Aim: To evaluate the effectiveness and safety of fingolimod in routine clinical practice in the region of Asturias and Cantabria (Spain).
Patients And Methods: We conducted a retrospective multicentre study of patients with relapsing-remitting multiple sclerosis treated with fingolimod, in accordance with the product data sheet. Effectiveness was evaluated in patients with at least one year's treatment. The following were calculated: annualised relapse rate (ARR), the percentage of patients free from relapses and free from gadolinium-enhancing lesions, and those who improved/maintained their score on the Expanded Disability Status Scale (EDSS). Both total population and according to previous treatment: immunomodulator (interferon beta-1 or glatiramer acetate) or natalizumab, were analysed.
Results: A total of 138 patients started treatment with fingolimod; 60% previously received an immunomodulator; 28% were given natalizumab; and 9% had no treatment. Ninety-nine patients were treated with fingolimod for at least one year. After one year of treatment, fingolimod decreased the ARR by 67% (1.26 to 0.42; p < 0.0001), increased the percentage of patients free from relapses from 24% to 69% (p < 0.0001) and the percentage of patients free from gadolinium-enhancing lesions from 70% to 85% (p < 0.0106). Altogether, 77% of the patients improved/maintained their score on the EDSS. Similar results were observed in patients previously treated with an immunomodulator. The effectiveness of the patients previously treated with natalizumab remained the same following treatment with fingolimod.
Conclusions: Routine clinical practice in the regions of Asturias and Cantabria shows that fingolimod yields similar results to those observed in clinical trials, on comparing the clinicoradiological variables used in them.
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Disabil Rehabil
January 2025
Clinic Institute of Medical and Surgical Specialties (ICEMEQ), Hospital Clinic of Barcelona, Barcelona, Spain.
Purpose: Adherence to home rehabilitation following total knee arthroplasty (TKA) is essential to reach optimal functional outcomes, especially in fast-track procedures. The aim of this study is to identify which sociodemographic and health factors significantly affect adherence in this context.
Methods: This is a secondary analysis of a randomized controlled trial with 52 patients.
J Bone Joint Surg Am
January 2025
Shriners Children's Northern California, Sacramento, California.
Background: Magnetic resonance imaging (MRI) has not been routinely used for infants with brachial plexus birth injury (BPBI); instead, the decision to operate is based on the trajectory of clinical recovery by 6 months of age. The aim of this study was to develop an MRI protocol that can be performed without sedation or contrast in order to identify infants who would benefit from surgery at an earlier age than the age at which that decision could be made clinically.
Methods: This prospective multicenter NAPTIME (Non-Anesthetized Plexus Technique for Infant MRI Evaluation) study included infants aged 28 to 120 days with BPBI from 3 tertiary care centers.
Cancer Nurs
January 2025
Author Affiliations: Department of Hematology, Second Hospital of Shanxi Medical University (Mss Guo, L. Liu, He, Ma, and Zhang, and Drs H. Liu and Zheng); and School of Nursing, Shanxi Medical University (Ms L. Liu), Taiyuan, China.
Background: Sleep problems and anxiety are imperative for continuity of care and rehabilitation in patients following an allogeneic hematopoietic stem cell transplantation (allo-HSCT).
Objective: The aim of this study was to investigate the impact on anxiety, sleep quality, and survival of integrating traditional Chinese Baduanjin exercises to track the control of continuous care in patients receiving an allo-HSCT.
Methods: A total of 75 patients discharged after receiving an allo-HSCT were included.
Importance: Delirium is common after cardiac surgery and associated with adverse outcomes. Intraoperative benzodiazepines may increase postoperative delirium but restricting intraoperative benzodiazepines has not yet been evaluated in a randomized trial.
Objective: To determine whether an institutional policy of restricted intraoperative benzodiazepine administration reduced the incidence of postoperative delirium.
Anesthesiology
January 2025
Department of Anesthesiology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Background: Tranexamic acid is an anti-fibrinolytic agent routinely used during hip and knee joint replacement surgery to minimize bleeding. Chronic kidney disease is a common chronic health problem seen among adults requiring major arthroplasty surgery. Tranexamic acid is renally cleared and may accumulate in chronic kidney disease.
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