Browsing by Author "Galleguillos, Lorna"

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    Occurrence of area postrema syndrome during follow-up: phenotype and influence over NMOSD activity in LATAM in real-world settings
    (2024) Pestchanker, Claudia; Cortez, Brenda Bertado; Peixoto, Marco A. Lana; Gortari, Jose Ignacio; Suarez, Sheila Castro; Zamalloa, Cesar Caparo; Galiana, Graciana; Penalver, Francisco; Marques, Vanesa Daccach; Messias, Katharina; Galleguillos, Lorna; Garcia, Fernando; Rojas, Juan I.; Patrucco, Liliana; Cristiano, Edgardo; Tkachuk, Veronica; Liwacki, Susana; Correale, Jorge; Marrodan, Mariano; Ysraelit, Maria C.; Vrech, Carlos; Deri, Norma; Leguizamon, Felisa; Tavolini, Dario; Mainella, Carolina; Zanga, Gisela; Serena, Marina Alonso; Ciampi, Ethel; Soares Neto, Herval Ribeiro; Lopez, Pablo; Contentti, Edgar Carnero
    IntroductionWe aimed to assess the frequency, duration, and severity of area postrema syndrome (APS) during follow-up in neuromyelitis optica spectrum disorder (NMOSD) patients, as well as its association with inflammatory activity and prognostic factors of APS severity in a real-world setting.MethodsWe conducted a retrospective study on a cohort of Latin American (LATAM) NMOSD patients who had experienced APS during their follow-up. Patients from Mexico, Peru, Brazil, Colombia, Panama, Chile and Argentina patients who met 2015 NMOSD criteria were included. We evaluated data on symptom type (nausea, vomiting and/or hiccups), frequency, duration, severity (measured by APS severity scale), association with other NMOSD core relapses, and acute treatments (symptomatic and immunotherapy or plasmapheresis). Logistic regression was conducted to evaluate factors associated with APS severity (vs. mild-moderate).ResultsOut of 631 NMOSD patients, 116 (18.3%) developed APS during their follow-up. The most common APS phenotype was severe. Inflammatory activity (i.e., relapses) significantly decreased after the onset of APS. Half of the patients experienced isolated APS with a median duration of 10 days, and the most frequently used acute treatment was IV steroids. All three symptoms were present in 44.6% of the patients. APS symptoms resolved following immunotherapy. Logistic regression did not identify independent factors associated with the severity of APS.ConclusionsOur findings indicate that 18.3% of NMOSD patients developed APS during the follow-up period, with most patients fulfilling criteria for severe APS. The inflammatory activity decreased after the onset of APS compared to the previous year.
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    Safety and humoral response rate of inactivated and mRNA vaccines against SARS-CoV-2 in patients with Multiple Sclerosis
    (2022) Ciampi, Ethel; Uribe-San-Martin, Reinaldo; Soler, Bernardita; García, Lorena; Guzmán, Jorge; Pelayo, Carolina; Jürgensen, Lukas; Guzmán, Ignacio; Vera, Francisco; Galleguillos, Lorna; Cárcamo, Claudia
    Background: Safety and effectiveness outcomes in Multiple Sclerosis (MS) patients receiving different disease- modifying therapies (DMT) and different types of vaccines against SARS-CoV-2 are limited. Growing evidence coming mainly from Israel, Europe and North America using mRNA and adenoviral vector vaccines has been published. Objectives: To assess the safety and humoral response of inactivated virus and mRNA vaccines against SARS-CoV- 2 in patients with MS. Methods: Ongoing, multicentric, prospective, observational study performed between February and September 2021. Humoral response (antibodies against spike-1 protein) was determined at least 4 weeks after the complete schedule of anti-SARS-CoV-2 vaccines. Categorical outcome (positive/negative) and total antibody titres were recorded. Adverse events supposedly attributable to vaccination (AESAV) were collected. Results: 178 patients, 68% women, mean age 39.7 ±11.2 years, 123 received inactivated (Coronavac-Sinovac), 51 mRNA (Pfizer-BioNtech), and 4 adenoviral vector vaccines (CanSino n =2, Jonhson&Johnson-Jannsen n =1, Oxford-AstraZeneca n =1). Six patients had a history of COVID-19 before vaccination. Overall humoral response was observed in 66.9% (62.6% inactivated vs. 78.4% mRNA, p =0.04). Positive anti-S1-antibodies were observed in 100% of patients with no DMT (n =3), 100% with interferon/glatiramer-acetate (n =11), 100% with teriflunomide/dimethyl-fumarate (n =16), 100% with natalizumab (n =10), 100% with alemtuzumab (n =8), 90% with cladribine (n =10), and 88% with fingolimod (n =17), while 43% of patients receiving antiCD20 (n =99) were positive (38% inactivated vaccine vs. 59% mRNA vaccine, p =0.05). In the multivariate analysis including antiCD20 patients, the predictors for a positive humoral response were receiving the mRNA vaccine (OR 8.11 (1.79–36.8), p =0.007) and a lower number of total infusions (OR 0.44 (0.27–0.74) p =0.002. The most frequent AESAV was local pain (14%), with 4 (2.2%) patients experiencing mild-moderate relapses within 8 weeks of first vaccination compared to 11 relapses (6.2%) within the 8 weeks before vaccination (Chi-squared 3.41, p =0.06). Discussion: A higher humoral response rate was observed using the mRNA compared to the inactivated vaccine, while patients using antiCD20 had a significantly lower response rate, and patients using antiCD20 and fingolimod had lower antibody titres. In this MS patient cohort, inactivated and mRNA vaccines against SARS-CoV-2 appear to be safe, with no increase in relapse rate. This information may help guidelines including booster shots and types of vaccines in selected populations.
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    Status of the neuromyelitis optica spectrum disorder in Latin America
    (ELSEVIER SCI LTD, 2021) Rivera, Victor M.; Hamuy, Fernando; Rivas, Veronica; Gracia, Fernando; Ignacio Rojas, Juan; Bichuetti, Denis Bernardi; Maria Villa, Andres; Marques, Vanessa Daccah; Soto, Arnoldo; Bertado, Brenda; Trevino Frenk, Irene; Galleguillos, Lorna; Quinones, Jairo; Ramirez, Deyanira A.; Caparo Zamalloa, Cesar; Ciampi Diaz Ethel Leslie; Lana Peixoto, Marco A.; Rodriguez, Emmanuel; Zarco, Luis; Sinay, Vladimiro; Armas, Elizabeth; Becker, Jefferson; Benzadon, Aron; Lopez, Ericka; Carnero Contentti, Edgar; Patricio Correa Diaz, Edgar; Diaz, Alejandro; Veronica Fleitas, Cynthia; Playas, Gil; Molina, Omaira; Rojas, Edgard; Sato, Douglas; Soto, Ibis; Vasquez Cespedes, Johana; Correale, Jorge; Barboza, Andres; Monterrey, Priscilla; Candelario, Awilda; Tavolini, Dario R.; Parajeles, Alexander; Pujol, Biany Santos; Diaz de la Fe, Amado; Alonso, Ricardo; Bolana, Carlos; Kagi Guzman, Marianne; Carra, Adriana; Gonzalez Gamarra, Oscar; Vera Raggio, Jose; Cesar Rodriguez, Luis; Eunice Ramirez, Nicia; Ordonez, Laura; Skromne, Eli; Lbeth Portillo, Ligia; Perez Canabal, Alfredo; Weiser, Roberto; Sirias, Vanessa; Fernandez Calderon, Ramiro; Arturo Cornejo, Ernesto; Hernandez, Marianella; Duran Quiroz, Juan Carlos; Alberto Garcia, Luis; Oviedo Cedeno, Carlos; Martinez, Jorge; Abad Herrera, Patricio
    Background: Neuromyelitis optica spectrum disorders (NMOSD) is an increasing diagnostic and therapeutic challenge in Latin America (LATAM). Despite the heterogeneity of this population, ethnic and socioeconomic commonalities exist, and epidemiologic studies from the region have had a limited geographic and population outreach. Identification of some aspects from the entire region are lacking.