1.Changes in the Multiple Sclerosis Treatment Paradigm. What Do We Do Now and What Were We Doing Before?.
Ricardo ALONSO ; María Bárbara EIZAGUIRRE ; Lucía ZAVALA ; Cecilia PITA ; Berenice SILVA ; Orlando GARCEA
Journal of Clinical Neurology 2018;14(4):487-491
BACKGROUND AND PURPOSE: The number of disease-modifying drugs (DMDs) available for treating relapsing-remitting multiple sclerosis is increasing. Numerous drugs have been approved since 2010 in South America, which has increased the complexity of the treatment algorithm. The aim of this study was to determine the changes in multiple sclerosis treatments relative to the underlying causes and the availability of new DMDs in Argentina. METHODS: A descriptive retrospective study was carried out on a group of 59 patients diagnosed with RRMS who use more than one DMD. RESULTS: The first treatment switch occurred before 2010 in 27% of the patients and after 2010 in the other 73%. Efficacy was the main reason for switching during both periods. A second treatment switch was required in 25% of the patients, with this occurring after 2010 in 86.6% of them. Interferon was the most-used drug before 2010 and fingolimod was the most-used drug thereafter. CONCLUSIONS: We have identified that the tendency for treatment changes has increased following the arrival of new drugs. Efficacy has been the main cause of these changes.
Argentina
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Drug Therapy
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Fingolimod Hydrochloride
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Humans
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Interferons
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Multiple Sclerosis*
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Multiple Sclerosis, Relapsing-Remitting
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Retrospective Studies
;
South America
2.The Role of Information Processing Speed in Clinical and Social Support Variables of Patients with Multiple Sclerosis.
María Bárbara EIZAGUIRRE ; Sandra VANOTTI ; Angeles MERINO ; Cecilia YASTREMIZ ; Berenice SILVA ; Ricardo ALONSO ; Orlando GARCEA
Journal of Clinical Neurology 2018;14(4):472-477
BACKGROUND AND PURPOSE: Information processing speed is one of the most impaired cognitive functions in multiple sclerosis (MS). There are two tests widely used for evaluating information processing speed: the Symbol Digit Modalities Test (SDMT) and the Paced Auditory Serial Addition Test (PASAT). To analyze the relationship between processing speed and the clinical and social support variables of patients with MS. METHODS: A group of 47 patients with relapsing-remitting MS was studied, 31 were women and 16, men. Age: 39.04±13.17, years of schooling: 13.00±3.87, Expanded Disability Status Scale (EDSS): 2.78±1.81, and disease evolution: 8.07±6.26. Instruments of measure; processing speed: SDMT, PASAT, clinical variables: EDSS, Fatigue Severity Scale (FSS), Beck's Depression Inventory II (BDI-II), and social support: Medical Outcomes Study Social Support Survey (MOS). RESULTS: Significant correlations were found between information processing speed and psychiatric, motor disability and social support variables. The SDMT correlated significantly and negatively with BDI-II, FSS, EDSS, and MOS (p < 0.05), whereas the PASAT correlated negatively with FSS and positively with MOS (p < 0.05). Information processing speed appeared as the performance predictor of these variables. The SDMT produced significant changes in EDSS (R2=0.343, p=0.000); FSS (R2=0.109, p=0.031); BDI-II (R2=0.124, p=0.018), and MOS (R2=between 0.212 and 0.379, p < 0.05). CONCLUSIONS: Information processing speed has influence on the clinical variables and the social support of patients with MS. These aspects are important to bear in mind for therapeutic approach.
Automatic Data Processing*
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Cognition
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Depression
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Fatigue
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Female
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Humans
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Male
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Multiple Sclerosis*