DSpace Angular :: Browsing by Author "Cárcamo Rodríguez, Claudia Andrea"

Browsing by Author "Cárcamo Rodríguez, Claudia Andrea"

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Biological and nonbiological complex drugs for multiple sclerosis in Latin America : regulations and risk management
(2015) Carra, Adriana; Macias Islas, Miguel Angel; Tarulla, Adriana; Bichuetti, Denis Bernardi; Finkelsztejn, Alessandro; Fragoso, Yara Dadalti; Árcega-Revilla, Raul; Cárcamo Rodríguez, Claudia Andrea; García Bonitto, Juan; León, Rosalba; Oehninger Gatti, Carlos; Orozco, Geraldine; Vizcarra Escobar, Darwin
Efficacy of andrographolide in not active progressive multiple sclerosis: a prospective exploratory double-blind, parallel-group, randomized, placebo-controlled trial
(2020) Ciampi, Ethel; Uribe-San-Martin, Reinaldo.; Cárcamo Rodríguez, Claudia Andrea; Cruz, Juan Pablo; Reyes, Ana.; Reyes, Diego.; Pinto, Carmen.; Vásquez Torres, Macarena.; Burgos, Rafael A.; Hancke, Juan.
Abstract Background Multiple sclerosis (MS) is a chronic immune mediated disease and the progressive phase appears to have significant neurodegenerative mechanisms. The classification of the course of progressive MS (PMS) has been re-organized into categories of active vs. not active inflammatory disease and the presence vs. absence of gradual disease progression. Clinical trial experience to date in PMS with anti-inflammatory medications has shown limited effect. Andrographolide is a new class of anti-inflammatory agent, that has been proposed as a potential drug for autoimmune disorders, including MS. In the present trial, we perform an exploratory pilot study on the efficacy and safety of andrographolide (AP) compared to placebo in not active PMS. Methods A pilot clinical trial using 140 mg oral AP or placebo twice daily for 24 months in patients with not active primary or secondary progressive MS was conducted. The primary efficacy endpoint was the mean percentage brain volume change (mPBVC). Secondary efficacy endpoints included 3-month confirmed disability progression (3-CDP) and mean EDSS change. Results Forty-four patients were randomized: 23 were assigned to the AP group, and 21 were assigned to the placebo group. The median baseline EDSS of both groups was 6.0. Annualized mPBVC was − 0.679% for the AP group and − 1.069% for the placebo group (mean difference: -0.39; 95% CI [− 0.836–0.055], p = 0.08, relative reduction: 36.5%). In the AP group, 30% had 3-CDP compared to 41% in the placebo group (HR: 0.596; 95% CI [0.200–1.777], p = 0.06). The mean EDSS change was − 0.025 in the AP group and + 0.352 in the placebo group (mean difference: 0.63, p = 0.042). Adverse events related to AP were mild rash and dysgeusia. Conclusions AP was well tolerated and showed a potential effect in reducing brain atrophy and disability progression, that need to be further evaluated in a larger clinical trial. Trial registration ClinicalTrials.gov NCT02273635 retrospectively registered on October 24th, 2014.
Frequency of diminished ovarian reserve in women with multiple sclerosis in Chile: An exploratory study
(2023) Pelayo Carolina; Ciampi Díaz, Ethel Leslie; Soler León, Bernardita María; Uribe San Martín, Reinaldo Moises; Reyes Delgado, Ana Cecilia; García, Lorena; Del Canto, Adolfo; Gutiérrez Carquin, Leticia; Barrerra Hormazabal, Antonia; Jurgensen Heinrich, Lukas; Guzman Cárcamo, Ignacio; Carvajal, Andrés; Troncoso, Carlos; Carvajal, Rodrigo; Cárcamo Rodríguez, Claudia Andrea
Introduction: Multiple Sclerosis (MS) is a chronic disease affecting around 2.8 million people worldwide. Two-thirds are women, and the mean age at diagnosis is about 30 years old. Social trends are moving towards older age at first pregnancy, both in women with and without MS. Objectives: To determine the frequency of diminished ovarian reserve (DOR) through anti-Mullerian Hormone (AMH) measurement in women with MS at fertile age and Healthy Females (HF) in Chile. Methods: Case-control, multicentric, cross-sectional study including relapsing-remitting people with MS (pwMS) between 18 and 40 years and sex and age-matched HF. We obtained a blood sample to determine AMH levels. We defined DOR as AMH <1.5 ng/mL and very-low AMH levels as <0.5 ng/mL. Also, we performed questions regarding reproductive decision-making. Results: We included 79 sex and age-matched HF and 92 pwMS, median age 32(19–40) years, median disease duration 6 (1–17)years, median EDSS 1.0 (0–6), 95% were receiving disease-modifying therapy (DMT), 70% high-efficacy DMT and 37% with a treatment that contraindicates pregnancy. DOR was observed in 24% (n = 22) of the pwMS, compared to 14% (n = 11) of the HF (p = 0.09), while very-low AMH levels were observed in 7.6% (n = 7) of pwMS and none of the HF (p = 0.0166). We observed an inverse correlation between age and AMH levels. Age was the only significant risk factor for low AMH levels in pwMS (OR 1.14 95%CI(1.00–1–31), p = 0.04), including smoking, body mass index (BMI), hormonal contraception, autoimmune comorbidity, high/low-moderate efficacy DMT, and active disease as covariables. We did not find statistically significant differences in age at diagnosis, BMI, disease duration, EDSS, autoimmune comorbidity, use of hormonal contraception, or percentage of active disease between MS women with normal vs DOR. Over 70% of pwMS desired to become pregnant in the future, while 60% considered that the diagnosis of MS was a limitation for pregnancy planning. Conclusions: No differences in DOR, measured by levels of AMH, were observed between pwMS MS and HF in Chile. As expected, AMH levels were correlated only with ageing. This information may be evaluated early during the disease course to help patients and neurologists with fertility counselling and family planning considerations regarding DMT use.
Low-dose rituximab should be used for treating MS in resource-limited settings: commentary
(2022) Cárcamo Rodríguez, Claudia Andrea; Ciampi Díaz, Ethel Leslie
Multiple sclerosis and related disorders: Short report peripheral vascular events in a real-world cohort of multiple sclerosis patients using Fingolimod
(2020) Pelayo, Carolina; Ciampi Díaz, Ethel Leslie; Uribe San Martín, Reinaldo; Soler León, Bernardita María; Reyes, Ana; Vergara, Elizabeth; Cárcamo Rodríguez, Claudia Andrea
Background: Fingolimod is a high-efficacy disease-modifying therapy for multiple sclerosis (MS) and was the first oral treatment approved for the disease. Adverse events include bradyarrhythmia, hypertension, macular oedema and increased risk of infections, mainly due to its main mechanism of action, the non-selective modulation of sphingosine-1-phosphate receptor.", "Methods and Results: We report the baseline characteristics, effectiveness outcomes and adverse events of a prospective cohort of 177 patients with a median treatment duration of 24 months, in which four patients (2.3%) presented with otherwise non-provoked peripheral vascular events (PVE).", "Conclusions: Further studies are still needed to evaluate the frequency and severity of PVE in fingolimod patients.
Neuromyelitis optica spectrum disorders: Profile of a cohort according to the 2015 diagnostic criteria
(Revista de Neurologia, 2017) Uribe San Martin, Reinaldo Moisés; Ciampi Diaz, Ethel Leslie; Galilea Izquierdo, Antonia; Sandoval Rubio, Patricio Alberto Mario; Miranda Vera, Héctor David; Mellado Talesnik, Patricio Andrés; Cárcamo Rodríguez, Claudia Andrea; Albornoz Cruz, Juan Pablo; Huete Garin, Isidro Álvaro
The new 2015 criteria for neuromyelitis optica spectrum disorders (NMOSD) have been recently incorporated in the study of different international cohorts. Aim. To describe clinical-radiological characteristics and prognostic factors in patients with NMOSD according to the 2015 criteria. Patients and methods. Retrospective analysis of 36 patients diagnosed with NMOSD according to serologic AQP4 status (positive, negative, unknown and negative + unknown). Clinical and radiological characteristics were compared and possible disability prognostic factors were evaluated. Results. AQP4 were positive in 7 patients, negative in 12 and unknown in 17. Age of presentation was 36.6 ± 16 years, with higher female proportion (4:1). Mean disease duration was 7.4 ± 7.6 years. Most frequent presenting symptoms were acute myelitis (61%), optic neuritis (33%) and area postrema syndrome (11%). Most frequent MRI lesion was longitudinally extensive transverse myelitis (75%). All patients received acute treatment during attacks, and preventive treatment was used in 81% (azathioprine and rituximab mostly prescribed). Median EDSS was 2.0 at the end of follow-up. No differences were observed in any of the variables comparing serologic status. Age of first attack was prognostic, with direct correlation with EDSS. First attack in < 30 years was protective, meanwhile > 50 years old patients had increased risk of disability. Conclusions. The 2015 criteria allow the description and classification of NMOSD patients within different cohorts. Age of first attack seems to be a prognostic factor for developing disability.
Practical Issues Concerning the Approval and Use of Biosimilar Drugs for the Treatment of Multiple Sclerosis in Latin America
(2019) Steinberg, Judith; Dadalti Fragoso, Yara; Duran Quiroz, Juan Carlos; García,Juan Raul; Guerra, Caroline; Rodriguez, Virginia; Cárcamo Rodríguez, Claudia Andrea; Ciampi Diaz, Ethel Leslie; Correa-Diaz, Edgar; Macías, Miguel; Novarro, Nelson; Vizcarra, Darwin; Oehninger Gatti, Carlos; Orozco, Geraldine; Carrá, Adriana
The use of biosimilar drugs for multiple sclerosis (MS) has become widespread in Latin America, with the goal of reducing costs of treatments, promoting the sustainability of healthcare systems, and improving patient access to these therapies. There is currently a need to define and comply with requirements to guarantee the efficacy, safety, and quality of these drugs. Thus, the objective of the present study was to compile up-to-date information from each Latin American country assessed on (a) approval of biosimilar drugs by regulatory agencies; (b) use of biosimilar drugs, pharmacovigilance plans, risk management; and (c) update in the knowledge on different molecules. To do so, a group of experts from Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Ecuador, Mexico, Panama, Peru, Uruguay, and Venezuela met to discuss the current situation regarding good practices and risks associated with the use of biosimilar drugs in their respective countries. Regulation, risk management plans, and pharmacovigilance in the whole continent must guide the strategies on the commercialization and access of biosimilar drugs and copies of complex molecules. Current regulations must be implemented for the registration of biosimilar drug products and complex molecules. It is paramount to ensure that new products follow the best quality standards at all stages beyond being safe and efficient. Uncontrolled interchangeability between original biological and biosimilar should be avoided. Latin America requires the implementation and full use of strong pharmacovigilance programs. National and multinational clinical studies are required to demonstrate the similarity in safety, efficacy, and immunogenicity profiles of complex molecules, as well as biological and biosimilar products.
Practical issues concerning the use of Magnetic Resonance Imaging in Multiple Sclerosis in Latin America: discussion from 16 centres on behalf of the Foro Latam EM Study Group
(Elsevier B.V., 2022) Ciampi, Ethel; Guerra-Posada, Carolina; Treviño-Frenk, Irene; Cortes-Enriquez, Fernando; Correa-Díaz, Edgar Patricio; Steinberg, Judith; Fragoso, Yara; Garcia Bonitto, Juan; Macias, Miguel Angel; Novarro, Nelson; Carra, Adriana; Vizcarra, Darwin; Vrech, Carlos; Cárcamo Rodríguez, Claudia Andrea
MAGNIMS-CMSC-NAIMS consensus recommendations on the use of MRI in patients with multiple sclerosis have been recently published, and they have been fundamental for improving patient care. Implementation of these and previous MAGNIMS recommendations have not been established in many countries. Addressing the local limitations behind these difficulties is needed. A panel of 14 MS neurologists from 16 different reference centres from Chile, Argentina, Mexico, Colombia, Ecuador, Panamá, Perú and Brazil met to discuss the current situation regarding the use of MRI in MS including a) Access and availability, b) Standardized acquisition protocols and reports, and c) Multicentric research potential.
Pregnancy outcomes in women with Multiple Sclerosis
(2021) Soler León, Bernardita María; Ciampi, Ethel; Uribe San Martín, Reinaldo; Keller K.; Astudillo M.; Charaf V.; Reyes A.; Vergara E.; Cárcamo Rodríguez, Claudia Andrea
Prevalence of comorbidities in Multiple Sclerosis and impact on physical disability according to disease phenotypes
(2020) Ciampi, Ethel; Uribe San Martín, Reinaldo; Soler León, Bernardita María; Molnar, Karolyn; Reyes Placencia, Diego Armando; Keller Matamala, Karina Pascale; Cárcamo Rodríguez, Claudia Andrea
Background: Comorbidities are prevalent among Multiple Sclerosis (MS) patients. Few studies have characterized their prevalence and impact in Latin American populations.Objective: We aim to assess the prevalence of comorbidities and their impact on the risk of physical disability across different MS phenotypes.Methods: Cross-sectional multicenter study of patients under regular clinical care at the Programa de Esclerosis Múltiple UC and Hospital Dr. Sótero del Río in Chile. Prevalence of comorbidities was estimated from the retrospective assessment of electronic medical charts. Disease phenotypes were categorized into two groups: clinically isolated syndrome/relapsing-remitting (inflammatory group) and primary/secondary progressive MS patients (progressive group). A multivariable analysis using binary logistic regression for assessing the risk of EDSS ≥ 6.0 in each group was performed.Results: A total of 453 patients was included, 71% female, mean age at onset 31 years, mean disease duration 10 years, and median EDSS 2.0 (range 0–10). In the whole sample, most prevalent comorbidities were ever-smoking (42.2%), depression/anxiety (34.9%), thyroid disease (15.7%), hypertension (11.3%) and insulin resistance/type 2 diabetes mellitus (11.0%). When assessing the risk of EDSS ≥ 6, in the inflammatory group (N = 366), age at onset (OR 1.06, 95%CI(1.02–1.11), p = 0.008), disease duration (OR 1.06, 95%CI(1.00–1.12), p = 0.039) and epilepsy comorbidity (OR 5.36, 95%CI(1.33–21.5), p = 0.018) were associated with a higher risk of disability. In the progressive group (N = 87), disease duration was a risk factor (OR 1.08 95%CI(1.02–1.16), p = 0.014), while shorter diagnostic delay (OR 0.91 95%CI(0.85–0.99), p = 0.025) and insulin resistance/type 2 diabetes mellitus comorbidity were protective factors (OR 0.18 95%CI(0.04–0.83), p = 0.028), 72% of these patients were receiving metformin.Conclusions: Comorbidities are common across different MS disease phenotypes. Epilepsy seems particularly related with a higher risk of physical disability in relapsing-remitting patients, while the role of insulin resistance/type 2 diabetes mellitus or the impact of metformin use as a protective factor should be further studied. Prospective and larger studies are still needed in order to assess the real impact of comorbidities and their management in MS outcomes.
Prevalence of epilepsy in a cohort of patients with multiple sclerosis
(2014) Uribe San Martín, Reinaldo; Ciampi, Ethel; Suárez Hernández, F.; Vasquez Torres, M.; Godoy F., Jaime; Cárcamo Rodríguez, Claudia Andrea
Refractory epilepsy associated with anti-ribosomal P antibodies successfully treated with topiramate
(2020) Uribe San Martín, Reinaldo; Ciampi, Ethel; Cruz, Juan Pablo; Vásquez, M.; Cárcamo Rodríguez, Claudia Andrea
Regional brain atrophy is related to social cognition impairment in multiple sclerosis
(ASSOC ARQUIVOS NEURO- PSIQUIATRIA, 2021) Labbe Atenas, Tomás Pablo; Montalba Zalaquett, Cristian Andrés; Zurita Soler, Mariana; Ciampi Diaz, Ethel Leslie; Albornoz Cruz, Juan Pablo; Vásquez Torres, Macarena; Uribe Arancibia, Sergio Andrés; Crossley Karmelic, Nicolás Andrés; Cárcamo Rodríguez, Claudia Andrea
Background: Multiple sclerosis exhibits specific neuropathological phenomena driving to both global and regional brain atrophy. At the clinical level, the disease is related to functional decline in cognitive domains as the working memory, processing speed, and verbal fluency. However, the compromise of social-cognitive abilities has concentrated some interest in recent years despite the available evidence suggesting the risk of disorganization in social life. Recent studies have used the MiniSEA test to assess the compromise of social cognition and have found relevant relationships with memory and executive functions, as well as with the level of global and regional brain atrophy. Objective: The present article aimed to identify structural changes related to socio-cognitive performance in a sample of patients with relapsing-remitting multiple sclerosis. Methods: 68 relapsing-remitting multiple sclerosis Chilean patients and 50 healthy control subjects underwent MRI scans and neuropsychological evaluation including social-cognition tasks. Total brain, white matter, and gray matter volumes were estimated. Also, voxel-based morphometry was applied to evaluate regional structural changes. Results: Patients exhibited lower scores in all neuropsychological tests. Social cognition exhibited a significant decrease in this group mostly related to the declining social perception. Normalized brain volume and white matter volume were significantly decreased when compared to healthy subjects. The regional brain atrophy analysis showed that changes in the insular cortex and medial frontal cortices are significantly related to the variability of social-cognitive performance among patients. Conclusions: In the present study, social cognition was only correlated with the deterioration of verbal fluency, despite the fact that previous studies have reported its link with memory and executive functions. The identification of specific structural correlates supports the comprehension of this phenomenon as an independent source of cognitive disability in these patients.
Relationship between Social Cognition and traditional cognitive impairment in Progressive Multiple Sclerosis and possible implicated neuroanatomical regions
(2018) Ciampi, Ethel; Uribe San Martín, Reinaldo; Vásquez, M.; Ruiz-Tagle, A.; Labbé Atenas, Tomás; Cruz, J. P.; Lillo, P.; Slachevsky, A.; Reyesk, D.; Reyes, A.; Cárcamo Rodríguez, Claudia Andrea
Resonancia magnética funcional : principios básicos y aplicaciones en neurociencias
(2018) Labbé Atenas, Tomás; Ciampi, Ethel; Cruz, Juan Pablo; Uribe Arancibia, Sergio A.; Cárcamo Rodríguez, Claudia Andrea
Resting state network disorganization as neural correlate of cognitive disfunction in multiple sclerosis
(2018) Labbé Atenas, Tomás; Cárcamo Rodríguez, Claudia Andrea; Crossley, Nicolás; Pontificia Universidad Católica de Chile. Facultad de Medicina
La Esclerosis Múltiple, una enfermedad neurodegenerativa e inflamatoria crónica que afecta al sistema nervioso central, produce compromiso estructural y funcional del cerebro humano que ha sido bien descrito tanto desde el tipo de daño específico que genera a nivel de la sustancia gris y blanca, como los respectivos cambios en la conectividad que involucran desconexión y aumentos compensatorios de la conectividad funcional. Estas alteraciones generan, a lo largo de la historia natural de la enfermedad, niveles significativos de discapacidad tanto física como cognitiva. En este último dominio, se ha descrito que hasta el 70% de los pacientes desarrollarán deterioro cognitivo afectando principalmente a funciones mentales como la velocidad de procesamiento, memoria de trabajo, aprendizaje y memoria verbal y visual, entre otros. Sin embargo, existe menos evidencia respecto al patrón en que se compromete la Cognición Social, un dominio cognitivo que ha motivado creciente interés en los últimos años y que podría tener un gran impacto en la calidad de vida de las personas afectadas. Se entiende por cognición social a los procesos mentales involucrados en la decodificación de información sensorial de relevancia para la interacción con otros sujetos, su interpretación en el amplio sentido y la producción de los sustratos mentales para la conducta social. Aunque existen múltiples definiciones y su funcionamiento se ha conceptualizado a través de la identificación de diversos dominios, en la presente investigación nos centramos específicamente en las funciones de Percepción Social y Teoría de la Mente. En primer lugar, la Percepción Social se relaciona con la adecuada capacidad de los sujetos de identificar los componentes emocionales contenidos, por ejemplo en la información visual. De esta forma, ante la observación de una cara con una tensa contracción de la frente y una particular disposición de los labios y dientes, es posible identificar esa expresión como enojo. Por otro lado, la Teoría de la Mente se relaciona con la capacidad de los sujetos de atribuir estados mentales a las personas con quienes interactúan en base a elementos del discurso, el contexto o bien de la expresión facial y corporal. Así, los componentes de la cognición social le permiten a las personas adaptarse adecuadamente a las situaciones, interactuar con el entorno social y generar respuestas conductuales adaptativas. El objetivo del presente estudio fue identificar los cambios estructurales y funcionales que se relacionan con alteraciones de la cognición social en pacientes con Esclerosis Múltiple. Se realizaron pruebas cognitivas y adquisiciones de resonancia magnética estructural y funcional en 50 sujetos controles sanos y 68 pacientes con Esclerosis Múltiple Recurrente-Remitente. Estos últimos tenían una edad media cercana a 37 años y bajos niveles de discapacidad física (medidos por EDSS). A nivel clínico, fue posible objetivar menor rendimiento en las pruebas de cognición social en pacientes comparados con sujetos controles sanos. Esta alteración se dio de manera más significativa en el dominio de la Percepción Social que en el de Teoría de la Mente. Además de la atrofia cerebral generalizada en los pacientes también fue posible identificar diversas regiones que mostraron significativas reducciones del volumen local, así como cambios en la conectividad funcional del cerebro completo en estado de reposo tanto con pares de regiones con aumento como disminución en la conectividad funcional. Específicamente, el compromiso estructural de la ínsula y estructuras frontales mediales bilaterales se correlacionó significativamente con el nivel de deterioro de los procesos de la cognición social. Así también, a nivel funcional, cambios en la conectividad de la amígdala y de la corteza fusiforme se vieron involucrados en el deterioro de este dominio cognitivo, particularmente de la Percepción Social.
Secondary paroxysmal dyskinesia in multiple sclerosis: Clinical-radiological features and treatment. Case report of seven patients.
(2017) Ciampi, Ethel; Uribe San Martín, Reinaldo; Godoy Santín, Jaime; Cruz, Juan Pablo; Cárcamo Rodríguez, Claudia Andrea; Juri Clavería, Carlos Andrés
Social cognition : concepts, neural basis and its role in multiple sclerosis
(2018) Labbé Atenas, Tomás; Ciampi, Ethel; Cárcamo Rodríguez, Claudia Andrea
Social cognition in Multiple Sclerosis is associated to changes in brain connectivity : A resting-state fMRI study
(2020) Labbé Atenas, Tomás; Zurita, M.; Montalba, C.; Ciampi, Ethel; Cruz, Juan Pablo; Vásquez, M.; Uribe Arancibia, Sergio A.; Crossley, Nicolás; Cárcamo Rodríguez, Claudia Andrea
Socioeconomic, health-care access and clinical determinants of disease severity in Multiple Sclerosis in Chile
(2023) Ciampi Díaz, Ethel Leslie; Soler León, Bernardita María; Uribe San Martín, Reinaldo; Jurgensen Heinrich, Lukas; Guzmán, I.; Keller Matamala, Karina Pascale; Reyes C., Ana Belén; Bravo Grau, Sebastián Eduardo; Cruz, Juan Pablo; Cárcamo Rodríguez, Claudia Andrea
Background: MS severity may be affected by genetic, patient-related, disease-related and environmental factors. Socioeconomic status, including income and healthcare access, amongst others, may also have a role in affecting diagnostic delay or therapy prescription. In Chile, two main healthcare systems exist, public-healthcare and private-healthcare, nonetheless universal care laws (e.g., access to High Efficacy Therapy-HET), including both systems, have been recently enacted for people with MS. Objective: To assess the role of Socioeconomic Conditions (SEC), clinical variables and public health policies on the impact of disease severity of MS patients in Chile. Methods: Multicentric, observational, cross-sectional study including patients from two reference centres (1 national reference centre from the private-health system and 1 regional reference centre from the public-health system). SEC and clinical variables included healthcare insurance (private or public), subclassification of health insurance according to monthly income, sex, age at onset, diagnostic delay, disease duration, diagnosis before HET law (as a proxy of HET delay), and current HET treatment. Progression Index (PI), EDSS ≥6.0 and Progressive MS diagnosis were used as outcome measures. Multivariable binary logistic regression was performed. Results: We included 604 patients (460 private-health, 144 public-health), 67% women, 100% white/mestizo, 88% RRMS, mean age 42±12 years, mean age at onset 32±11 years, mean disease duration 10±6 years, median diagnostic delay 0 (0–34) years, 86% currently receiving any DMT, 55% currently receiving HET, median EDSS at last visit of 2.0 (0–10), and median PI 0.17 (0–4.5). Lower monthly income was associated with higher EDSS and higher PI. In the multivariable analysis, public-healthcare (OR 10.2), being diagnosed before HET-law (OR 4.89), longer diagnostic delay (OR 1.26), and older age at onset (OR 1.05) were associated with a higher risk of PI>0.2, while current HET (OR 0.39) was a protective factor. Diagnosis before HET-law (OR 7.59), public-healthcare (OR 6.49), male sex (OR 2.56), longer disease duration (OR 1.2) and older age at onset (OR 1.1) were associated with a higher risk of Progressive MS. Public-healthcare (OR 5.54), longer disease duration (OR 1.14) and older age at onset (OR 1.08) were associated with a higher risk of EDSS ≥6.0 while current treatment with HET had a trend as being a protective factor (OR 0.44, p = 0.05). Conclusion: MS severity is impacted by non-modifiable factors such as sex and age at onset. Interventions focused on shortening diagnostic delay and encouraging early access to high-efficacy therapies, as well as initiatives that may reduce the disparities inherent to lower socioeconomic status, may improve outcomes in people with MS.

Browsing by Author "Cárcamo Rodríguez, Claudia Andrea"

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