Publications by authors named "Breogan Rodriguez Acevedo"
Article Synopsis
- - Organizing pneumonia (OP) has been identified in patients with inflammatory demyelinating diseases (IDDs) after COVID-19, particularly those treated with anti-CD20 therapies, but comprehensive data is scarce.
- - This study analyzed 19 patients with conditions like multiple sclerosis and neuromyelitis optica who developed COVID-19-associated OP; symptoms included intermittent fever, and most required hospitalization, but none died.
- - After about 1.5 years of follow-up, most lung issues resolved, although many patients experienced long-COVID symptoms; the study suggests that OP should be considered in anti-CD20-treated patients exhibiting specific CT findings and fever.
Background: Alemtuzumab is administered intravenously (IV) for relapsing-remitting multiple sclerosis (RRMS), with limited studies of subcutaneous (SC) treatment.
Objectives: We sought to evaluate the pharmacodynamics (PD), pharmacokinetics (PK), and safety profile of SC-administered alemtuzumab in people with progressive multiple sclerosis (PMS).
Design: SCALA was a phase I, open-label, randomized, parallel-group study with two 12-month periods and a safety monitoring phase to 60 months.
Importance: Vaccination in patients with highly active multiple sclerosis (MS) requiring prompt treatment initiation may result in impaired vaccine responses and/or treatment delay.
Objective: To assess the immunogenicity and safety of inactivated vaccines administered during natalizumab treatment.
Design, Setting, And Participants: This self-controlled, prospective cohort study followed adult patients with MS from 1 study center in Spain from September 2016 to February 2022.
Background: Limited data exist regarding treatment response prediction to oral disease-modifying therapies (DMTs) in multiple sclerosis (MS).
Objectives: We assessed the capacity of available scoring systems to anticipate disease activity parameters in naïve relapsing-remitting MS (RRMS) patients initiating daily oral DMTs, hypothesizing that they exhibit different predictive potentials.
Methods: We conducted a retrospective study and applied the Rio Score (RS), modified Rio Score (mRS), and MAGNIMS Score 12 months after DMT initiation.
Background And Objectives: We aimed to assess the presence of retinal neurodegeneration independent of optic neuritis (ON) in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) and to investigate the development of trans-synaptic anterograde degeneration in these patients after ON.
Methods: Cross-sectional, retrospective study of 34 adult patients with MOGAD and 23 healthy controls (HC). Clinical, optical coherence tomography (OCT), and MRI data were collected.
Background: Mumps-Measles-Rubella (MMR) and Varicella zoster vaccines (VAR) are live attenuated vaccines, usually administered in a two-dose scheme at least 4 weeks apart. However, single-dose immunization schemes may also be effective and can reduce delays in immunosuppressive treatment initiation in patients with multiple sclerosis (pwMS) who need to be immunized.
Objectives: To evaluate the immunogenicity of a single-dose attempt (SDA) versus the standard immunization scheme (SIS) with VAR and/or MMR in pwMS.
Objective: Myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) distinguish multiple sclerosis (MS) from MOG-associated disease in most cases. However, studies analyzing MOG-Ab at the time of a first demyelinating event suggestive of MS in adults are lacking. We aimed to (1) evaluate the prevalence of MOG-Ab in a first demyelinating event suggestive of MS and (2) compare clinical and paraclinical features between seropositive (MOG-Ab+) and seronegative (MOG-Ab-) patients.
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- Early treatment after a first demyelinating event is linked to improved long-term outcomes in patients with multiple sclerosis (MS), but MR findings are often overlooked when evaluating these outcomes.
- The study analyzed data from 580 patients between 1994 and 2021, categorizing them based on how soon they received disease-modifying drugs (DMDs) after their first event, creating a 5-point MR score (MRS) to assess disability risk.
- Results showed that very early treatment significantly reduced the risk of developing severe disability and secondary progressive MS compared to those who started treatment later, highlighting the importance of timely intervention and MR score in treatment decisions.
The application of convolutional neural networks (CNNs) to MRI data has emerged as a promising approach to achieving unprecedented levels of accuracy when predicting the course of neurological conditions, including multiple sclerosis, by means of extracting image features not detectable through conventional methods. Additionally, the study of CNN-derived attention maps, which indicate the most relevant anatomical features for CNN-based decisions, has the potential to uncover key disease mechanisms leading to disability accumulation. From a cohort of patients prospectively followed up after a first demyelinating attack, we selected those with T1-weighted and T2-FLAIR brain MRI sequences available for image analysis and a clinical assessment performed within the following six months (N = 319).
View Article and Find Full Text PDFImportance: Progression independent of relapse activity (PIRA) is the main event responsible for irreversible disability accumulation in relapsing multiple sclerosis (MS).
Objective: To investigate clinical and neuroimaging predictors of PIRA at the time of the first demyelinating attack and factors associated with long-term clinical outcomes of people who present with PIRA.
Design, Setting, And Participants: This cohort study, conducted from January 1, 1994, to July 31, 2021, included patients with a first demyelinating attack from multiple sclerosis; patients were recruited from 1 study center in Spain.
Leishmaniasis is a protozoan disease caused by species of genus Leishmania. Immunosuppression increases the risk of severe clinical forms and impairs response to treatment. The expansion of the use of immunomodulatory drugs for different conditions has raised the number of these cases.
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- Intrathecal production of kappa free light chains, measurable by the kappa free light chain index, is significant in diagnosing multiple sclerosis and may be easier and more sensitive than traditional methods like oligoclonal bands and the IgG index.
- A study involving 214 patients assessed various diagnostic indices and found strong concordance between oligoclonal bands and different kappa free light chain cut-offs (specifically 5.9 and 6.6).
- The addition of kappa free light chain indexes to existing diagnostic criteria increased the number of confirmed multiple sclerosis cases, with the kappa free light chain-5.9 cut-off adding the most diagnoses.
Article Synopsis
- The study investigates how disease-modifying therapies, specifically anti-CD20 treatments and sphingosine 1-phosphate receptor modulators (S1PRM), affect immune responses to SARS-CoV-2 vaccines in patients with multiple sclerosis (MS) and other autoimmune diseases.
- Researchers enrolled 457 patients and measured both humoral (antibody) and cellular (T-cell) immune responses before and after vaccination, finding that responses varied based on treatment type and duration.
- Results indicate that while anti-CD20 and S1PRM treatments can reduce antibody responses, anti-CD20 patients may still generate T-cell responses even without detectable antibodies, highlighting the complexities of vaccine response in these populations.
Background And Objectives: Information about humoral and cellular responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and antibody persistence in convalescent (COVID-19) patients with multiple sclerosis (PwMS) is scarce. The objectives of this study were to investigate factors influencing humoral and cellular responses to SARS-CoV-2 and its persistence in convalescent COVID-19 PwMS.
Methods: This is a retrospective study of confirmed COVID-19 convalescent PwMS identified between February 2020 and May 2021 by SARS-CoV-2 antibody testing.
Oral contraceptives do not modify the risk of a second attack and disability accrual in a prospective cohort of women with a clinically isolated syndrome and early multiple sclerosis.
Mult Scler
May 2022
Article Synopsis
- The study aimed to determine if the use of oral contraceptives (OCs) affects the risk of a second attack and disability progression in women with clinically isolated syndrome (CIS) and early multiple sclerosis (MS).
- Researchers analyzed data from a cohort of 495 women in Barcelona, focusing on their OC usage, and found that OC use did not significantly impact the risk of having a second attack or increased disability.
- The conclusion suggests that oral contraceptive use does not alter the risk of relapse or disability in these patients, even when considering various factors that could influence the results.
Background And Objectives: Different treatment response scoring systems in treated MS patients exist. The objective was to assess the long-term predictive value of these systems in RRMS patients treated with self-injectable DMTs.
Methods: RRMS-treated patients underwent brain MRI before the onset of therapy and 12 months thereafter, and neurological assessments every 6 months.
Background And Objectives: To explore whether time to diagnosis, time to treatment initiation, and age to reach disability milestones have changed in patients with clinically isolated syndrome (CIS) according to different multiple sclerosis (MS) diagnostic criteria periods.
Methods: This retrospective study was based on data collected prospectively from the Barcelona-CIS cohort between 1994 and 2020. Patients were classified into 5 periods according to different MS criteria, and the times to MS diagnosis and treatment initiation were evaluated.
Menopause does not modify disability trajectories in a longitudinal cohort of women with clinically isolated syndrome and multiple sclerosis followed from disease onset.
Eur J Neurol
April 2022
Background And Purpose: To evaluate the effect of menopause on disability accumulation in women followed from their clinically isolated syndrome (CIS).
Methods: We examined the longitudinal changes in Expanded Disability Status Scale (EDSS) scores from CIS until the last follow-up in women belonging to the Barcelona CIS prospective cohort, followed through their menopausal transition. The analysis is based on 13,718 EDSS measurements, with an average of 28 EDSS measurements per patient.
Article Synopsis
- The study investigated how often multiple sclerosis (MS) is misdiagnosed and the factors involved in such cases at the Multiple Sclerosis Centre of Catalonia.
- Out of 354 new patients, 8 were misdiagnosed with MS, representing 7.1% misdiagnosis rate, and these cases often had non-specific MRI findings and more comorbidities.
- Overall, the research concluded that while misdiagnosis is relatively low, certain MRI characteristics and the presence of other health issues may increase the risk of incorrectly diagnosing MS.
Background And Purpose: Information regarding multiple sclerosis (MS) patients with the 2019 novel coronavirus disease (COVID-19) is scarce. The study objective was to describe the incidence and characteristics of MS patients with COVID-19, to identify susceptibility and severity risk factors and to assess the proportion of positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serologies according to disease-modifying treatments.
Methods: This was a retrospective study of an MS cohort analysing data collected between February and May 2020.
Objective: To assess the added value of the optic nerve region (by using visual evoked potentials [VEPs]) to the current diagnostic criteria.
Methods: From the Barcelona clinically isolated syndrome (CIS) cohort, patients with complete information to assess dissemination in space (DIS), the optic nerve region, and dissemination in time at baseline (n = 388) were selected. Modified DIS (modDIS) criteria were constructed by adding the optic nerve to the current DIS regions.
Aim: Neurogenic lower urinary tract dysfunction (NLUTD) is very common in multiple sclerosis (MS) patients. Early diagnosis and treatment are crucial to avoid irreversible damage and improve quality of life. Our aim was to develop recommendations to improve NLUTD identification in MS patients, along with their referral and management.
View Article and Find Full Text PDFObjective: To explore the long-term outcomes of patients with clinically isolated syndromes from the Barcelona cohort.
Methods: We selected patients with a follow-up longer than 10 years to (1) estimate the risks of multiple sclerosis (MS) and disability accumulation according to the baseline number of T2 lesions and to compare treated versus untreated patients and early versus delayed treatment, and (2) to study baseline features of patients with aggressive MS (Expanded Disability Status Scale (EDSS) ⩾6.0 at 10 years).