Abstract:
INTRODUCTION:Fingolimod is a selective immunosuppressant that targets the S1P receptor, and is indicated in the treatment of aggressive relapsing-remitting multiple sclerosis (RRMS) and following treatment failure with first-order drugs. AIM:To investigate the safety and effectiveness of fingolimod under the conditions of routine clinical practice. PATIENTS AND METHODS:We conducted an observational study with prospective follow-up of patients with RRMS who received fingolimod from January 2011 until February 2014. Data assessed were the annualised relapse rate (ARR), disability measured by the Expanded Disability Status Scale (EDSS), magnetic resonance activity and the appearance of side effects. RESULTS:Our sample consisted of 122 patients, 79.5% of them females and with a mean age of 26.8 years. They were classified, according to the last treatment received, as being: naive (aggressive RRMS; n = 17), previous treatment failure (n = 67) and withdrawal of natalizumab due to risk of progressive multifocal leukoencephalopathy (n = 38). After a mean follow-up of 29.9 ± 15.9 months, the ARR and the appearance of new lesions with gadolinium enhancement were reduced in both the naive and the previous treatment failure groups. There were no differences between the various subgroups as regards the progression of EDSS or the time elapsed until the first attack or treatment failure. The risk of treatment failure is higher with a baseline EDSS > 3 (hazard ratio: 4.24; p = 0.001) and presence of IgM oligoclonal bands (hazard ratio: 2.45; p < 0.022). CONCLUSIONS:Fingolimod is an effective and well-tolerated drug under conditions of routine clinical practice. Having a baseline EDSS > 3 and IgM oligoclonal bands is predictive of a poor response to fingolimod. TITLE:Tratamiento de la esclerosis multiple remitente recurrente con fingolimod en la practica clinica habitual. :Introduccion. El fingolimod es un inmunosupresor selectivo dirigido contra el receptor SP-1, indicado en el tratamiento de la esclerosis multiple remitente recurrente (EMRR) agresiva y tras el fracaso del tratamiento con farmacos de primera linea. Objetivo. Investigar la seguridad y efectividad del fingolimod en condiciones de practica clinica habitual. Pacientes y metodos. Estudio observacional con seguimiento prospectivo de pacientes con EMRR que recibieron fingolimod desde enero de 2011 hasta febrero de 2014. Se evaluo la tasa anual de brotes (TAB), la discapacidad medida por la escala expandida del estado de discapacidad (EDSS), la actividad en la resonancia magnetica y la aparicion de efectos adversos. Resultados. Incluimos 122 pacientes, el 79,5% mujeres y con una edad media de 26,8 antilde;os. Se clasificaron segun el ultimo tratamiento recibido en: naive (EMRR agresiva; n = 17), fracaso a terapias previas (n = 67) y retirada de natalizumab por riesgo de leucoencefalopatia multifocal progresiva (n = 38). Tras un seguimiento medio de 29,9 ± 15,9 meses, se redujo de forma significativa la TAB y la aparicion de nuevas lesiones con realce de gadolinio en el grupo naive y el de fracaso a terapias previas. No ha habido diferencias en la evolucion de la EDSS ni en el tiempo hasta el primer brote o el fracaso terapeutico entre los diferentes subgrupos. El riesgo a fracaso terapeutico es mayor con la EDSS basal > 3 (hazard ratio: 4,24; p = 0,001) y presencia de bandas oligoclonales IgM (hazard ratio: 2,45; p < 0,022). Conclusiones. El fingolimod es un farmaco eficaz y seguro en la EMRR en condiciones de practica clinica habitual. Tener una EDSS basal > 3 y bandas oligoclonales IgM predice una mala respuesta al fingolimod.
journal_name
Rev Neuroljournal_title
Revista de neurologiaauthors
Alcala-Vicente C,Perez-Miralles FC,Gascon-Gimenez F,Bosca-Blasco I,Navarre-Gimeno A,Coret-Ferrer F,Casanova-Estruch Bsubject
Has Abstractpub_date
2017-05-16 00:00:00pages
445-453issue
10eissn
0210-0010issn
1576-6578pii
rn2016359journal_volume
64pub_type
杂志文章abstract:INTRODUCTION:Various neuropsychological studies have been conducted to determine the cognitive functioning of patients with Huntington s disease and their results have shown that the pattern of cognitive decline is thought to be typical of a frontal subcortical dementia. OBJECTIVES:To determine if significant differen...
journal_title:Revista de neurologia
pub_type: 杂志文章
doi:
更新日期:2003-07-01 00:00:00
abstract:INTRODUCTION:Adrenoleukodystrophy is a hereditary recessive sex-linked disorder with very variable phenotype expression, including classical infantil ALD, adrenomyeloneuropathy (AMN) in adults and sex-linked Addison's disease. Clinical observations. Three affected patients are presented. The first showed signs of myelo...
journal_title:Revista de neurologia
pub_type: 杂志文章
doi:
更新日期:1996-07-01 00:00:00
abstract:INTRODUCTION:Epidemiological studies have demonstrated contradictory results about the association between smoking and the risk of Parkinson s disease (PD). OBJECTIVE:Examine the hypothesis of the EUROPARKINSON group that smoking protects against PD only in patients below 75 years of age. MATERIAL AND METHODS:We cond...
journal_title:Revista de neurologia
pub_type: 杂志文章,meta分析
doi:
更新日期:2003-03-16 00:00:00
abstract:INTRODUCTION:Epilepsy is one of the most common neurological disorders, affecting about one percent of the world population. Pharmacological treatment fails in one-third of these patients. Surgical intervention has become an accepted treatment option for those patients with seizure disorders that are refractory to conv...
journal_title:Revista de neurologia
pub_type: 杂志文章,评审
doi:
更新日期:1998-10-01 00:00:00
abstract:INTRODUCTION:It is today well recognised that preterm infants are at risk of neurodevelopmental impairments later in life. The preterm brain is exposed to different stimuli that may affect its normal development. Develoment. Magnetic resonance imaging (MRI) offers the possibility of monitoring normal brain development ...
journal_title:Revista de neurologia
pub_type: 杂志文章,评审
doi:
更新日期:2006-10-10 00:00:00
abstract:AIMS:In this study we review the economic impact involved in suffering from this disease in an attempt to determine how it affects both the individual and society, and the potential benefits deriving from its prevention and treatment. DEVELOPMENT:The World Health Organisation and the World Bank have pointed out that 9...
journal_title:Revista de neurologia
pub_type: 杂志文章,评审
doi:
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:The aortic atherosclerotic debris is considered a high risk embolic source, being an independent predictor for cerebrovascular ischemia. The incidence is higher in the elderly and in patients with coronary artery disease. Transesophageal echocardiogram (TEE) is an important diagnostic tool that allows its de...
journal_title:Revista de neurologia
pub_type: 杂志文章
doi:
更新日期:2003-06-16 00:00:00
abstract:INTRODUCTION:The developmental amnesia is a recently known entity that occurs as a consequence of hypoxic-ischemic events in the perinatal period. This is a specific deficit of episodic memory with greater preservation of semantic memory and other memory components such as the immediate and working memory. It occurs in...
journal_title:Revista de neurologia
pub_type: 杂志文章
doi:
更新日期:2011-03-01 00:00:00
abstract:INTRODUCTION:Transient ischemic attacks (TIA) often precede a stroke. AIMS:The purpose of this study is to examine the modifiable cardiovascular risk factors for non-cardioembolic TIA. PATIENTS AND METHODS:A population based case control study was conducted in a district within the city of Barcelona. The cases were 1...
journal_title:Revista de neurologia
pub_type: 杂志文章
doi:
更新日期:2003-08-01 00:00:00
abstract:INTRODUCTION:Lyme disease is a complex infectious disease affecting multiple organic systems. The most frequent complications are of a dermatological, rheumatological, ophthalmological, cardiac and neurological nature. Among the neurological complications, pseudotumour cerebri is considered to be a rare manifestation o...
journal_title:Revista de neurologia
pub_type: 杂志文章
doi:
更新日期:2003-04-16 00:00:00
abstract:INTRODUCTION:It is necessary to know the degree of concordance of preoperative studies in temporal lobe epilepsy (TLE). AIM. To analyze the relative importance of different preoperative tests (vEEG, EEG, SPECT and MRI), the degree of agreement between them, and to develop a Bayesian probability model for diagnosis. PA...
journal_title:Revista de neurologia
pub_type: 杂志文章
doi:
更新日期:2010-10-01 00:00:00
abstract:INTRODUCTION AND DEVELOPMENT:Reported observations of acquired aphasia in children contain all the symptoms and syndromes that have been described in adult aphasiology. Recovery of colloquial language is good even if anomia and verbal memory deficits persist as the most frequent defects. At long term outcome there are ...
journal_title:Revista de neurologia
pub_type: 杂志文章,评审
doi:
更新日期:2008-01-01 00:00:00
abstract:INTRODUCTION:According to the 1981 International League Against Epilepsy classification, absence seizures are the paradigm of idiopathic generalised seizures of childhood. Although absences are mainly of an idiopathic origin, there are also symptomatic absences, which account for 10% of all cases of absences. It is tho...
journal_title:Revista de neurologia
pub_type: 杂志文章
doi:
更新日期:2017-09-16 00:00:00
abstract:INTRODUCTION:Myasthenia gravis is an autoimmune disease of the neuromuscular junction that presents clinically as fluctuating weakness of skeletal muscles, as of the ocular region (myasthenia ocular). AIM:To demonstrate that the sensitivity and specificity of the ice pack test are high, in the differential diagnosis o...
journal_title:Revista de neurologia
pub_type: 杂志文章
doi:
更新日期:2013-11-01 00:00:00
abstract:INTRODUCTION:Chronic migraine is the most frequent complication of migraine. It is defined by the presence of headache on 15 or more days a month, of which at least eight must meet the criteria of migraine without aura for a minimum of three months. In addition they must not be due to medication abuse or attributable t...
journal_title:Revista de neurologia
pub_type: 杂志文章,评审
doi:
更新日期:2012-05-16 00:00:00
abstract:INTRODUCTION:Surgical treatment for thoracolumbar union instability represents a challenge, due to the difficult access to this area of the spine, and to the extreme variability of morphological and biomechanical lesions observed. AIM:To describe the indications and clinical and neuroradiological results obtained with...
journal_title:Revista de neurologia
pub_type: 杂志文章
doi:
更新日期:2005-01-01 00:00:00
abstract::Based on the interrelation between science and philosophy, this article addresses the impact of neurosciences on the philosophical issues posed by today's society, especially those related with epistemology and the philosophy of science. To do so, the different approaches in the cognitive sciences are taken into accou...
journal_title:Revista de neurologia
pub_type: 杂志文章
doi:
更新日期:2013-03-16 00:00:00
abstract:OBJECTIVE:Theories about consciousness are in an initial state of development. In the recent past, diverse theories have been proposed to explain the phenomenon of the consciousness using the Quantum Mechanics (QM) as a fundamental tool. Here, we criticize some of these theories in the light of the current knowledge in...
journal_title:Revista de neurologia
pub_type: 杂志文章,评审
doi:
更新日期:2002-07-01 00:00:00
abstract::The cognitive effects of the most commonly used antiepileptic drugs (AEDs) are reviewed, discussing both the absolute effects (the effects compared to no treatment) and the relative effects (the comparison of one AED with an other). The cognitive profile per AED is given, based on a literature database, consisting of ...
journal_title:Revista de neurologia
pub_type: 杂志文章,评审
doi:
更新日期:2002-05-01 00:00:00
abstract:INTRODUCTION:Vascular pathology is considered to be uncommon, with a much lower incidence than cerebral vascular pathology. PATIENTS AND METHODS:We reviewed the clinical histories of patients with a clinical diagnosis of spinal cord infarction-ischemia attended by the Neurology Department and the Neuropaediatric secti...
journal_title:Revista de neurologia
pub_type: 杂志文章
doi:
更新日期:1999-11-16 00:00:00
abstract:INTRODUCTION:Depression is a state of mind often associated with Parkinson's disease, which is not correlated with the stage of the disease or the response to treatment with L-dopa. It has been suggested that patients with right-sided Parkinsonism have more depression than those with left-sided. OBJECTIVE:To assess wh...
journal_title:Revista de neurologia
pub_type: 杂志文章
doi:
更新日期:2000-12-16 00:00:00
abstract:INTRODUCTION:The incidence of deep vein thrombosis and pulmonary embolism in patients with cerebral neoplasia has been estimated at 120/100,000 (the second highest rate for any kind of malignant neoplasia). A timely diagnosis is an indispensable requisite in the clinical evaluation of neurological patients. Patients su...
journal_title:Revista de neurologia
pub_type: 杂志文章,评审
doi:
更新日期:2003-11-01 00:00:00
abstract:INTRODUCTION:Orthostatic tremor is a rare kind of tremor which is clinically characterised by a feeling of instability or being about to fall that is experienced on standing up, which disappears or improves on walking and is absent when sitting or lying down. AIM:To shed light on the main features of this tremor syndr...
journal_title:Revista de neurologia
pub_type: 杂志文章,评审
doi:
更新日期:2012-04-01 00:00:00
abstract::Autonomic dysfunction is a common manifestation in patients with in Parkinson's disease, which can sometimes precede motor impairment. It can be expressed as orthostatic and postprandial hypotension, supine hypertension, hypersalivation, constipation, delayed gastric emptying, dyshidrosis, bladder and sexual dysfuncti...
journal_title:Revista de neurologia
pub_type: 杂志文章,评审
doi:
更新日期:2015-04-16 00:00:00
abstract:INTRODUCTION:The cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is caused by mutations of the Notch3 gene in the chromosome 19p13.1. and is characterized by small-vessel disease of the cerebral. The clinical feature consists of migraine, recurrent strokes, mood chan...
journal_title:Revista de neurologia
pub_type: 杂志文章
doi:
更新日期:2000-11-16 00:00:00
abstract:INTRODUCTION:Nonconvulsive status epilepticus (NCSE) of frontal origin is a form of partial status epilepticus which has rarely been well-documented. The inespecificity of the symptoms contribute frequently to its misinterpretation being the EEG the most useful tool to make an accurate diagnosis. CLINICAL CASE:We repo...
journal_title:Revista de neurologia
pub_type: 杂志文章
doi:
更新日期:2000-06-01 00:00:00
abstract:INTRODUCTION:Attention deficit hyperactivity disorder (ADHD) is a neurobiological condition essentially characterised by inattention, hyperactivity and impulsiveness, and has a prevalence of around 5%. Because it is a biological disorder, both boys and girls with ADHD display these same symptoms, but more boys are diag...
journal_title:Revista de neurologia
pub_type: 杂志文章
doi:
更新日期:2007-03-02 00:00:00
abstract::INTRODUCTION. Scientific collaboration is vital for to the advance of knowledge and is especially important in health sciences. The aim of this study is to identify scientific collaboration indicators and co-authorship networks of researchers and Spanish institutions that publish on multiple sclerosis (MS) during the ...
journal_title:Revista de neurologia
pub_type: 杂志文章
doi:
更新日期:2013-08-16 00:00:00
abstract:INTRODUCTION:The Kamayura tribe is made up of 300 persons living in the Alto Xingu in Mato Grosso, Brazil. Their traditional system of health care is based on the pajé, a witch doctor who uses plants and prayers for treatment. MATERIAL AND METHODS:Field work was done in the Kamayura village holding successive intervie...
journal_title:Revista de neurologia
pub_type: 杂志文章
doi:
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVES:The aim of the study was the short term test-retest-reliability of electrophyisiological correlates of simple processes of the motor control, i.e. the execution (go) and the inhibition (no go) of a prepared motor response, evoked during the Continuous Performance Test (CPT). Our interest was centered in the ...
journal_title:Revista de neurologia
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00