Browsing by Author "Lopez, Pablo A."

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    COVID-19 in multiple sclerosis and neuromyelitis optica spectrum disorder patients in Latin America COVID-19 in MS and NMOSD patients in LATAM
    (2021) Alonso, Ricardo; Silva, Berenice; Garcea, Orlando; Correa Diaz, Patricio E.; dos Passos, Giordani Rodrigues; Ramirez Navarro, Deyanira A.; Garcia Valle, Luis A.; Rodriguez Salinas, Luis C.; Negrotto, Laura; Luetic, Geraldine; Tkachuk, Veronica A.; Miguez, Jimena; Diaz de Bedoya, Fernando Hamuy; Goiry, Lorna Galleguillos; Ramirez Sanchez, Nicia E.; Burgos, Marcos; Steinberg, Judith; Balbuena, Maria E.; Monterrey Alvarez, Priscilla; Lopez, Pablo A.; Ysrraelit, Maria C.; Leon, Rosalba A.; Cohen, Aron Benzadon; Gracia, Fernando; Molina, Omaira; Casas, Magdalena; Deri, Norma H.; Pappolla, Agustin; Patrucco, Liliana; Cristiano, Edgardo; Tavolini, Dario; Nadur, Debora; Granda, Ana M. Toral; Weiser, Roberto; Cassara, Fatima Pagani; Sinay, Vladimiro; Carcamo Rodriguez, Claudia; Lazaro, Luciana G.; Menichini, Maria L.; Piedrabuena, Raul; Orozco Escobar, Geraldine; Carra, Adriana; Chertcoff, Anibal; Santos Pujols, Biany; Vrech, Carlos; Tarulla, Adriana; Carvajal, Rene; Mainella, Carolina; Becker, Jefferson; Peeters, Liesbet M.; Walton, Clare; Alonso Serena, Marina; Nunez, Sebastian; Rojas, Juan, I
    Background: There is no data regarding COVID-19 in Multiple Sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) patients in Latin America. Objective: The objective of this study was to describe the clinical characteristics and outcomes of patients included in RELACOEM, a LATAM registry of MS and NMOSD patients infected with COVID-19. Methods: RELACOEM is a longitudinal, strictly observational registry of MS and NMOSD patients who suffer COVID-19 and Dengue in LATAM. Inclusion criteria to the registry were either: (1) a biologically confirmed COVID-19 diagnosis based on a positive result of a COVID-19 polymerase chain reaction (PCR) test on a naso-pharyngeal swab; or (2) COVID-19-typical symptoms (triad of cough, fever, and asthenia) in an epidemic zone of COVID-19. Descriptive statistics were performed on demographic and clinical variables. The cohort was later stratified for MS and NMOSD and univariate and multivariate logistic regression analysis was performed to identify variables associated with hospitalizations/intensive critical units (ICU) admission. Results: 145 patients were included in the registry from 15 countries and 51 treating physicians. A total of 129 (89%) were MS patients and 16 (11%) NMOSD. 81.4% patients had confirmed COVID-19 and 18.6% were suspected cases. 23 (15.8%) patients were hospitalized, 9 (6.2%) required ICU and 5 (3.4 %) died due to COVID-19. In MS patients, greater age (OR 1.17, 95% CI 1.05 - 1.25) and disease duration (OR 1.39, 95%CI 1.14-1.69) were associated with hospitalization/ICU. In NMOSD patients, a greater age (54.3 vs. 36 years, p=<0.001), increased EDSS (5.5 vs 2.9, p=0.0012) and disease duration (18.5 vs. 10.3 years, p=0.001) were significantly associated with hospitalization/ICU. Conclusion: we found that in MS patients, age and disease duration was associated with hospitalization and ICU admission requirement, while age, disease duration and EDSS was associated in NMOSD.
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    Treatment of older patients with multiple sclerosis: Results of an International Delphi Survey
    (2023) Tumani, Hayrettin; Coyle, Patricia K.; Carcamo, Claudia; Cordioli, Cinzia; Lopez, Pablo A.; Peterka, Marek; Ramo-Tello, Cristina; Zuluaga, Maria, I; Koster, Thijs; Vignos, Megan
    BackgroundPeople over age 50-55 have historically been excluded from randomized clinical trials for multiple sclerosis (MS). However, more than half of those living with an MS diagnosis are over 55.ObjectiveExplore the unique considerations of treating older people with MS (PwMS) using an iterative and structured Delphi-based assessment to gather expert opinions.MethodsEight MS neurologists with an interest in older PwMS developed a 2-round survey. Survey respondents were qualified neurologists with >= 3 years' experience, personally responsible for treatment decisions, and treating >= 20 patients per month, of whom >= 10% were >= 50 years old. Consensus was defined as >= 75% agreement on questions with categorical responses or as a mean score >= 4 on questions with numerical responses.ResultsIn Survey 1, 224 neurologists responded; 180 of these completed Survey 2. Limited consensus was reached with varying levels of agreement on several topics including identification and assessment of older patients; factors relating to treatment decisions including immunosenescence and comorbidities; considerations for high-efficacy treatments; de-escalation or discontinuation of treatment; effects of COVID-19; and unmet needs for treating this population.ConclusionThe results of this Delphi process highlight the need for targeted studies to create guidance for the care of older PwMS.