Stress ulcer prophylaxis guidelines: Are they being implemented in Lebanese health care centers?

AIM: To evaluate the current practice of stress ulcer prophylaxis (SUP) in Lebanese Health care centers

Barriers to Access Multiple Sclerosis Disease-Modifying Therapies in Middle East and North Africa: A Regional Survey-Based Study

International audienceMultiple sclerosis (MS) management varies markedly between different countries of the Middle East and North Africa (MENA) region based on disease-modifying therapies (DMTs) availability, accessibility, and reimbursement. In general, introduction of novel DMTs in most MENA countries is usually delayed, as drug approval can take several months to years once approved for use by the Food and Drug Administration (FDA) or European Medicines Agency (EMA), depending on the country. To our knowledge, there are no published studies assessing the accessibility to DMTs across different countries of the region

Barriers to Access Multiple Sclerosis Disease-Modifying Therapies in Middle East and North Africa: A Regional Survey-Based Study

International audienceMultiple sclerosis (MS) management varies markedly between different countries of the Middle East and North Africa (MENA) region based on disease-modifying therapies (DMTs) availability, accessibility, and reimbursement. In general, introduction of novel DMTs in most MENA countries is usually delayed, as drug approval can take several months to years once approved for use by the Food and Drug Administration (FDA) or European Medicines Agency (EMA), depending on the country. To our knowledge, there are no published studies assessing the accessibility to DMTs across different countries of the region

Barriers to accessing multiple sclerosis disease-modifying therapies in the Middle East and North Africa region: A regional survey-based study

International audienc

Quality of Life, Knowledge and Access to Treatment in Times of Economic Crisis Among Lebanese Multiple Sclerosis Patients

International audienc

Quality of Life, Knowledge and Access to Treatment in Times of Economic Crisis Among Lebanese Multiple Sclerosis Patients

International audienc

Disease-Modifying Therapies, Outcomes, Risk Factors and Severity of COVID-19 in Multiple Sclerosis: A MENACTRIMS Registry Based Study

International audienceMultiple sclerosis (MS) patients have been considered a higher-risk population for COVID-19 due to the high prevalence of disability and disease-modifying therapy use; however, there is little data in our Middle East and North Africa region (MENA) identifying clinical characteristics of MS associated with worse COVID-19 outcomes

Disease-modifying therapies, outcomes, risk factors and severity of COVID-19 in multiple sclerosis: A MENACTRIMS registry based study

International audienceBackground: There is a lack information regarding risk factors associated with worse COVID-19 outcomes in patients with multiple sclerosis (MS) in the MENA region. Methods: This is a multicenter, retrospective cohort study that included all MS patients with a suspected or confirmed COVID-19 infection using the MENACTRIMS registry. The association of demographics, disease characteristics, and use of disease-modifying therapies (DMTs) with outcomes and severity of COVID-19 were evaluated by multivariate logistic model. Results: A total of 600 MS patients with confirmed (n = 542) or highly suspected (n = 58) COVID-19 were analyzed. Seventy-three patients (12.2 %) had a COVID-19 severity score of ≥3 on a 7-point ordinal scale (ranging from 1 [not hospitalized with no limitations on activities] to 7 [death] with a cutoff at 3 [hospitalized and not requiring supplemental oxygen]), and 15 patients (2.5 %) died. Out of 73 patients with a severity score ≥3, 90.4 % were on DMTs; 50.6 % of them were on anti-CD20, including ocrelizumab and rituximab. Multivariate logistic regression showed that older age (odds ratio per 10 years, 1.4 [95 %CI, 1.0-1.8]), disability (OR for EDSS 3.0-5.5, 2.9 [95 %CI. 1.5-5.7], OR for EDSS ≥6.0, 2.3 [95 %CI. 1.0-5.1]), obesity (OR, 3.0 [95 %CI, 1.5-6.0]), and treatment with rituximab (OR, 9.0 [95 %CI, 3.1-25.3]) or off-label immunosuppressive medications (OR, 5.6 [95 %CI. 1.1-27.8]) were risk factors for moderate or severe COVID-19.</div

Safety and Efficacy of Disease Modifying Therapies After Switching from Natalizumab: A MENACTRIMS Observational Study

International audienc

Safety and effectiveness of disease-modifying therapies after switching from natalizumab

International audienceIntroduction: One strategy to mitigate progressive multifocal leukoencephalopathy (PML) risk is to switch to other highly effective disease-modifying therapies (DMTs). However, the optimal switch DMT following natalizumab (NTZ) discontinuation is yet to be determined. Objective: The objective of the study is to determine the most effective and tolerable DMTs to switch to following NTZ discontinuation due to John Cunningham virus (JCV) antibody positivity. Methods: This is a multicenter observational cohort study that included all stable relapsing-remitting multiple sclerosis (MS) patients who were treated with NTZ for at least 6 months before switching therapy due to JCV antibody positivity. Results: Of 321 patients, 255 switched from NTZ to rituximab/ocrelizumab, 52 to fingolimod, and 14 to alemtuzumab, with higher annualized relapse rate (ARR) in fingolimod switchers (0.193) compared with rituximab/ocrelizumab or alemtuzumab (0.028 and 0.032, respectively). Fingolimod switchers also had increased disability progression ( p = 0.014) and a higher proportion developed magnetic resonance imaging (MRI) lesions compared with rituximab/ocrelizumab (62.9% vs. 13.0%, p &lt; 0.001, and 66.6% vs. 24.0%, p &lt; 0.001, respectively). Mean drug survival favored rituximab/ocrelizumab or alemtuzumab over fingolimod ( p &lt; 0.001). Conclusion: Our study shows superior effectiveness of rituximab/ocrelizumab and alemtuzumab compared with fingolimod in stable patients switching from NTZ due to JC virus antibody positivity