Rebound activity after fingolimod cessation: A case - control study

Background: There has been an increase in the number of reports of multiple sclerosis (MS) rebound activity (RA), which is usually defined as a severe disease reactivation after natalizumab or fingolimod withdrawal that exceeds pre-treatment baseline inflammatory activity. The frequency and risk factors that could predict RA remain unknown. Fingolimod is currently the most frequently prescribed disease modifying therapy for MS in Argentina, so that there is a need to determine possible predictors of RA. Objectives: To identify risk factors for developing RA after fingolimod cessation; to describe RA characteristics, management and evolution. Methods: The study was a multicenter, retrospective, case-control study of patients with MS who had discontinued fingolimod and were followed up to nine months after discontinuation. Demographic, clinical and paraclinical data was extracted, including age, gender, MS phenotype, reason for discontinuation, number of relapses during the year prior to suspension, time treated with fingolimod, EDSS before, during and after rebound, MRI findings. Results: 26 cases of RA were matched 1:1 with patients without RA. The median time elapsed to RA was 50 days. 68% showed worsening of the EDSS in the evaluation at 3 months of RA. When compared with the control group, no difference was found in terms of age, gender, phenotype, EDSS at the moment of suspension, reason for discontinuation, number of relapses in the previous year, and time on therapy. Conclusion: In this case-controlled study, no risk factors could be identified to predict RA after fingolimod cessation. Further controlled, prospective, better powered studies are needed to confirm these findings.Fil: Barboza, Andrés G. Hospital Central de Mendoza; Argentina.Fil: Gaitán, María Inés. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina.Fil: Alonso, Ricardo. Hospital Ramos Mejía; Argentina.Fil: Ysrraelit, María Célica. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina.Fil: Luetic, Geraldine. Instituto de Neurociencias de Rosario; Argentina.Fil: Liwacki, Susana. Hospital Córdoba; Argentina.Fil: Patrucco, Liliana. Hospital Italiano de Buenos Aires; Argentina.Fil: Halfon, Mario Javier. Hospital Británico de Buenos Aires; Argentina.Fil: Burgos, Marcos. Hospital San Bernardo; Argentina.Fil: Mainella, Carolina. Hospital Español de Rosario; Argentina.Fil: Pierdabuena, Raul. Clinica Reina Fabiola; Argentina.Fil: Recchia, Luciano. Hospital Central de Mendoza; Argentina.Fil: Steinberg, Judith. Hospital Britanico de Buenos Aires; Argentina.Fil: Tkachuk, Veronica Analia. Hospital de Clínicas José de San Martin; Argentina.Fil: Zanga, Gisela. ENERI; Argentina.Fil: Carra, Adriana. Hospital Británico de Buenos Aires; ArgentinaFil: Chertcoff, Aníbal. Hospital Británico de Buenos Aires; Argentina.Fil: Fernandez Liguori, Nora. Sanatorio Güemes; Argentina.Fil: Lazaro, Luciana. Sanatorio Güemes; Argentina.Fil: Menichini, Maria Laura. Instituto de Neurociencias de Rosario; Argentina

Recommendations On Nmosd Treatment In Latin America: Consensus-Based Rand/Ucla Methodology

Introduction: Neuromyelitis optica spectrum disorder (NMOSD) is a serious condition affecting people worldwide, including Latin America (LATAM). Healthcare disparities and economic limitations make effective treatment access challenging. It is crucial to consider the best practice therapeutic decision-making, including emerging long-term preventive therapies, to ensure patients in LATAM and elsewhere can effectively manage their disease all over the world. Objectives/Aims: To establish evidence-based guidelines for treatment approaches in NMOSD patients in LATAM. A consensus process was conducted to develop validated statements. Methods: A group of NMOSD experts from LATAM utilized a 9-point Likert scale to vote on statements related to NMOSD management. The predetermined consensus threshold was set at a minimum expert agreement of 70 %. The RAND/UCLA methodology was employed to reach consensus recommendations. Results: Nineteen experts completed the consensus process between March and April 2023. In round 1, no statement failed to reach the predetermined consensus, resulting in 31 agreed statements. The statements were divided between general recommendations (14/31) and clinical scenarios (17/31). The scenarios were based on treatment-na & iuml;ve NMOSD AQP4 positive patients (4/17); treatment-naive seronegative NMOSD patients (4/17); treatment switching (5/17) and safety (4/17). Conclusions: Consensus recommendations were developed on the most important areas of NMOSD treatment by a panel of experts in LATAM. These statements are a valuable tool to guide decision-making and improve patient outcomes, serving as the foundation for developing standardized practice guidelines in our region

Update from the from the Latin American COVID-19 registry in MS and NMOSD patients

The research was funded by BIOGEN

Update from the from the Latin American COVID-19 registry in MS and NMOSD patients

The research was funded by BIOGEN