Norma Deri

[Sharmin, S.; Malpas, C.; Kalincik, T.] Univ Melbourne, Dept Med, CORe, Melbourne, Vic, Australia. [Horakova, D.; Havrdova, E. K.] Charles Univ Prague, Fac Med 1, Dept Neurol, Prague, Czech Republic. [Horakova, D.; Havrdova, E. K.] Charles Univ Prague, Fac Med 1, Ctr Clin Neurosci, Prague, Czech Republic. [Horakova, D.; Havrdova, E. K.] Gen Univ Hosp, Prague, Czech Republic. [Izquierdo, G.; Eichau, S.] Hosp Univ Virgen Macarena, Seville, Spain. [Trojano, M.] Univ Bari, Dept Basic Med Sci Neurosci & Sense Organs, Bari, Italy. [Prat, A.; Girard, M.; Duquette, P.] Hop Notre Dame De Bon Secours, Montreal, PQ, Canada. [Prat, A.; Girard, M.; Duquette, P.] CHUM, Montreal, PQ, Canada. [Prat, A.; Girard, M.; Duquette, P.] Univ Montreal, Montreal, PQ, Canada. [Onofrj, M.] Univ G DAnnunzio, Dept Neurosci Imaging & Clin Sci, Chieti, Italy. [Lugaresi, A.] IRCCS Ist Sci Neurol Bologna, Bologna, Italy. [Lugaresi, A.] Univ Bologna, Dept Biomed & Neuromotor Sci, Bologna, Italy. [Grand'Maison, F.] Neuro Rive Sud, Quebec City, PQ, Canada. [Grammond, P.] CISSS Chaudiere Appalache, Levis, PQ, Canada. [Sola, P.; Ferraro, D.] Azienda Osped Univ, Dept Neurosci, Modena, Italy. [Terzi, M.] 19 Mayis Univ, Fac Med, Samsun, Turkey. [Hupperts, R.] Zuyderland Ziekenhuis, Sittard, Netherlands. [Alroughani, R.] Amiri Hosp, Dept Med, Div Neurol, Sharq, Kuwait. [Boz, C.] Farabi Hosp, KTU Med Fac, Trabzon, Turkey. [Shaygannejad, V.] Isfahan Univ Med Sci, Esfahan, Iran. [Van Pesch, V.] Clin Univ St Luc, Brussels, Belgium. [Van Pesch, V.] Catholic Univ Louvain, Brussels, Belgium. [Cartechini, E.] Azienda Sanit Unica Reg Marche AV3, UOC Neurol, Macerata, Italy. [Kappos, L.] Univ Hosp, Neurol Clin & Policlin, Dept Med, Basel, Switzerland. [Kappos, L.] Univ Hosp, Neurol Clin & Policlin, Dept Clin Res, Basel, Switzerland. [Kappos, L.] Univ Basel, Basel, Switzerland. [Lechner-Scott, J.] Univ Newcastle, Sch Med & Publ Hlth, Newcastle, NSW, Australia. [Lechner-Scott, J.] Hunter New England Hlth, John Hunter Hosp, Dept Neurol, Newcastle, NSW, Australia. [Bergamaschi, R.] IRCCS Mondino Fdn, Pavia, Italy. [Turkoglu, R.] Haydarpasa Numune Training & Res Hosp, Istanbul, Turkey. [Solaro, C.] ASL3 Genovese, Dept Neurol, Genoa, Italy. [Solaro, C.] ML Novarese Hosp Moncrivello, Dept Rehabil, Genoa, Italy. [Ramo-Tello, C.] Hosp Badalona Germans Trias & Pujol, Badalona, Spain. [Iuliano, G.] Osped Riuniti Salerno, Salerno, Italy. [Granella, F.] Univ Parma, Dept Med & Surg, Parma, Italy. [Granella, F.] Parma Univ Hosp, Dept Emergency & Gen Med, Parma, Italy. [Van Wijmeersch, B.] Rehabil & MS Ctr Overpelt, Hasselt, Belgium. [Van Wijmeersch, B.] Hasselt Univ, Hasselt, Belgium. [Spitaleri, D.] Azienda Osped Rilievo Nazl San Giuseppe Moscati A, Avellino, Italy. [Bolanos, R. F.] Hosp Univ Virgen de Valme, Seville, Spain. [Slee, M.] Flinders Univ S Australia, Adelaide, SA, Australia. [McCombe, P.] Univ Queensland, Brisbane, Qld, Australia. [McCombe, P.] Royal Brisbane & Womens Hosp, Brisbane, Qld, Australia. [Prevost, J.] CSSS St Jerome, St Jerome, PQ, Canada. [Ampapa, R.] Nemocnice Jihlava, Jihlava, Czech Republic. [Ozakbas, S.] Dokuz Eylul Univ, Konak Izmir, Turkey. [Sanchez-Menoyo, J. L.] Hosp Galdakao Usansolo, Galdakao, Spain. [Soysal, A.] Bakirkoy Educ & Res Hosp Psychiat & Neurol Dis, Istanbul, Turkey. [Vucic, S.] Westmead Hosp, Sydney, NSW, Australia. [Petersen, T.] Kommunehospitalet, Aarhus C, Denmark. [Verheul, F.] Groene Hart Ziekenhuis, Gouda, Netherlands. [Butler, E.] Monash Med Ctr, Melbourne, Vic, Australia. [Hodgkinson, S.] Liverpool Hosp, Sydney, NSW, Australia. [Sidhom, Y.; Gouider, R.] Razi Hosp, Dept Neurol, Manouba, Tunisia. [Butzkueven, H.] Monash Univ, Cent Clin Sch, Melbourne, Vic, Australia. [Butzkueven, H.] Alfred Hosp, Dept Neurol, Melbourne, Vic, Australia. [Butzkueven, H.] Monash Univ, Box Hill Hosp, Dept Neurol, Melbourne, Vic, Australia.

We aimed to evaluate mortality and causes of death among Argentinean neuromyelitis optica spectrum disorder (NMOSD) patients and identify predictors of death. Retrospective study included 158 NMOSD patients and 11 (7%) patients died after 11 years of follow-up for a total exposure time of 53,345 days with an overall incidence density of 2.06 × 10.000 patients/day (95% CI 1.75–2.68). Extensive cervical myelitis with respiratory failure (45%) was the most frequent cause of death. Older age (HR = 2.05, p = 0.002) and higher disability score (HR = 2.30, p < 0.001) at disease onset were independent predictors of death. We found an 11-year mortality rate of 7% in Argentinean NMOSD patients.

We report COVID-19 presentation, course and outcomes in teriflunomide-treated MS patients in Argentina. Methods: descriptive, retrospective, multicentre, study that included MS patients receiving teriflunomide who developed COVID-19, with clinical follow-up at reference MS centres, also listed in a nationwide registry. Results: Eighteen MS patients on teriflunomide treatment, from eight MS centres developed COVID-19. The mean age was 41,2 years and 72% of them were female; 94% had diagnosis of relapsing-remitting MS and 6% presented a radiologically isolated syndrome. Median EDSS was 2.5 (range 0-5.5). The average time on teriflunomide therapy was 3.3 years. COVID-19 diagnosis was confirmed with nasal swab in 61%. None required hospitalization and they completely recovered from the acute-phase within 7-14 days. All the patients continued their teriflunomide therapy during COVID-19 course. No MS relapses occurred during or after COVID-19 course. Conclusion: Our report adds to the evidence that COVID-19 is mild in patients receiving teriflunomide therapy and that continuing with teriflunomide therapy during Sars-CoV-2 infection is safe and advisable for MS patients.

Introduction: The objective was to assess the immunogenicity and effectiveness of vaccines against SARSCoV-2 in multiple sclerosis (MS) patients included in the Argentinean MS registry. Methods: A prospective cohort study between May and December 2021. The primary outcome was immunogenicity and effectiveness of vaccines during a three-month follow-up. Immunogenicity was evaluated based on detection of total antibodies (Ab) against spike protein and neutralizing Ab in serum 4 weeks after the second vaccine dose. A positive COVID-19 case was defined according to Argentinean Ministry of Health. Results: 94 patients were included, mean age: 41.7 ± 12.1 years. Eighty (85.1%) had relapsing remitting multiple sclerosis (RRMS); 30 (31.9%) were under fingolimod treatment. The Sputnik V vaccine was the first dose in 33 (35.1%), and AstraZeneca in 61 (64.9%). In 60 (63.8%), the vaccine elicited a specific humoral response. Immunological response according to the vaccination schemes showed no qualitative differences (p = 0.45). Stratified analysis according to the MS treatment showed that a significantly smaller number of subjects developed antibodies against spike antigen among those that were on ocrelizumab compared to other groups (p = 0.001), while a reduced number of patients under ocrelizumab where evaluated (n = 7). This was also observed for neutralizing antibodies in the ocrelizumab group (p < 0.001). During the three-month follow-up, two individuals were diagnosed with COVID-19. Conclusion: We found that MS patients that received Sputnik V or AstraZeneca vaccines for SARS-CoV-2 developed a serological response with no differences between the vaccines used.

Background: We aimed to assess the frequency of new asymptomatic lesions on brain and spinal imaging (magnetic resonance imaging (MRI)) and their association with subsequent relapses in a large cohort of neuromyelitis optica spectrum disorder (NMOSD) patients in Argentina. Methods: We retrospectively reviewed 675 MRI (225 performed during an attack and 450 during the relapse-free period (performed at least 3 months from the last attack)) of NMOSD patients who had at least 2 years of clinical and MRI follow-up since disease onset. Kaplan–Meier (KM) curves were used for depicting time from remission MRI to subsequent relapse. Results: We included 135 NMOSD patients (64.4% were aquaporin-4-immunoglobulin G (AQP4-IgG)-positive). We found that 26 (19.26%) and 66 (48.88%) of patients experienced at least one new asymptomatic MRI lesion during both the relapse-free period and attacks, respectively. The most frequent asymptomatic MRI lesions were optic nerves followed by short-segment myeli...

Several studies in multiple sclerosis (MS) suggest a trend of increasing disease frequency in women during the last decades. A direct comparison of gender ratio trends among MS populations from Argentina remains to be carried out. The objective of the study was to compare gender ratio trends, over a 50-year span in MS populations from Argentina. multicenter study that included patients from 14 MS Centers of Argentina. Patients with definite MS with birth years ranging from 1940 to 1989 were included. Gender ratios were calculated by five decades based on year of birth and were adjusted for the F/M born-alive ratio derived from the Argentinean national registry of births. The F/M ratios were calculated using a multivariate logistic regression per five decades by the year of birth approach. Analyses were performed using Stata 10.1. 1069 patients were included. Gender ratios showed a significant increase from the first to the last decade in the whole MS sample (from 1.8 to 2.7; p value...

Background The influence of pregnancy on Multiple Sclerosis (MS) has been extensively studied but such influence on Latin American women with MS has not been characterized. Our objective was to describe the course of pregnancy and birth outcome in Argentinean MS patients and the evolution of MS during pregnancy and after delivery. Method We used a retrospective design in eight MS centers in Argentina and administered a survey to women with definite MS (Mc Donald) with pregnancies during or after MS onset. We contacted 355 women of which 81 met inclusion criteria. We recorded 141 pregnancies. Results Involuntary abortion was observed in 16% of pregnancies (95% CI = 10–23). Thirty five women received immunomodulatory therapy (IMT) before 42 pregnancies. Twenty three (55%) out of 42 pregnancies were exposed to IMT. The mean time of IMT discontinuation before conception in 19 (45.2%) pregnancies without exposure, was 104 days (95% CI = 61.0–147.0). There were 103 deliveries: 79% full te...

Background: In the absence of evidence from randomised controlled trials, observational data can be used to emulate clinical trials and guide clinical decisions. Observational studies are, however, susceptible to confounding and bias. Among the used techniques to reduce indication bias are propensity score matching and marginal structural models. Objective: To use the comparative effectiveness of fingolimod vs natalizumab to compare the results obtained with propensity score matching and marginal structural models. Methods: Patients with clinically isolated syndrome or relapsing remitting MS who were treated with either fingolimod or natalizumab were identified in the MSBase registry. Patients were propensity score matched, and inverse probability of treatment weighted at six monthly intervals, using the following variables: age, sex, disability, MS duration, MS course, prior relapses, and prior therapies. Studied outcomes were cumulative hazard of relapse, disability accumulation, ...

Background: With the advent of MRI scanning, the value of lumbar puncture to assess oligoclonal band (OCB) statusfor the diagnosis of multiple sclerosis (MS) is increasingly uncertain. One major issue is that the reported frequency of cerebrospinal fluid (CSF)-restricted oligoclonal banding for the diagnosis of MS varies considerably in different studies. In addition, the relationship between OCB positivity and disease outcome remains uncertain, as reported studies are generally too small to assess comparative disability outcomes with sufficient power. Methods: In order to further investigate variation of OCB positivity in patients with MS, we utilized MSBase, a longitudinal, Web-based collaborative MS outcomes registry following clinical cohorts in several continents and latitudes. We also assessed whether OCB positivity affects long-term disability outcome. Results: A total of 13,242 patient records were obtained from 37 MS specialist centres in 19 different countries. OCB status ...

Background We aimed to determine the proportion of highly active multiple sclerosis patients under high-efficacy therapies (HETs) achieve no evidence of disease activity-3 (NEDA-3) at 1 and 2 years, and to identify factors associated with failing to meet no evidence of disease activity 3 at 2 years. Methods This retrospective cohort study based on Argentina Multiple Sclerosis patient registry (RelevarEM), includes highly active multiple sclerosis patients who received HETs. Results In total, 254 (78.51%) achieved NEDA-3 at year 1 and 220 (68.12%) achieved NEDA-3 at year 2. Patients who achieved NEDA-3 at 2 years had a shorter duration of multiple sclerosis ( p &lt; 0.01) and a shorter time between first treatment and current treatment ( p = 0.01). Early high-efficacy strategy patients reached NEDA-3 more frequently ( p &lt; 0.01). Being a naïve patient (odds ratio: 3.78, 95% confidence interval 1.50–9.86, p &lt; 0.01) was an independent predictor to reach NEDA-3 at 2 years. No assoc...

... Jolley, Damien; Trojano, Maria; Zwanikken, Cees; Maison, Francois Grand; Duquette, Pierre; Grammond, Pierre; Bergamaschi, Roberto; Giuliani, Giorgio; Timmermans, Bertine; Boz, Cavit; Rio, Maria Edite; Petersen, Thor; Poehlau, Dieter; Cristiatio, Edgardo; ...

BackgroundDisability progression is a key milestone in the disease evolution of people with multiple sclerosis (PwMS). Prediction models of disability progression have not yet reached the level of trust needed to be adopted in the clinic. A common benchmark to assess model development in multiple sclerosis is also currently lacking.MethodsData of adult PwMS with a follow-up of at least three years from 146 MS centers, spread over 40 countries and collected by the MSBase consortium was used. With basic inclusion criteria for quality requirements, it represents a total of 15, 240 PwMS. External validation was performed and repeated five times to assess the significance of the results. TRIPOD guidelines were followed.Confirmed disability progression after two years was predicted, with a confirmation window of six months. Only routinely collected variables were used such as the expended disability status scale, treatment, relapse information, and MS course.To learn the probability of di...

Background and ObjectivesThe severity of multiple sclerosis (MS) varies widely among individuals. Understanding the determinants of this heterogeneity will help clinicians optimize the management of MS. The aim of this study was to investigate the association between latitude of residence, UV B radiation (UVB) exposure, and the severity of MS.MethodsThis observational study used the MSBase registry data. The included patients met the 2005 or 2010 McDonald diagnostic criteria for MS and had a minimum dataset recorded in the registry (date of birth, sex, clinic location, date of MS symptom onset, disease phenotype at baseline and censoring, and ≥1 Expanded Disability Status Scale score recorded). The latitude of each study center and cumulative annualized UVB dose at study center (calculated from National Aeronautics and Space Administration’s Total Ozone Mapping Spectrometer) at ages 6 and 18 years and the year of disability assessment were calculated. Disease severity was quantified...

Supplemental material, MSJ868990_online_supplement for Risk of secondary progressive multiple sclerosis: A longitudinal study by Adam Fambiatos, Vilija Jokubaitis, Dana Horakova, Eva Kubala Havrdova, Maria Trojano, Alexandre Prat, Marc Girard, Pierre Duquette, Alessandra Lugaresi, Guillermo Izquierdo, Francois Grand&#39;Maison, Pierre Grammond, Patrizia Sola, Diana Ferraro, Raed Alroughani, Murat Terzi, Raymond Hupperts, Cavit Boz, Jeannette Lechner-Scott, Eugenio Pucci, Roberto Bergamaschi, Vincent Van Pesch, Serkan Ozakbas, Franco Granella, Recai Turkoglu, Gerardo Iuliano, Daniele Spitaleri, Pamela McCombe, Claudio Solaro, Mark Slee, Radek Ampapa, Aysun Soysal, Thor Petersen, Jose Luis Sanchez-Menoyo, Freek Verheul, Julie Prevost, Youssef Sidhom, Bart Van Wijmeersch, Steve Vucic, Edgardo Cristiano, Maria Laura Saladino, Norma Deri, Michael Barnett, Javier Olascoaga, Fraser Moore, Olga Skibina, Orla Gray, Yara Fragoso, Bassem Yamout, Cameron Shaw, Bhim Singhal, Neil Shuey, Suzanne ...

Supplemental material, sj-pdf-1-mso-10.1177_20552173211032334 for Assessing attacks and treatment response rates among adult patients with NMOSD and MOGAD: Data from a nationwide registry in Argentina by Edgar Carnero Contentti, Pablo A Lopez, Juan Pablo Pettinicchi, Juan Criniti Liliana Patrucco María E Balbuena Carlos Vrech Norma Deri María C Ysrraelit Geraldine Lueticmes Alejandro Caride Friedemann Paul Juan I Rojas in Multiple Sclerosis Journal – Experimental, Translational and Clinical

Background PPMS (primary progressive multiple sclerosis) patients represent less than 10% of MS patients in Argentina, men and women were similarly affected and most of them had a severe functional impairment. More rapid progression has been reported in males, but this is not the case in all datasets. The main objective of our study was to determine the time to EDSS (Expanded disability Status Scale) 4, 6 and 7 in PPMS patients. We also compared the times to reach these EDSS in men and women and aimed to identify factors associated with the disability progression. Method This cohort of patients with diagnosis of PPMS (n = 253) was selected from follow-up recorded in the RelevarEM registry database. Result The median times to EDSS 4, 6 and 7 were 24 (IQR 12-48), 72 (IQR 36-96) and 96 (IQR 60-120) months, respectively. Comparison of the survival curves to EDSS 4, 6 and 7 according to gender did not show significant differences (p = 0.33, p = 0.55 and p = 0.59). There is no evidence of an association between the clinical adjustment variables (sex, age &gt;40 years at diagnosis, EDSS &gt; 3 at onset and multifocal MS symptoms at disease onset) and the time of arrival at the EDSS 4, 6 and 7. Conclusion Severe disability was observed six years after the onset of symptoms. No association was found between the studied factors and the time to arrival to severe disability.

Resumen Introduccion La esclerosis multiple es una enfermedad con componente autoinmune, y un numero significativo de pacientes se encuentra bajo tratamiento inmunomodulador e inmunosupresor. Frecuentemente los medicos tratantes se preguntan si la vacunacion podra tener un impacto en el desarrollo de la enfermedad, y si existen indicaciones o contraindicaciones para la vacunacion de acuerdo a las terapias indicadas. Objetivo Elaborar una guia de referencia sobre indicaciones y contraindicaciones de vacunacion para neurologos que participan en el manejo de pacientes con esclerosis multiple con o sin terapias modificadoras de la enfermedad. Desarrollo Se conformo un equipo de elaboracion de las guias entre los miembros del Grupo de Trabajo de Enfermedades Desmielinizantes de la Sociedad Neurologica Argentina (SNA). La metodologia implementada fue de acuerdo a recomendaciones establecidas por la SNA, basadas en evidencia, con clasificacion de la misma y elaboracion de las recomendaciones segun el formato GRADE. Conclusiones Se detallan las vacunas disponibles en Argentina, el impacto potencial que podrian tener en el curso de la enfermedad, las indicaciones de vacunacion previas al inicio de cada tratamiento y las contraindicaciones para cada vacuna de acuerdo a la terapia indicada.

BACKGROUND Identification of triggers that potentially instigate attacks in neuromyelitis optica spectrum disorders (NMOSD) and multiple sclerosis (MS) has remained challenging. We aimed to analyze the seasonality of NMOSD and MS attacks in an Argentinean cohort seeking differences between the two disorders. METHODS A retrospective study was conducted in a cohort of NMOSD and MS patients followed in specialized centers from Argentina and enrolled in RelevarEM, a nationwide, longitudinal, observational, non-mandatory registry of MS/NMOSD patients. Patients with complete relapse data (date, month and year) at onset and during follow-up were included. Attack counts were analyzed by month using a Poisson regression model with the median monthly attack count used as reference. RESULTS A total of 551 patients (431 MS and 120 NMOSD), experiencing 236 NMOSD-related attacks and 558 MS-related attacks were enrolled. The mean age at disease onset in NMOSD was 39.5 ± 5.8 vs. 31.2 ± 9.6 years in MS (p &lt; 0.01). Mean follow-up time was 6.1 ± 3.0 vs. 7.4 ± 2.4 years (p &lt; 0.01), respectively. Most of the included patients were female in both groups (79% vs. 60%, p &lt; 0.01). We found a peak of number of attacks in June (NMOSD: 28 attacks (11.8%) vs MS: 33 attacks (5.9%), incidence rate ratio 1.82, 95%CI 1.15-2.12, p = 0.03), but no differences were found across the months in both disorders when evaluated separately. Strikingly, we observed a significant difference in the incidence rate ratio of attacks during the winter season when comparing NMOSD vs. MS (NMOSD: 75 attacks (31.7%) vs MS: 96 attacks (17.2%), incidence rate ratio 1.82, 95%CI 1.21-2.01, p = 0.02) after applying Poisson regression model. Similar results were observed when comparing the seropositive NMOSD (n = 75) subgroup vs. MS. CONCLUSIONS Lack of seasonal variation in MS and NMOSD attacks was observed when evaluated separately. Future epidemiological studies about the effect of different environmental factors on MS and NMOSD attacks should be evaluated prospectively in Latin America population.

Background The purpose of this study was to assess family planning (FP) among women with multiple sclerosis (WwMS). Methods We invited 604 WwMS to answer a survey focused on FP: a) Temporal relationship between pregnancy and the diagnosis of multiple sclerosis; b) History of FP; c) Childbearing desire; d) Information on family planning. Comparisons between pregnancy and not pregnancy after MS, as well as, planned and unplanned pregnancy were analyzed. Multivariate and univariate analyses were used to assess the impact of independent variables and FP Result 428 (71.7%) WwMS completed the survey. A 19.1% got pregnant after MS diagnosis and we evaluated FP in the last pregnancy, 56.1% patients had a planned pregnancy. Professional addressing FP (OR = 0.27, 95%-CI 0.08-0.92, p = 0.03) and non-injection drug treatment before pregnancy (OR = 2.88, 95%-CI 1.01-8.21, p = 0.047) were independent predictors of unplanned pregnancy in our multivariate model. Among WwMS ≤ 40 years, 48.7% had fut...

BACKGROUND In multiple sclerosis demographics there is a well-known female prevalence and male patients have been less specifically evaluated in clinical studies, though some clinical differences have been reported between sexes. OBJECTIVE The objective of this study was to assess clinical and demographic differences between male and female patients included in the national Argentine MS Registry-RelevarEM. MATERIAL AND METHODS This study was observational, retrospective, and was based on the data of 3099 MS patients included as of 04 April 2021. The statistical analysis plan included bivariate analyses with the crude data and also after adjustment for the MS phenotype, further categorized as progressive-onset MS or relapsing-onset MS. In the adjusted analysis, the Mantel-Haenszel odds ratio was compared to the crude odds ratio, to account for the phenotype as a confounder. RESULTS The data from 1,074 (34.7%) men and 2,025 (65.3%) women with MS diagnosis were analysed. Males presented primary progressive disease two times more often than women (11% and 5%, respectively). In the crude analyses by sex, the presence of exclusively infratentorial lesions in the magnetic resonance imaging studies was more frequent in males than in females, but after adjustment by MS onset phenotype, such difference was only present in males with relapsing-onset MS (p = 0.00006). Similarly, worse Expanded Disability Status Scale scores were confirmed only in men with relapsing-onset disease after phenotype adjustment (p = 0.02). CONCLUSION We did not find any statistically significant clinical or demographic difference between sexes when the progressive MS phenotype was specifically considered. However, the differences we found between the clinical phenotypes are in line with the literature and highlight the importance of stratifying the analyses by sex and phenotype when designing MS studies.

This study evaluated the effect of relapse phenotype on disability accumulation in multiple sclerosis. Analysis of prospectively collected data was conducted in 19,504 patients with relapse-onset multiple sclerosis and minimum 1-year prospective follow-up from the MSBase cohort study. Multivariable linear regression models assessed associations between relapse incidence, phenotype and changes in disability (quantified with Expanded Disability Status Scale and its Functional System scores). Sensitivity analyses were conducted. In 34,858 relapses recorded during 136,462 patient-years (median follow-up 5.9 years), higher relapse incidence was associated with greater disability accumulation (β = 0.16, p &lt; 0.001). Relapses of all phenotypes promoted disability accumulation, with the most pronounced increase associated with pyramidal (β = 0.27 (0.25-0.29)), cerebellar (β = 0.35 (0.30-0.39)) and bowel/bladder (β = 0.42 (0.35-0.49)) phenotypes (mean (95% confidence interval)). Higher inc...

Limited data suggest that multiple sclerosis (MS) in Latin America (LA) could be less severe than in the rest of the world. The objective was to compare the course of MS between LA and other regions. Methods Centers from 18 countries with &gt;20 cases enrolled in the MSBase Registry participated. Patients with MS with a disease duration of &gt;1 year and &lt;30 years at time of EDSS measurement were evaluated. The MS Severity Score (MSSS) was used as a measure of disease progression. Comparisons among regions (North America, Europe, Australia and LA), hemispheres and countries were performed. Results A total of 9610 patients were included. Patients were from: Europe, 6290 (65.6%); North America, 1609 (16.7%); Australia, 1119 (11.6%); and LA, 592 (6.1%). The mean MSSS in patients from LA was 4.47 ± 2.8, 4.53 ± 2.8 in North America, 4.51 ± 2.8 in Europe and 4.49 ± 2.7 in Australia. Mean MSSS in the northern hemisphere was 4.51 ± 1.6 compared to 4.48 ± 1.9 in the southern hemisphere. N...

Nora Fernandez Liguori a,∗, Juan Ignacio Rojas b, Mario Bana c,d, Andres Barboza e, Adriana Carra f, Jorge Correale g, Edgardo Cristiano b, Norma Deri h, Marcela Fiol g, Orlando Garcea i, Alejandra Martinez j, Cristina Martinez c, Daniel Munoz h,k, Marcela Parada Marcilla l, Liliana Patrucco b, Walter Perez m, Lucas Martin Romano n, Marina Romano o, Roberto Rotta Escalante p, Vladimiro Sinay q,r, Adriana Tarulla d,s, Silvia Tenembaum t, Andres Villa u, Maria Celica Ysrraelit g y por el Grupo de trabajo de enfermedades desmielinizantes y el Grupo de trabajo de neurofarmacologia de la Sociedad Neurologica Argentina

The objective of the study was to assess the cost of multiple sclerosis (MS) patients in Argentina categorized by disease severity using a societal perspective.Method:Cross-sectional study including MS patients from 21 MS centers in 12 cities of Argentina. Patients were stratified by disease severity using the expanded disability status scale (EDSS) (group 1 with EDSS score between 0 and 3; group 2 with EDSS &gt;3 and &lt;7; group 3 with EDSS ≥7). Direct and indirect costs were analyzed for the second quarter of 2012 from public sources and converted to US Dollars.Results:266 patients were included. Mean annual cost per MS patient was USD 36,025 (95%CI 31,985-38,068) for patients with an EDSS between 0-3; USD 40,705 (95%CI 37,199-46,300) for patients with EDSS &gt;3 and &lt;7, and USD 50,712 (95%CI 47,825-62,104) for patients with EDSS ≥7.Conclusions:This is the first Argentine study evaluating the costs of MS considering disease severity.

SUMMARY Intracraneal mass lesions (IML) are the most common opportunistic neurological complications in patients with AIDS. The current international recommendations for the management of these lesions are mainly based on their etiological frequency as well as on serological and neuroimaging data. Recent studies suggest partial differences in the etiological profile of IML between AIDS patients from Latin-America and those from