaging (DTI) measures of the fornix to episodic memory performance.

Methods: A sample of 80 people with multiple sclerosis (mean age 51.9 ± 8.1 years; 24% male) underwent baseline clinical evaluation, neuropsychological assessment, and MRI. Sixty-four participants had follow-up neuropsychological testing after 1-2 years. Linear regression was used to assess the relationship of baseline imaging measures to follow-up episodic memory performance, measured using the Selective Reminding Test and Brief Visuospatial Memory Test. A reduced prediction model included cognitive function at baseline, age, sex, and disease course.

Results: Radial (β = -0.222, p < 0.026; likelihood ratio test (LRT) p < 0.018), axial (β = -0.270, p < 0.005; LRT p < 0.003), and mean (β = -0.242, p < 0.0139; LRT p < 0.009) diffusivity of the fornix significantly added to the model, with follow-up analysis indicating that a longer prediction interval may increase accuracy.

Conclusion: These results suggest that fornix DTI has predictive value specific to memory function in MS and warrants additional investigation in the drive to develop predictors of disease progression.

背景:认知功能障碍是多发性硬化症(MS)的一个已知症状,而记忆被认为是一个经常受到影响的领域。在此,我们使用 7 特斯拉高分辨率核磁共振成像技术,在横断面研究的基础上,评估了穹窿部弥散张量成像(DTI)测量与外显记忆表现的纵向关系:80名多发性硬化症患者(平均年龄为51.9 ± 8.1岁;24%为男性)接受了基线临床评估、神经心理学评估和核磁共振成像检查。64名患者在1-2年后接受了后续神经心理学测试。采用线性回归评估了基线成像测量与后续外显记忆表现之间的关系,外显记忆表现采用选择性记忆测试和简短视觉空间记忆测试进行测量。简化预测模型包括基线认知功能、年龄、性别和病程:Radial (β = -0.222, p p p p p 结论:这些结果表明,穹窿 DTI 对多发性硬化症患者的记忆功能具有预测价值,值得进一步研究,以开发疾病进展的预测指标。
{"title":"High-resolution diffusion tensor imaging of the fornix predicts memory function in multiple sclerosis.","authors":"Katherine A Koenig, Ken E Sakaie, Daniel Ontaneda, Kedar R Mahajan, Se-Hong Oh, Kunio Nakamura, Stephen E Jones, Stephen M Rao, Mark J Lowe","doi":"10.1177/20552173241240937","DOIUrl":"10.1177/20552173241240937","url":null,"abstract":"<p><strong>Background: </strong>Cognitive dysfunction is a known symptom of multiple sclerosis (MS), with memory recognized as a frequently impacted domain. Here, we used high-resolution MRI at 7 tesla to build on cross-sectional work by evaluating the longitudinal relationship of diffusion tensor imaging (DTI) measures of the fornix to episodic memory performance.</p><p><strong>Methods: </strong>A sample of 80 people with multiple sclerosis (mean age 51.9 ± 8.1 years; 24% male) underwent baseline clinical evaluation, neuropsychological assessment, and MRI. Sixty-four participants had follow-up neuropsychological testing after 1-2 years. Linear regression was used to assess the relationship of baseline imaging measures to follow-up episodic memory performance, measured using the Selective Reminding Test and Brief Visuospatial Memory Test. A reduced prediction model included cognitive function at baseline, age, sex, and disease course.</p><p><strong>Results: </strong>Radial (β = -0.222, <i>p</i> < 0.026; likelihood ratio test (LRT) <i>p</i> < 0.018), axial (β = -0.270, <i>p</i> < 0.005; LRT <i>p</i> < 0.003), and mean (β = -0.242, <i>p</i> < 0.0139; LRT <i>p</i> < 0.009) diffusivity of the fornix significantly added to the model, with follow-up analysis indicating that a longer prediction interval may increase accuracy.</p><p><strong>Conclusion: </strong>These results suggest that fornix DTI has predictive value specific to memory function in MS and warrants additional investigation in the drive to develop predictors of disease progression.</p>","PeriodicalId":18961,"journal":{"name":"Multiple Sclerosis Journal - Experimental, Translational and Clinical","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11075608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140876866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Coronavirus disease 2019 infection among working-aged people with multiple sclerosis and the impact of disease-modifying therapies. 2019年多发性硬化症工作年龄段患者中的冠状病毒疾病感染以及疾病缓解疗法的影响。
IF 2.8 Q2 Medicine Pub Date : 2024-04-27 eCollection Date: 2024-04-01 DOI: 10.1177/20552173241248293
Chantelle Murley, Emma Pettersson, Jan Hillert, Alejandra Machado, Emilie Friberg

Background: The risk of coronavirus disease 2019 among people with multiple sclerosis with different disease-modifying therapies is not well established.

Objective: To investigate the occurrence of coronavirus disease 2019 and the remaining symptoms among people with multiple sclerosis and the associations with different disease-modifying therapies.

Methods: Individuals aged 20-50 listed in the Swedish Multiple Sclerosis Registry were invited to participate in a survey in 2021. Information on reported coronavirus disease 2019 infection and remaining symptoms were linked to individual-level register data. The risks by disease-modifying therapy of having coronavirus disease 2019 or having remaining symptoms were estimated with logistic regression.

Results: Of the 4393 participants, 1030 (23.4%) self-reported coronavirus disease 2019 (749 confirmed and 281 suspected). The observed odds for coronavirus disease 2019 did not differ by disease-modifying therapy (p-values <0.05). The majority reporting coronavirus disease 2019 had fully recovered (68.5%), 4.2% were currently/recently sick, and 27.0% had symptoms remaining after 2 months. The most frequently reported remaining symptoms involved one's sense of smell or taste (37.0%), fatigue (20.0%), and breathing (12.0%). No statistically significant associations were observed between having remaining symptoms and the disease-modifying therapy.

Conclusion: Despite the initial concerns of differing infection risks by MS treatments, we observed no differences in coronavirus disease 2019 occurrence or remaining symptoms among those who had coronavirus disease 2019. Nonetheless, exercising caution in interpreting our findings, it remains implicit that people with multiple sclerosis are particularly susceptible to infection and that lingering symptoms may persist beyond the initial infection.

背景:多发性硬化症患者在接受不同的疾病改变疗法后发生冠状病毒病2019年最新注册送彩金的风险尚不明确:调查多发性硬化症患者中2019年冠状病毒病的发生率和剩余症状,以及与不同疾病调节疗法的关联:方法:邀请瑞典多发性硬化症登记处登记的 20-50 岁患者参加 2021 年的调查。报告的2019年冠状病毒疾病感染和剩余症状信息与个人层面的登记数据相关联。采用逻辑回归法估算了接受疾病调节疗法后感染冠状病毒病2019年最新注册送彩金或出现剩余症状的风险:在 4393 名参与者中,有 1030 人(23.4%)自我报告患有冠状病毒病 2019 年(749 人确诊,281 人疑似)。冠状病毒2019年最新注册送彩金的观察几率因疾病调节疗法的不同而无差异(P值 结论:冠状病毒2019年最新注册送彩金的观察几率因疾病调节疗法的不同而无差异(P值):尽管最初有人担心 MS 治疗会带来不同的感染风险,但我们观察到 2019 年冠状病毒病发生率或剩余症状在 2019 年冠状病毒病患者中没有差异。尽管如此,在解释我们的研究结果时仍需谨慎,因为多发性硬化症患者特别容易受到感染,而且在初次感染后可能会持续出现残留症状。
{"title":"Coronavirus disease 2019 infection among working-aged people with multiple sclerosis and the impact of disease-modifying therapies.","authors":"Chantelle Murley, Emma Pettersson, Jan Hillert, Alejandra Machado, Emilie Friberg","doi":"10.1177/20552173241248293","DOIUrl":"https://doi.org/10.1177/20552173241248293","url":null,"abstract":"<p><strong>Background: </strong>The risk of coronavirus disease 2019 among people with multiple sclerosis with different disease-modifying therapies is not well established.</p><p><strong>Objective: </strong>To investigate the occurrence of coronavirus disease 2019 and the remaining symptoms among people with multiple sclerosis and the associations with different disease-modifying therapies.</p><p><strong>Methods: </strong>Individuals aged 20-50 listed in the Swedish Multiple Sclerosis Registry were invited to participate in a survey in 2021. Information on reported coronavirus disease 2019 infection and remaining symptoms were linked to individual-level register data. The risks by disease-modifying therapy of having coronavirus disease 2019 or having remaining symptoms were estimated with logistic regression.</p><p><strong>Results: </strong>Of the 4393 participants, 1030 (23.4%) self-reported coronavirus disease 2019 (749 confirmed and 281 suspected). The observed odds for coronavirus disease 2019 did not differ by disease-modifying therapy (<i>p</i>-values <0.05). The majority reporting coronavirus disease 2019 had fully recovered (68.5%), 4.2% were currently/recently sick, and 27.0% had symptoms remaining after 2 months. The most frequently reported remaining symptoms involved one's sense of smell or taste (37.0%), fatigue (20.0%), and breathing (12.0%). No statistically significant associations were observed between having remaining symptoms and the disease-modifying therapy.</p><p><strong>Conclusion: </strong>Despite the initial concerns of differing infection risks by MS treatments, we observed no differences in coronavirus disease 2019 occurrence or remaining symptoms among those who had coronavirus disease 2019. Nonetheless, exercising caution in interpreting our findings, it remains implicit that people with multiple sclerosis are particularly susceptible to infection and that lingering symptoms may persist beyond the initial infection.</p>","PeriodicalId":18961,"journal":{"name":"Multiple Sclerosis Journal - Experimental, Translational and Clinical","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11055478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing illness-related uncertainty in relapsing-remitting multiple sclerosis: A psychometric analysis of the Mishel Uncertainty of Illness Scale 评估复发缓解型多发性硬化症患者与疾病相关的不确定性:米谢尔疾病不确定性量表的心理计量分析
IF 2.8 Q2 Medicine Pub Date : 2024-04-01 DOI: 10.1177/20552173241247680
J. Sabin, E. Salas, J. Martín-Martínez, A. Candeliere-Merlicco, F.J. Barrero, Ana Alonso, J. Sánchez-Menoyo, L. Borrega, M. Rodríguez-Rodríguez, M. Gómez-Gutiérrez, S. Eichau, M.A. Hernández-Pérez, C. Calles, E. Fernández-Díaz, O. Carmona, A. Orvíz, Ana López-Real, P. López-Muñoz, A. Mendoza, Eduardo Agüera, Jorge Mauriño, J. Ballesteros
A multicenter study involving 204 adults with relapsing-remitting multiple sclerosis (RRMS) assessed the dimensionality and item characteristics of the Mishel-Uncertainty of Illness Scale (MUIS), a generic self-assessment tool. Mokken analysis identified two dimensions in the MUIS with an appropriate item and overall scale scalability after excluding nonclassifiable items. A refined 12-item MUIS, employing a grade response model, effectively discriminated uncertainty levels among RRMS patients (likelihood ratio test p-value = .03). These findings suggest the potential value of the 12-item MUIS as a reliable measure for assessing uncertainty associated with the course of illness in RRMS.
一项涉及 204 名复发缓解型多发性硬化症(RRMS)成人患者的多中心研究评估了疾病不确定性量表(MUIS)的维度和项目特征,这是一种通用的自我评估工具。莫肯(Mokken)分析确定了 MUIS 的两个维度,在排除不可分类的项目后,MUIS 具有适当的项目和整体量表可扩展性。改进后的 12 项 MUIS 采用等级反应模型,能有效区分 RRMS 患者的不确定性水平(似然比检验 p 值 = 0.03)。这些研究结果表明,12项MUIS作为评估与RRMS病程相关的不确定性的可靠测量方法具有潜在价值。
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引用次数: 0
Subclinical atherosclerosis in multiple sclerosis 多发性硬化症的亚临床动脉粥样硬化
IF 2.8 Q2 Medicine Pub Date : 2024-04-01 DOI: 10.1177/20552173241238627
R. Marrie, Ronak Patel, Stephen Allan Schaffer
Background People with multiple sclerosis (MS) have an increased risk of ischemic heart disease as compared to people without MS after accounting for traditional vascular risk factors. Objective We assessed whether subclinical atherosclerosis, an inflammatory disease of arteries, occurs in persons with MS who do not have traditional vascular risk factors, and whether the Framingham Score (FRS) predicted carotid intima media thickness (CIMT) similarly in people with and without MS. Methods We recruited participants with and without MS who did not have vascular disease. Participants completed questionnaires, physical assessments, underwent an ultrasound (CIMT), and provided samples for HbA1c and lipid measurements. We defined subclinical atherosclerosis as an average CIMT ≥75th percentile, and tested the association between MS/not-MS, FRS, and atherosclerosis using logistic regression. Results We recruited 106 participants with MS 101 without MS. The average (SD) CIMT did not differ between the MS (0.60 [0.11]) and non-MS (0.61 [0.12]) cohorts (p = 0.69), nor did the proportion with atherosclerosis (MS: 11.3% vs. non-MS 13.4%, p = 0.58). On regression analysis a 1-point increase in the FRS was associated with 11% increased odds of having atherosclerosis (95%CI: 1.04, 1.19) but MS was not. Conclusion MS was not associated with subclinical atherosclerosis.
背景 在考虑了传统的血管风险因素后,多发性硬化症(MS)患者患缺血性心脏病的风险比无 MS 患者高。目的 我们评估了亚临床动脉粥样硬化(一种动脉炎症性疾病)是否会发生在没有传统血管风险因素的多发性硬化症患者身上,以及弗雷明汉评分(FRS)对多发性硬化症患者和非多发性硬化症患者颈动脉内膜厚度(CIMT)的预测是否相似。方法 我们招募了没有血管疾病的多发性硬化症患者和非患者。参与者完成了问卷调查和身体评估,接受了超声波检查(CIMT),并提供了 HbA1c 和血脂测量样本。我们将平均 CIMT 值≥第 75 百分位数定义为亚临床动脉粥样硬化,并使用逻辑回归法检验了 MS/非 MS、FRS 和动脉粥样硬化之间的关联。结果 我们招募了 106 名多发性硬化症患者 101 名非多发性硬化症患者。多发性硬化症组群(0.60 [0.11])和非多发性硬化症组群(0.61 [0.12])的平均(标清)CIMT 没有差异(P = 0.69),动脉粥样硬化的比例也没有差异(多发性硬化症:11.3% 对非多发性硬化症 13.4%,P = 0.58)。在回归分析中,FRS 每增加 1 分,动脉粥样硬化的几率就会增加 11%(95%CI:1.04, 1.19),但 MS 与之无关。结论 MS 与亚临床动脉粥样硬化无关。
{"title":"Subclinical atherosclerosis in multiple sclerosis","authors":"R. Marrie, Ronak Patel, Stephen Allan Schaffer","doi":"10.1177/20552173241238627","DOIUrl":"https://doi.org/10.1177/20552173241238627","url":null,"abstract":"Background People with multiple sclerosis (MS) have an increased risk of ischemic heart disease as compared to people without MS after accounting for traditional vascular risk factors. Objective We assessed whether subclinical atherosclerosis, an inflammatory disease of arteries, occurs in persons with MS who do not have traditional vascular risk factors, and whether the Framingham Score (FRS) predicted carotid intima media thickness (CIMT) similarly in people with and without MS. Methods We recruited participants with and without MS who did not have vascular disease. Participants completed questionnaires, physical assessments, underwent an ultrasound (CIMT), and provided samples for HbA1c and lipid measurements. We defined subclinical atherosclerosis as an average CIMT ≥75th percentile, and tested the association between MS/not-MS, FRS, and atherosclerosis using logistic regression. Results We recruited 106 participants with MS 101 without MS. The average (SD) CIMT did not differ between the MS (0.60 [0.11]) and non-MS (0.61 [0.12]) cohorts (p = 0.69), nor did the proportion with atherosclerosis (MS: 11.3% vs. non-MS 13.4%, p = 0.58). On regression analysis a 1-point increase in the FRS was associated with 11% increased odds of having atherosclerosis (95%CI: 1.04, 1.19) but MS was not. Conclusion MS was not associated with subclinical atherosclerosis.","PeriodicalId":18961,"journal":{"name":"Multiple Sclerosis Journal - Experimental, Translational and Clinical","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140768866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy of dalfampridine in neuromyelitis optica spectrum disorder: A pilot study. 达福普啶对神经脊髓炎视网膜频谱障碍的疗效:试点研究
IF 2.8 Q2 Medicine Pub Date : 2024-02-29 eCollection Date: 2024-01-01 DOI: 10.1177/20552173241233952
Jérôme de Seze, Christine Clerc, Matthieu Béreau, Bertrand Bourre, Hélène Zephir, Nicolas Collongues, Laurent Kremer, Patrick Vermersch, Kevin Bigaut

Objective: To assess the efficacy of dalfampridine in patients with neuromyelitis optica spectrum disorder.

Methods: We included 15 consecutive patients, who were started on a treatment of dalfampridine 10 mg twice daily for 2 weeks. Efficacy assessment was based on walking ability improvement using Timed-25-Foot Walk and 12-item Multiple Sclerosis Walking Scale tests.

Results: The mean Timed-25-Foot Walk score was reduced from 14.8 (±2.4) to 11.3 (±1.9) seconds (p = 0.01). The mean score on the 12-item Multiple Sclerosis Walking Scale was reduced from 41.2 (±3.5) to 31.4 (±3.2) (p = 0.004).

Conclusion: Dalfampridine seems to be useful for symptomatic treatment of walking impairment in neuromyelitis optica spectrum disorder.

目的:评估达尔福林对神经脊髓炎视谱系障碍患者的疗效:评估达尔福林对神经脊髓炎视网膜频谱障碍患者的疗效:我们连续收治了15名患者,他们开始接受达法瑞汀治疗,每天两次,每次10毫克,疗程2周。疗效评估基于使用定时-25 英尺步行和 12 项多发性硬化步行量表测试的步行能力改善情况:结果:计时-25 英尺步行的平均得分从 14.8 秒(±2.4)降至 11.3 秒(±1.9)(p = 0.01)。12项多发性硬化症步行量表的平均得分从41.2(±3.5)分降至31.4(±3.2)分(p = 0.004):结论:达尔福林似乎可用于神经脊髓炎视网膜频谱障碍患者行走障碍的对症治疗。
{"title":"Efficacy of dalfampridine in neuromyelitis optica spectrum disorder: A pilot study.","authors":"Jérôme de Seze, Christine Clerc, Matthieu Béreau, Bertrand Bourre, Hélène Zephir, Nicolas Collongues, Laurent Kremer, Patrick Vermersch, Kevin Bigaut","doi":"10.1177/20552173241233952","DOIUrl":"10.1177/20552173241233952","url":null,"abstract":"<p><strong>Objective: </strong>To assess the efficacy of dalfampridine in patients with neuromyelitis optica spectrum disorder.</p><p><strong>Methods: </strong>We included 15 consecutive patients, who were started on a treatment of dalfampridine 10 mg twice daily for 2 weeks. Efficacy assessment was based on walking ability improvement using Timed-25-Foot Walk and 12-item Multiple Sclerosis Walking Scale tests.</p><p><strong>Results: </strong>The mean Timed-25-Foot Walk score was reduced from 14.8 (±2.4) to 11.3 (±1.9) seconds (<i>p</i> = 0.01). The mean score on the 12-item Multiple Sclerosis Walking Scale was reduced from 41.2 (±3.5) to 31.4 (±3.2) (<i>p</i> = 0.004).</p><p><strong>Conclusion: </strong>Dalfampridine seems to be useful for symptomatic treatment of walking impairment in neuromyelitis optica spectrum disorder.</p>","PeriodicalId":18961,"journal":{"name":"Multiple Sclerosis Journal - Experimental, Translational and Clinical","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10908237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140022217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Frequency of cognitive impairment in patients with neuromyelitis optica spectrum disorder in Mexico. 墨西哥神经脊髓炎视网膜谱系障碍患者认知障碍的发生率。
IF 2.8 Q2 Medicine Pub Date : 2024-02-25 eCollection Date: 2024-01-01 DOI: 10.1177/20552173241231678
Edgar R Valdivia-Tangarife, Fernando Cortés-Enríquez, Alejandra Morlett-Paredes, Teresita Villaseñor-Cabrera, Jorge I Gámez-Nava, Mario A Mireles-Ramírez, Laura González-López, Miguel Á Macías-Islas

Background: Between 29% and 67% of neuromyelitis optica spectrum disorder patients have cognitive alterations.

Objective: To assess the frequency of cognitive impairment in patients with neuromyelitis optica spectrum disorder in Mexico using the Brief International Cognitive Assessment for Multiple Sclerosis.

Methods: We evaluated 40 neuromyelitis optica spectrum disorder patients and 40 healthy controls from Mexico.

Results: 28 (70.0%) patients with neuromyelitis optica spectrum disorder had cognitive impairment in two or more cognitive domains. Student´s T test showed statistically poor performance by neuromyelitis optica spectrum disorder patients compared to healthy controls on all three neuropsychological test scores. This significant difference was observed on the Symbols Digit Modalities Test (t = 8.875; p ≤ 0.001); California Verbal Learning Test-II memory (t = 10.418; p ≤ 0.001); and Brief Visuospatial Memory Test Revised (t = 6.123; p ≤ 0.001).

Conclusions: This study showed that 70% of neuromyelitis optica spectrum disorder patients exhibited cognitive impairment in two or more cognitive domains. Determining the frequency of cognitive impairment will guide the decision of Neuropsychologists in planning cognitive rehabilitation across various domains.

背景:29%到67%的神经脊髓炎视网膜频谱障碍患者有认知改变:29%至67%的神经脊髓炎视网膜频谱障碍患者存在认知改变:使用多发性硬化症国际认知评估简表评估墨西哥神经脊髓炎视网膜频谱障碍患者认知障碍的频率:结果:28 名(70.0%)神经脊髓炎视网膜频谱障碍患者在两个或两个以上认知领域存在认知障碍。学生 T 检验显示,与健康对照组相比,神经脊髓炎视谱系障碍患者在所有三项神经心理测试中的成绩都较差。在符号数字模型测试(t = 8.875;p ≤ 0.001)、加州言语学习测试-II记忆(t = 10.418;p ≤ 0.001)和简明视觉空间记忆测试修订版(t = 6.123;p ≤ 0.001)上都观察到了这一明显差异:这项研究表明,70%的神经脊髓炎视网膜频谱障碍患者在两个或两个以上的认知领域表现出认知障碍。确定认知障碍的频率将为神经心理学家规划不同领域的认知康复提供指导。
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Multiple Sclerosis Journal - Experimental, Translational and Clinical
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