96 results match your criteria: "Nehme and Therese Tohme Multiple Sclerosis Center[Affiliation]"

Factors affecting fatigue progression in multiple sclerosis patients.

Sci Rep

December 2024

Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Riad El-Solh, PO Box 11-0236, 1107 2020, Beirut, Lebanon.

Fatigue is one of the most prevalent and disabling symptoms among patients with MS, but there is limited research investigating the longitudinal determinants of fatigue progression. This study aims to identify the sociodemographic, behavioral and clinical characteristics, and therapeutic regimens that are correlated with worsening fatigue over time in patients diagnosed with MS. This is a retrospective chart review of 483 patients.

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Prevalence of Progression Independent of Relapse Activity and Relapse-Associated Worsening in Patients With AQP4-IgG-Positive NMOSD.

Neurology

December 2024

From the Department of Neuroscience (P.S., A.V.D.W., P.G.S., Y.C.F., W.Z.Y., C.Z., V.G.J., H.B., M.M.), Central Clinical School, Monash University, Melbourne, Victoria; Department of Neurology (P.S., A.V.D.W., P.G.S., Y.C.F., W.Z.Y., V.G.J., H.B., M.M.), Alfred Health, Melbourne, Victoria, Australia; Department of Neurology (P.S., S.H.), Walton Centre NHS Foundation Trust, Liverpool, United Kingdom; Neuroimmunology Centre (S.S., I.R., T.K.), Department of Neurology, The Royal Melbourne Hospital, Parkville; CORe (S.S., I.R., T.K.), Department of Medicine, University of Melbourne, Victoria; Royal Hobart Hospital (Y.C.F.), Hobart, Tasmania, Australia; Nehme and Therese Tohme Multiple Sclerosis Center (S.J.K.), American University of Beirut Medical Center, Beirut, Lebanon; Department of Neurology (T.C.), Faculty of Medicine, University of Debrecen, Hungary; Department of Neurology (B.W.), Antwerp University Hospital, Edegem; Translational Neurosciences Research Group (B.W.), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium; Faculty of Medicine (M.E.), Isfahan University of Medical Sciences; Neurology (M.E.), Dr. Etemadifar MS Institute, Isfahan, Iran; Izmir University of Economics (S.O.), Medical Point Hospital; Multiple Sclerosis Research Association (S.O.), Izmir, Turkey; Department of Neurology and Center of Clinical Neuroscience (P.N., D.H.), First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic; Department of Neurology (A.A.), School of Medicine and Koc University Research Center for Translational Medicine (KUTTAM), Koc University, Istanbul, Turkey; College of Medicine & Health Sciences and Sultan Qaboos University Hospital (A.A.-A.), Sultan Qaboos University, Al-Khodh, Oman; Department of Neuroscience (C.M.R.-T.), Hospital Germans Trias I Pujol, Badalona, Spain; Department of Neurology (G.L.), University Hospital Ghent, Belgium; Department of Medical and Surgical Sciences and Advanced Technologies (F.P.), GF Ingrassia, Catania, Italy; Multiple Sclerosis Unit (F.P.), AOU Policlinico G Rodolico-San Marco, University of Catania; Department of Neuroscience (M.F.), MS Center, Neurology Unit, S. Maria delle Croci Hospital, AUSL Romagna, Ravenna, Italy; Department of Biotechnological and Applied Clinical Sciences (DISCAB) (M.F.), University of L'Aquila, Italy; Department of Neurology (C.B.), Karadeniz Technical University, Medical Faculty, Trabzon, Turkey; Department of Neurology (P.A.M.), Royal Brisbane Hospital; University of Queensland (P.A.M.), Australia; Department of Neurology (R.T.), Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey; Hunter Medical Research Institute (J.L.-S.), Neurology, University of Newcastle; and Hunter New England Health (J.L.-S.), John Hunter Hospital, New South Wales, Australia.

Article Synopsis
  • The study investigated the prevalence of two types of disability progression in patients with aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (AQP4-IgG NMOSD): Progression Independent of Relapse Activity (PIRA) and Relapse-Associated Worsening (RAW).
  • It included 181 patients from the MSBase registry, mostly females with an average age of 38.1 years, monitored for an average of 4.5 years, where only 2.2% experienced PIRA and 7.2% experienced RAW.
  • The findings suggest PIRA is rare in AQP4-IgG NMOSD cases, but the study had limitations, such as using
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Article Synopsis
  • - The study examines the effectiveness of high-efficacy disease-modifying treatments (hDMTs) versus low-efficacy treatments (lDMTs) in reducing spinal cord lesions in multiple sclerosis (MS) patients, noting the limited previous data on this specific outcome.
  • - Researchers analyzed data from patients with relapse-onset MS who underwent MRI scans before and after starting treatment, comparing new lesions in both cord and brain areas.
  • - Results indicate that while hDMTs significantly reduced new brain lesions and MS relapses compared to lDMTs, they did not show a significant benefit in preventing new spinal cord lesions.
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Predictors of relapse risk and treatment response in AQP4-IgG positive and seronegative NMOSD: A multicentre study.

J Neurol Neurosurg Psychiatry

September 2024

Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, Victoria, Australia

Background: Neuromyelitis optica spectrum disorder (NMOSD) can be categorised into aquaporin-4 antibody (AQP4-IgG) NMOSD or seronegative NMOSD. While our knowledge of AQP4-IgG NMOSD has evolved significantly in the past decade, seronegative NMOSD remains less understood. This study aimed to evaluate the predictors of relapses and treatment responses in AQP4-IgG NMOSD and seronegative NMOSD.

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Background: There is a lack information regarding risk factors associated with worse COVID-19 outcomes in patients with multiple sclerosis (MS) in the MENA region.

Methods: This is a multicenter, retrospective cohort study that included all MS patients with a suspected or confirmed COVID-19 infection using the MENACTRIMS registry. The association of demographics, disease characteristics, and use of disease-modifying therapies (DMTs) with outcomes and severity of COVID-19 were evaluated by multivariate logistic model.

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Effectiveness of cladribine compared to fingolimod, natalizumab, ocrelizumab and alemtuzumab in relapsing-remitting multiple sclerosis.

Mult Scler

August 2024

CORe, Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia; Neuroimmunology Centre, Department of Neurology, The Royal Melbourne Hospital, Melbourne, VIC, Australia.

Background: Comparisons between cladribine and other potent immunotherapies for multiple sclerosis (MS) are lacking.

Objectives: To compare the effectiveness of cladribine against fingolimod, natalizumab, ocrelizumab and alemtuzumab in relapsing-remitting MS.

Methods: Patients with relapsing-remitting MS treated with cladribine, fingolimod, natalizumab, ocrelizumab or alemtuzumab were identified in the global MSBase cohort and two additional UK centres.

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Retinal optical coherence tomography measures in multiple sclerosis: a systematic review and meta-analysis.

Ann Clin Transl Neurol

September 2024

Nehme and Therese Tohme Multiple Sclerosis Center, Department of Neurology, American University of Beirut, Beirut, Lebanon.

Spectral domain-optical coherence tomography plays a crucial role in the early detection and monitoring of multiple sclerosis (MS) pathophysiology. We aimed to quantify differences in retinal layer measures among different groups of MS and explored different variables that correlate with retinal measures. This study was reported according PRISMA guidelines.

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Article Synopsis
  • The study focuses on finding the best disease-modifying therapies (DMTs) to switch to after stopping natalizumab (NTZ) due to John Cunningham virus (JCV) antibody positivity.
  • A multicenter study involved 321 relapsing-remitting multiple sclerosis patients, comparing the outcomes of those who switched to rituximab/ocrelizumab, fingolimod, and alemtuzumab.
  • Results indicated that patients switching to rituximab/ocrelizumab or alemtuzumab experienced lower relapse rates and less disability progression, making them more effective options than fingolimod.
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Background: The COVID-19 pandemic raised concern amongst clinicians that disease-modifying therapies (DMT), particularly anti-CD20 monoclonal antibodies (mAb) and fingolimod, could worsen COVID-19 in people with multiple sclerosis (pwMS). This study aimed to examine DMT prescribing trends pre- and post-pandemic onset.

Methods: A multi-centre longitudinal study with 8,771 participants from MSBase was conducted.

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Health-related quality of life and utilities among Lebanese patients with Multiple Sclerosis: A cross-sectional study.

Mult Scler Relat Disord

June 2024

INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon; Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon.

Objective: This study assessed the Health-Related Quality of Life (HRQoL) and utilities of Multiple Sclerosis (MS) patients in Lebanon using generic and MS-specific QoL instruments, categorized by disease severity, and explored factors associated with HRQoL.

Methods: This was a cross-sectional, retrospective HRQoL study collecting data through face-to-face interviews using the EQ-5D-5 L and the Multiple Sclerosis International Quality of Life (MusiQoL) questionnaires. We enrolled Lebanese patients aged ≥18 years, diagnosed with MS for >6 months.

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Background: It remains unclear whether routine cerebrospinal fluid (CSF) parameters can serve as predictors of multiple sclerosis (MS) disease course.

Methods: This large-scale cohort study included persons with MS with CSF data documented in the MSBase registry. CSF parameters to predict time to reach confirmed Expanded Disability Status Scale (EDSS) scores 4, 6 and 7 and annualised relapse rate in the first 2 years after diagnosis (ARR2) were assessed using (cox) regression analysis.

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Comparative Effectiveness of Natalizumab, Fingolimod, and Injectable Therapies in Pediatric-Onset Multiple Sclerosis: A Registry-Based Study.

Neurology

April 2024

From the MSBase Foundation (T.S.), Melbourne, Australia; Department of Clinical Neuroscience (T.S.), Karolinska Institute, Stockholm, Sweden; Biogen (G.S.), Toronto, Ontario, Canada; Biogen (R.H., Robert Kuhelj), Baar, Switzerland; Division of Neurology (R.A.), Department of Medicine, Amiri Hospital, Sharq, Kuwait; Dokuz Eylul University (S.O.), Konak/Izmir; Hacettepe University (Rana Karabudak), Ankara, Turkey; Nehme and Therese Tohme Multiple Sclerosis Center (B.I.Y., S.J.K.), American University of Beirut Medical Center, Lebanon; 19 Mayis University (M.T.), Samsun; KTU Medical Faculty Farabi Hospital (C.B.), Trabzon, Turkey; Department of Neurology and Center of Clinical Neuroscience (D.H., E.K.H.), First Faculty of Medicine, Charles University in Prague and General University Hospital, Czech Republic; Department of Neurology (B.W.-G.), Buffalo General Medical Center, Buffalo, NY; Department of Medical and Surgical Sciences and Advanced Technologies (F.P.), GF Ingrassia, Catania, Italy; Department of Neurology (A.A.), School of Medicine and Koc University Research Center for Translational Medicine (KUTTAM), Koc University, Istanbul, Turkey; Department of Neurology and Clinical Investigation Center Neurosciences and Mental Health (S.M.), Razi University Hospital; Department of Neurology (R.G.), Razi University Hospital, Tunis, Tunisia; Rashid Hospital (J.I.), Dubai, United Arab Emirates; Isfahan University of Medical Sciences (V.S.), Iran; Department of Neurology (S.E.), Hospital Universitario Virgen Macarena, Sevilla, Spain; Ashfield MedComms (W.L.W.), Middletown, CT; Department of Neuroscience (H.B.), Central Clinical School, Monash University, Melbourne; and Department of Neurology (H.B.), Box Hill Hospital, Monash University, Box Hill, Victoria, Australia.

Background And Objectives: Patients with pediatric-onset multiple sclerosis (POMS) typically experience higher levels of inflammation with more frequent relapses, and though patients with POMS usually recover from relapses better than adults, patients with POMS reach irreversible disability at a younger age than adult-onset patients. There have been few randomized, placebo-controlled clinical trials of multiple sclerosis (MS) disease-modifying therapies (DMTs) in patients with POMS, and most available data are based on observational studies of off-label use of DMTs approved for adults. We assessed the effectiveness of natalizumab compared with fingolimod using injectable platform therapies as a reference in pediatric patients in the global MSBase registry.

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With evolving diagnostic criteria and the advent of new oral and parenteral therapies for Multiple Sclerosis (MS), most current diagnostic and treatment algorithms need revision and updating. The diagnosis of MS relies on incorporating clinical and paraclinical findings to prove dissemination in space and time and exclude alternative diseases that can explain the findings at hand. The differential diagnostic workup should be guided by clinical and laboratory red flags to avoid unnecessary tests.

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Background: To mimic as closely as possible a randomised controlled trial (RCT) and calibrate the real-world evidence (RWE) studies against a known treatment effect would be helpful to understand if RWE can support causal conclusions in selected circumstances. The aim was to emulate the TRANSFORMS trial comparing Fingolimod (FTY) versus intramuscular interferon β-1a (IFN) using observational data.

Methods: We extracted from the MSBase registry all the patients with relapsing-remitting multiple sclerosis (RRMS) collected in the period 2011-2021 who received IFN or FTY (0.

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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.
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Background: Multiple sclerosis (MS) is an autoimmune demyelinating disease that involves the central nervous system (CNS). Individuals with Multiple Sclerosis (MS) may experience difficulty adapting to their diagnosis as the unpredictable nature of the disease can be challenging to cope with.

Methods: The purpose of this study is twofold.

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Importance: Autologous hematopoietic stem cell transplant (AHSCT) is available for treatment of highly active multiple sclerosis (MS).

Objective: To compare the effectiveness of AHSCT vs fingolimod, natalizumab, and ocrelizumab in relapsing-remitting MS by emulating pairwise trials.

Design, Setting, And Participants: This comparative treatment effectiveness study included 6 specialist MS centers with AHSCT programs and international MSBase registry between 2006 and 2021.

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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.
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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.
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Central vein sign and paramagnetic rim sign: From radiologically isolated syndrome to multiple sclerosis.

Eur J Neurol

September 2023

Medical Imaging Sciences Program, Division of Health Professions, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.

The widespread use of magnetic resonance imaging (MRI) has led to an increase in incidental findings in the central nervous system. Radiologically isolated syndrome (RIS) is a condition where imaging reveals lesions suggestive of demyelinating disease without any clinical episodes consistent with multiple sclerosis (MS). The prognosis for RIS patients is uncertain, with some remaining asymptomatic while others progress to MS.

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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.*
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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'.

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The societal costs of multiple sclerosis in Lebanon: a cross-sectional study.

Expert Rev Pharmacoecon Outcomes Res

April 2023

Department of Natural Sciences, Lebanese American University, School of Arts and Sciences, Byblos, Lebanon.

Introduction: This study assessed the societal costs of multiple sclerosis (MS) in Lebanon, categorized by disease severity.

Methods: This was a cross-sectional, prevalence-based, bottom-up study using a face-to-face questionnaire. Patients were stratified by disease severity using the expanded disability status scale (EDSS); EDSS scores of 0-3, 4-6.

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Comparative effectiveness in multiple sclerosis: A methodological comparison.

Mult Scler

March 2023

CORe, Department of Medicine, University of Melbourne, Melbourne, VIC, Australia/Neuroimmunology Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, VIC, Australia.

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.

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Background 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.

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