Publications by authors named "Radek Ampapa"
Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS) mainly afflicting young women. Various steroids can influence the onset and development of the disease or, on the contrary, mitigate its course; however, a systematic review of steroidomic changes in MS patients is lacking. Based on the gas chromatography tandem mass spectrometry (GC-MS/MS) platform and, in the case of estradiol, also using immunoassay, this study performed a comprehensive steroidomic analysis in 25 female MS patients aged 39(32, 49) years compared to 15 female age-matched controls aged 38(31, 46) years.
View Article and Find Full Text PDFBackground And Objectives: Women with multiple sclerosis (MS) are at risk of disease reactivation in the early postpartum period. Ocrelizumab (OCR) is an anti-CD20 therapy highly effective at reducing MS disease activity. Data remain limited regarding use of disease-modifying therapies (DMTs), including OCR, and disease activity during peripregnancy periods.
View Article and Find Full Text PDFBackground: Cladribine, a selective immune reconstitution therapy, is approved for the treatment of adult patients with highly active multiple sclerosis (MS).
Objectives: Provide experience with cladribine therapy in a real-world setting.
Methods: This is a registry-based retrospective observational cohort study.
Article Synopsis
- * Machine learning models were applied to predict confirmed disability progression after two years, achieving a ROC-AUC score of 0.71, indicating moderate accuracy, while historical disability was found to be a stronger predictor than treatment or relapse history.
- * The research followed strict guidelines and made its coding accessible for others to facilitate future benchmarking in predicting disability progression in MS patients.
Article Synopsis
- The study aims to identify predictors of treatment switching in patients with relapsing-remitting MS using data from multiple national registries.
- A total of 269,822 treatment episodes from 110,326 patients were analyzed, focusing on those who started disease-modifying treatments during their RRMS phase.
- Key findings indicate that higher disability scores (EDSS), being female, and older age increase the likelihood of treatment switching, with certain DMTs initiated between 2007 and 2012 showing even higher rates of switching.
Article Synopsis
- This study investigates the relationship between environmental factors and progressive-onset multiple sclerosis (POMS) compared to relapse-onset multiple sclerosis (ROMS), aiming to better understand the causes of POMS.
- Data is drawn from two major studies, including a sample of 155 POMS, 204 ROMS, and 558 controls, ensuring that the POMS sample is representative of the broader Australian POMS population.
- The research addresses various methodological challenges, such as biases and differences between POMS and controls, and will present findings on the associations in future publications.
Article Synopsis
- This study examines the effectiveness of six different therapies for treating relapsing-remitting multiple sclerosis (RRMS) over 5 years, using a large dataset from 74 centers across 35 countries.
- Researchers found that natalizumab and fingolimod were more effective in reducing relapses and worsening disability compared to other therapies like dimethyl fumarate, teriflunomide, glatiramer acetate, and interferon beta.
- The findings highlight the potential of marginal structural models (MSMs) to simulate clinical trials and compare various treatment outcomes in real-world patient populations.
Article Synopsis
- The study investigates geographical differences in the risk of secondary progressive multiple sclerosis (SPMS) and how these may be influenced by factors like latitude and treatment types.
- It utilizes data from a global patient registry, focusing on relapsing-remitting multiple sclerosis patients and factors such as age, sex, and treatment efficacy.
- The research analyzes data from over 51,000 patients across 27 countries to establish patterns in the progression from relapsing-remitting to secondary progressive phases of the disease.
Introduction: The influence of breastfeeding and it´s duration on the course of multiple sclerosis (MS) is unclear. Here we analyzed a real-world data for breastfeeding women with MS and their disease course collected from a Czech national registry ReMuS.
Objectives: To identify risk factors associated with not initiating breastfeeding after delivery, to analyze the impact of breastfeeding on the MS disease course, evaluate the assumption, that breastfeeding is not harmful in MS patients, and compare the disease course by breastfeeding status.
Background: In relapsing-remitting multiple sclerosis (RRMS) the most common treatment strategy has been to start with low-moderate efficacy disease modifying therapy (LE-DMT) and to escalate to more efficacious treatments in cases of breakthrough disease activity. However, recent evidence suggests a better outcome in patients commencing with moderate-high efficacy DMT (HE-DMT) immediately after clinical onset.
Objective: The aim of this study is to compare disease activity and disability outcomes in patients treated with the two alternative strategies using the Swedish and Czech national multiple sclerosis registries, taking advantage of the fact that the relative frequency of each strategy differs markedly between these two countries.
What Is This Summary About?: Patient registries contain anonymous data from people who share the same medical condition. The MSBase registry contains information from over 80,000 people living with multiple sclerosis (MS) across 41 countries. Using information from the MSBase registry, the GLIMPSE (Generating Learnings In MultiPle SclErosis) study looked at real-life outcomes in 3475 people living with MS who were treated with cladribine tablets (Mavenclad) compared with other oral treatments.
View Article and Find Full Text PDFThe Czech National MS Registry (ReMuS): Data trends in multiple sclerosis patients whose first disease-modifying therapies were initiated from 2013 to 2021.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub
September 2024
Aims: Multiple sclerosis treatment strategies are changing in the Czech Republic. According to data from 2013-2021, the proportion of patients starting high-efficacy disease-modifying therapies is increasing. In this survey, we describe the actual data trends in multiple sclerosis (MS) patients beginning their first disease‑modifying therapies (DMTs) from 2013 to 2021.
View Article and Find Full Text PDFDisability accrual in primary and secondary progressive multiple sclerosis.
J Neurol Neurosurg Psychiatry
September 2023
Article Synopsis
- The study compares disability progression in primary progressive multiple sclerosis (PPMS) and secondary progressive multiple sclerosis (SPMS), revealing that SPMS has a later onset and slower disability accrual compared to PPMS.* -
- Analysis utilized data from the MSBase cohort, adjusting for factors like age, sex, and drug therapies, and included 1,872 PPMS patients and 2,575 SPMS patients.* -
- Findings suggest that although SPMS patients start with greater baseline disability, their slower progression may lead to similar disability levels over time, indicating the need for careful consideration when combining these groups in clinical trials.*
Background: The prognostic significance of non-disabling relapses in people with relapsing-remitting multiple sclerosis (RRMS) is unclear.
Objective: To determine whether early non-disabling relapses predict disability accumulation in RRMS.
Methods: We redefined mild relapses in MSBase as 'non-disabling', and moderate or severe relapses as 'disabling'.
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.
View Article and Find Full Text PDFBackground And Purpose: This study assessed the effect of patient characteristics on the response to disease-modifying therapy (DMT) in multiple sclerosis (MS).
Methods: We extracted data from 61,810 patients from 135 centers across 35 countries from the MSBase registry. The selection criteria were: clinically isolated syndrome or definite MS, follow-up ≥ 1 year, and Expanded Disability Status Scale (EDSS) score ≥ 3, with ≥1 score recorded per year.
Background: Effectiveness of cladribine tablets, an oral disease-modifying treatment (DMT) for multiple sclerosis (MS), was established in clinical trials and confirmed with real-world experience.
Objectives: Use real-world data to compare treatment patterns and clinical outcomes in people with MS (pwMS) treated with cladribine tablets versus other oral DMTs.
Methods: Retrospective treatment comparisons were based on data from the international MSBase registry.
Article Synopsis
- This study evaluates the rate of disease activity return in multiple sclerosis (MS) patients after they stop using disease-modifying therapy, focusing on relapse rates and factors influencing relapse.
- A large sample of 14,213 patients showed that relapse rates typically increased within 2 months after stopping treatment, with earlier commencement of new therapy reducing these rates significantly.
- Factors predicting relapse included having a higher relapse rate prior to stopping therapy, being younger, being female, and having a higher Expanded Disability Status Scale (EDSS) score, with subsequent therapy reducing both relapse risk and disability progression.
Article Synopsis
- This study looks at how to predict long-term disability in people with multiple sclerosis (MS) after they show signs of worsening over six months.
- Researchers checked data from thousands of patients to figure out who is more likely to have lasting problems.
- They found that things like age, sex, and how MS affects the person can help tell if someone will continue to get worse, which can help doctors in future treatments.
Importance: Multiple sclerosis can also affect children. Approximately 3-10% of patients develop multiple sclerosis before the age of 16.
Objective: The aim of this analysis is to describe the characteristics of pediatric patients with multiple sclerosis who started their treatment with disease-modifying drugs in 2013-2020, with data obtained from the Czech National Registry of patients with multiple sclerosis.
Article Synopsis
- The study aimed to explore how the latitude of residence and UVB radiation exposure affects the severity of multiple sclerosis (MS) among patients, using data from the MSBase registry.
- Results indicated that patients living at higher latitudes (above 40°) experienced more severe MS symptoms, while this trend was not observed in those living below this latitude.
- Additionally, lower UVB exposure during childhood (ages 6 and 18) was linked to faster progression of disability in MS, suggesting the importance of environmental factors in disease severity.
Background: The MSBase prediction model of treatment response leverages multiple demographic and clinical characteristics to estimate hazards of relapses, confirmed disability accumulation (CDA), and confirmed disability improvement (CDI). The model did not include Multiple Sclerosis Severity Score (MSSS), a disease duration-adjusted ranked score of disability.
Objective: To incorporate MSSS into the MSBase prediction model and compare model accuracy with and without MSSS.
Background: A special care of MS women planning a pregnancy is highly demanding especially in the terms of disease modifying treatment (DMD) decisions and counselling regarding periods of conception, pregnancy and postpartum period.
Objective: To provide data about impact of pregnancy, delivery or miscarriage/artificial abortion on MS disease course in Czech women with MS based on analysis of retrospective data from the Czech national registry ReMuS.
Methods: The analysis focused on women with MS with at least one record of pregnancy in the registry.
Background: Short-term outcomes of optic neuritis (ON) have been well characterized. Limited data exists on longer-term visual outcomes in patients who present with ON. The large MSBase registry allows for characterization of long-term visual outcomes after ON.
View Article and Find Full Text PDFBackground: When the novel coronavirus disease 2019 (COVID-19) appeared, concerns about its course in patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) arose. This study aimed to evaluate the incidence, severity and risk factors of the more severe COVID-19 course among MS and NMOSD patients.
Methods: From March 1, 2020, to February 28, 2021, 12 MS centres, representing 70% of the Czech MS and NMOSD population, reported laboratory-confirmed COVID-19 cases via the Czech nationwide register of MS and NMOSD patients (ReMuS).