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Evaluation of NEDA-3 in Relapsing Remitting Multiple Sclerosis Patients Treated with Fingolimod
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| Author:
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WALEED MOHAMMED ALI, NAWFAL MADHI SHAHEED
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| Abstract:
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Background: One of the most common autoimmune disorder of central nervous system is multiple sclerosis. Fingolimod is the first oral drug approved to treat relapsing multiple sclerosis. 'No evidence of disease activity' 3, a composite measure of clinical and radiological outcomes, provides a comprehensive assessment of disease activity.
Aim of study: To estimate the proportion of patients with relapsing remitting multiple sclerosis who have achieved No Evidence of Disease Activity up to one year kept on fingolimod therapy.
Methods: A descriptive observational study that was conducted in the multiple sclerosis clinic at Baghdad Teaching Hospital during a period of one year from December 2018 till December 2019 in real world formatting. It included 100 patients diagnosed with multiple sclerosis and shifted from first line directly to second line fingolimod for one year. Expanded Disability Status Scale was calculated for all patients at onset of the year of the study, after six months, and after one year. Brain and cord MRI 1.5 tesla study before and after one year of treatment. The baseline and follow up results compared with the results at the end of the study year while the patients on fingolimod to see the percentage of patients who have achieved no evidence of disease activity.
Results: In this study, the most common cause of shift to fingolimod was the failure of the 1st line treatment (64%). No relapse in 79% of cases. means of Expanded Disability Status Scale were significantly decreased after six months and after one year of treatment with fingolimod compared to that before treatment. T2 value and Gadolinium enhancement were significantly decreased after one year of treatment with fingolimod compared to that before treatment. By overall NEDA3, 66% of cases were improved. Prevalence of deteriorated cases was significantly increased with increasing in age and age of diagnosis. Post dose hypertension, fatigue, and lymphopenia were reported in 3% of patients.
Conclusion: The No Evidence of Disease Activity parameters are significantly achieved with more doses of fingolimod therapy.
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| Keyword:
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Multiple sclerosis, fingolimod, EDSS, NEDA-3, Iraq.
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2020.12.03.512
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| Download:
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