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Rojas JI, Gracia F, Parciak T, Alonso R, Becker J, Treviño-Frenk I, Alonso-Serena M, Giunta D, Abad P, Carnero-Contentti E, Carrá A, Correa-Díaz EP, Correale J, Cristiano E, Flores J, Fruns M, Galleguillos L, Garcea O, Hamuy F, Lana-Peixoto M, Navas C, Pappais-Alvarenga R, Patrucco L, Rivera V, Tenembaum S, Ysrraelit MC, Peeters LM. [Core data set for real world data in multiple sclerosis: customization for latin america from a global task force recommendation]. Rev Neurol 2024; 78:185-197. [PMID: 38502167 DOI: 10.33588/rn.7807.2023326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
INTRODUCTION The primary objective of the core data set is to reduce heterogeneity and promote harmonization among data sources in EM, thereby reducing the time needed to execute real life data collection efforts. Recently, a group led by the Multiple Sclerosis Data Alliance has developed a core data set for collecting real-world data on multiple sclerosis (MS) globally. Our objective was to adapt this global data set to the needs of Latin America, so that it can be implemented by the registries already developed and in the process of development in the region. MATERIAL AND METHODS A working group was formed regionally, the core data set created globally was adapted (translation process into Spanish, incorporation of regional variables and consensus on variables to be used). Consensus was obtained through the remote Delphi methodology of a round of questionnaires and remote discussion of the core data set variables. RESULTS A total of 25 professionals from Latin America carried out the adaptation process between November 2022 and July 2023. Agreement was established on a core data set of nine categories and 45 variables, version 2023 to suggest its implementation in developed or developing registries, and MS cohorts in the region. CONCLUSION The core data set seeks to harmonize the variables collected by registries and cohorts in MS in Latin America in order to facilitate said collection and allow collaboration between sources. Its implementation will facilitate real life data collection and collaboration in the region.
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Affiliation(s)
- J I Rojas
- Hospital Alemán, Buenos Aires, Argentina
- Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Buenos Aires, Argentina
| | - F Gracia
- Hospital Santo Tomás, Panamá, República de Panamá
| | - T Parciak
- Universidad Hasselt, Diepenbeek, Bélgica
| | - R Alonso
- Hospital J. M. Ramos Mejía, Buenos Aires, Argentina
- Universidad de Buenos Aires, Buenos Aires, Argentina
- Sanatorio Güemes, Buenos Aires, Argentina
| | - J Becker
- Universidad Pontificia de Rio Grande do Sul, Porto Alegre, Brasil
| | - I Treviño-Frenk
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | | | - D Giunta
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - P Abad
- Hospital Metropolitano de Quito, Quito, Ecuador
| | | | - A Carrá
- Hospital Británico, Buenos Aires, Argentina
- Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina
| | - E P Correa-Díaz
- Hospital Carlos Andrade Marín. Universidad Central del Ecuador, Quito, Ecuador
| | | | - E Cristiano
- Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Buenos Aires, Argentina
| | - J Flores
- Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, México
| | - M Fruns
- Clínica Las Condes , Santiago de Chile, Chile
| | - L Galleguillos
- Clinica Alemana, Santiago de Chile, Chile
- Universidad del Desarrollo, Santiago de Chile, Chile
| | - O Garcea
- Hospital J. M. Ramos Mejía, Buenos Aires, Argentina
- Universidad de Buenos Aires, Buenos Aires, Argentina
| | - F Hamuy
- Hospital IMT, Asunción, Paraguay
| | - M Lana-Peixoto
- Universidad Federal de Minas Gerais, Belo Horizonte, Brasil
| | - C Navas
- Clínica Universitaria Colombia, Bogotá, Colombia
| | | | - L Patrucco
- Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Buenos Aires, Argentina
| | - V Rivera
- Universidad de Medicina Baylor, Houston, EE.UU
| | - S Tenembaum
- Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina
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Cristiano E, Patrucco L, Ysrraelit MC, Alonso R, Balbuena ME, Ballario C, Barboza AG, Bestoso S, Burgos M, Cáceres FJ, Carrá A, Carnero-Contentti E, Deri N, Fernández-Liguori N, Garcea O, Hryb JP, Jacobo M, Kohler E, Luetic GG, Mainella C, Menichini ML, Míguez J, Nofal PG, Piedrabuena R, Rugilo C, Saladino ML, Silva BA, Silva E, Sinay V, Tavolini D, Tkachuk VA, Villa A, Vrech C, Rojas JI. [Argentinean consensus guidelines on the identification and clinical care of secondary progressive multiple sclerosis]. Rev Neurol 2021; 72:23-32. [PMID: 33378076 DOI: 10.33588/rn.7201.2020379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The identification, diagnosis, follow-up, and treatment of patients with secondary progressive multiple sclerosis (SPMS) show significant differences between health care professionals in Argentina. AIM To provide consensus recommendations on the management of patients with SPMS in Argentina to optimize patient care. DEVELOPMENT A panel of expert neurologists from Argentina dedicated to the diagnosis and care of multiple sclerosis patients gathered during 2019 and 2020 to carry out a consensus recommendation on the diagnosis and treatment of SPMS patients in Argentina. To achieve consensus, the methodology of 'formal consensus-RAND/UCLA method' was used. Recommendations were established based on published evidence and the expert opinion. Recommendations focused on how to define SPMS and how to follow SPMS patients. CONCLUSION The recommendations of this consensus guidelines attempt to optimize the care of SPMS patients in Argentina.
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Affiliation(s)
- E Cristiano
- Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Buenos Aires, Argentina
| | - L Patrucco
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - M C Ysrraelit
- Instituto de Investigaciones Neurológicas Dr. Raúl Carrea (FLENI), Buenos Aires, Argentina
| | - R Alonso
- Hospital Ramos Mejía. Universidad de Buenos Aires, Buenos Aires, Argentina.,Hospital Universitario Sanatorio Güemes, Buenos Aires, Argentina
| | - M E Balbuena
- Hospital de Clínicas José de San Martín, Buenos Aires, Argentina
| | | | - A G Barboza
- Hospital Central de Mendoza, Mendoza, Argentina
| | - S Bestoso
- Hospital Escuela de Corrientes. Universidad Nacional del Nordeste, Corrientes, Argentina
| | - M Burgos
- Hospital San Bernardo, Salta, Argentina
| | - F J Cáceres
- Instituto de Neurociencias de Buenos Aires (INEBA), Buenos Aires, Argentina
| | - A Carrá
- Hospital Británico, Buenos Aires, Argentina.,Fundación Favaloro/INECO, Buenos Aires, Argentina
| | | | - N Deri
- Hospital General de Agudos Juan A. Fernández, Buenos Aires, Argentina.,Centro de Investigaciones Diabaid, Buenos Aires, Argentina
| | - N Fernández-Liguori
- Hospital Universitario Sanatorio Güemes, Buenos Aires, Argentina.,Hospital Enrique Tornu, Buenos Aires, Argentina
| | - O Garcea
- Hospital Ramos Mejía. Universidad de Buenos Aires, Buenos Aires, Argentina
| | - J P Hryb
- Hospital Carlos G. Durand, Buenos Aires, Argentina
| | - M Jacobo
- Red Integral Asistencial al Paciente con Esclerosis Múltiple (RIAPEM), Santiago del Estero, Argentina
| | - E Kohler
- Fundación Sinapsis, Santa Rosa, Argentina
| | - G G Luetic
- Instituto de Neurociencias de Rosario, Rosario, Argentina
| | - C Mainella
- Hospital Español de Rosario, Rosario, Argentina
| | - M L Menichini
- Sanatorio Británico, Rosario, Argentina.,Hospital Provincial del Centenario, Rosario, Argentina
| | - J Míguez
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - P G Nofal
- Hospital de Clínicas Nuestra Señora del Carmen, San Miguel de Tucumán, Argentina
| | - R Piedrabuena
- Instituto Lennox, Córdoba, Argentina.,Clínica Reina Fabiola, Córdoba, Argentina
| | - C Rugilo
- Hospital Británico de Buenos Aires, Buenos Aires, Argentina.,Hospital Dr. Juan P. Garrahan, Buenos Aires, Argentina
| | - M L Saladino
- Instituto de Neurociencias de Buenos Aires (INEBA), Buenos Aires, Argentina
| | - B A Silva
- Hospital Ramos Mejía. Universidad de Buenos Aires, Buenos Aires, Argentina
| | - E Silva
- Predigma. Centro de Medicina Preventiva, Posadas, Argentina
| | - V Sinay
- Fundación Favoloro/INECO, Buenos Aires, Argentina
| | - D Tavolini
- Hospital Provincial del Centenario, Rosario, Argentina.,INECO Neurociencias Oroño, Rosario, Argentina
| | - V A Tkachuk
- Hospital de Clínicas José de San Martín, Buenos Aires, Argentina
| | - A Villa
- Hospital J. M. Ramos Mejía, Buenos Aires, Argentina
| | - C Vrech
- Sanatorio Allende, Córdoba, Argentina
| | - J I Rojas
- Hospital Universitario de CEMIC, Buenos Aires, Argentina.,Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Buenos Aires, Argentina
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Marrodan M, Bensi C, Pappolla A, Rojas JI, Gaitán MI, Ysrraelit MC, Negrotto L, Fiol MP, Patrucco L, Cristiano E, Farez MF, Correale J. Disease activity impacts disability progression in primary progressive multiple sclerosis. Mult Scler Relat Disord 2020; 39:101892. [PMID: 31846866 DOI: 10.1016/j.msard.2019.101892] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 11/15/2019] [Accepted: 12/10/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although solid information on the natural history of primary progressive multiple sclerosis (PPMS) is available, evidence regarding impact of disease activity on PPMS progression remains controversial. OBJECTIVE To describe the clinical characteristics, presence or absence of MRI activity, and natural history of a PPMS cohort from two referral centers in Argentina and assess whether clinical and/or radiological disease activity correlated with disability worsening. METHODS Retrospective study conducted at two MS clinics in Buenos Aires, Argentina, through comparative analysis of patients with and without evidence of disease activity. RESULTS Clinical and/or radiologic activity was presented in 56 (31%) of 178 patients. When stratified by age at onset, we found that for every 10 years of increase in age at onset, risk of reaching EDSS scores of 4 and 6 increased by 26% and 31%, respectively (EDSS 4: HR 1.26, CI 95%: 1.06-1.50; EDSS 6: HR 1.31, CI 95%: 1.06-1.62). Patients who presented clinical exacerbations reached EDSS scores of 6, 7 and 8 faster than those without associated exacerbations (p = 0.009, p = 0.016 and p = 0.001, respectively). Likewise, patients who presented gadolinium-enhancing lesions during the course of disease reached EDSS scores of 7 earlier (p = 0.002). CONCLUSION Older age at onset and presence of clinical and/or radiological disease activity correlated with accelerated disability progression in this cohort of PPMS patients.
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Affiliation(s)
- M Marrodan
- Department of Neurology, Fleni, Montañeses 2325 (1428), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - C Bensi
- Department of Neurology, Fleni, Montañeses 2325 (1428), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - A Pappolla
- Department of Neurology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - J I Rojas
- Department of Neurology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Centro de Esclerosis Múltiple de Buenos Aires, Buenos Aires, Argentina
| | - M I Gaitán
- Department of Neurology, Fleni, Montañeses 2325 (1428), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - M C Ysrraelit
- Department of Neurology, Fleni, Montañeses 2325 (1428), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - L Negrotto
- Department of Neurology, Fleni, Montañeses 2325 (1428), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - M P Fiol
- Department of Neurology, Fleni, Montañeses 2325 (1428), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - L Patrucco
- Department of Neurology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Centro de Esclerosis Múltiple de Buenos Aires, Buenos Aires, Argentina
| | - E Cristiano
- Centro de Esclerosis Múltiple de Buenos Aires, Buenos Aires, Argentina
| | - M F Farez
- Department of Neurology, Fleni, Montañeses 2325 (1428), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina; Center for Biostatistics, Epidemiology and Public Health (CEBES). Fleni, Buenos Aires, Argentina
| | - J Correale
- Department of Neurology, Fleni, Montañeses 2325 (1428), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.
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Rojas JI, Patrucco L, MIguez J, Sinay V, Cassara FP, Cáceres F, Liguori NF, Saladino ML, Deri N, Jaacks G, Marcilla MP, Arrigoni MI, Correale J, Fiol M, Ysrraelit MC, Carrá A, Curbelo MC, Martinez A, Steinberg J, Bestoso S, Hryb JP, Di Pace JL, Perassolo MB, Contentti EC, Caride A, Lopez PA, Martinez C, Reich E, Giunta D, Cristiano E. Gender ratio trends over time in multiple sclerosis patients from Argentina. J Clin Neurosci 2017; 38:84-86. [PMID: 28087187 DOI: 10.1016/j.jocn.2016.12.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 12/26/2016] [Indexed: 11/19/2022]
Abstract
Several studies in multiple sclerosis (MS) suggest a trend of increasing disease frequency in women during the last decades. A direct comparison of gender ratio trends among MS populations from Argentina remains to be carried out. The objective of the study was to compare gender ratio trends, over a 50-year span in MS populations from Argentina. METHODS multicenter study that included patients from 14 MS Centers of Argentina. Patients with definite MS with birth years ranging from 1940 to 1989 were included. Gender ratios were calculated by five decades based on year of birth and were adjusted for the F/M born-alive ratio derived from the Argentinean national registry of births. The F/M ratios were calculated using a multivariate logistic regression per five decades by the year of birth approach. Analyses were performed using Stata 10.1. RESULTS 1069 patients were included. Gender ratios showed a significant increase from the first to the last decade in the whole MS sample (from 1.8 to 2.7; p value for trend=0.023). The Gender ratio did not show differences considering MS subtype. CONCLUSION our study showed a modest increase of the F/M ratio (from 1.8 to 2.7) over time among patients affected by MS in Argentina.
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Affiliation(s)
- J I Rojas
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina.
| | - L Patrucco
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina
| | - J MIguez
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina
| | - V Sinay
- Instituto de Neurociencias Fundación Favaloro (INCyT), Argentina
| | - F Pagani Cassara
- Instituto de Neurociencias Fundación Favaloro (INCyT), Argentina
| | - F Cáceres
- Neurosciences Institute of Buenos Aires (INEBA), Buenos Aires, Argentina
| | | | - M L Saladino
- Neurosciences Institute of Buenos Aires (INEBA), Buenos Aires, Argentina
| | - N Deri
- Centro de Investigación DIABAID, Argentina
| | - G Jaacks
- Centro de Investigación DIABAID, Argentina
| | | | | | - J Correale
- Department of Neurology, Institute for Neurological Research Dr. Raúl Carrea, FLENI, Argentina
| | - M Fiol
- Department of Neurology, Institute for Neurological Research Dr. Raúl Carrea, FLENI, Argentina
| | - M C Ysrraelit
- Department of Neurology, Institute for Neurological Research Dr. Raúl Carrea, FLENI, Argentina
| | - A Carrá
- Hospital Británico Buenos Aires, Argentina
| | | | - A Martinez
- Hospital Británico Buenos Aires, Argentina
| | | | - S Bestoso
- Hospital Escuela "José F. De San Martín", Corrientes, Argentina
| | - J P Hryb
- Hospital General de Agudos Carlos G Durand, Buenos Aires, Argentina
| | - J L Di Pace
- Hospital General de Agudos Carlos G Durand, Buenos Aires, Argentina
| | - M B Perassolo
- Hospital General de Agudos Carlos G Durand, Buenos Aires, Argentina
| | | | - A Caride
- Hospital Alemán, Buenos Aires, Argentina
| | - P A Lopez
- Hospital Alemán, Buenos Aires, Argentina
| | | | - E Reich
- Hospital Julio Mendez, Buenos Aires, Argentina
| | - D Giunta
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina
| | - E Cristiano
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina
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Rojas JI, Patrucco L, MIguez J, Sinay V, Cassara FP, Cáceres F, Liguori NF, Saladino ML, Deri N, Jaacks G, Marcilla MP, Arrigoni MI, Correale J, Fiol M, Ysrraelit MC, Carrá A, Curbelo MC, Martinez A, Steinberg J, Bestoso S, Hryb JP, Di Pace JL, Perassolo MB, Carnero Contentti E, Caride A, Lopez PA, Martinez C, Reich E, Cristiano E. Disease onset in familial and sporadic multiple sclerosis in Argentina. Mult Scler Relat Disord 2016; 6:54-56. [PMID: 27063623 DOI: 10.1016/j.msard.2016.01.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 12/28/2015] [Accepted: 01/19/2016] [Indexed: 10/22/2022]
Abstract
UNLABELLED The present study was carried out to assess if there is an anticipation of age at onset in younger generations of familial multiple sclerosis (FMS) vs. sporadic MS (SMS) in Argentina. METHODS multicenter study that included patients from 14 MS Centers of Argentina. Patients were considered as FMS if they had in their family at least one relative of first or second degree diagnosed with MS; otherwise, patients were considered to have SMS. We compared the age at onset between familial and sporadic cases as well as the age at onset between relatives from different generations in FMS vs. SMS. RESULTS 1333 patients were included, 97 of them were FMS (7.3%). A lower age at onset in the younger generations of FMS cases was found compared with older generations of FMS as well as. SMS cases (24.1±3.7 years vs. 30.3±5.7 years, and 32.4±9.4 respectively; p<0.001). No differences were observed between older generations of FMS vs. SMS cases (p=0.12). CONCLUSION we observed an anticipation of age at onset of MS in younger generations of patients with FMS vs. older generations of FMS and SMS.
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Affiliation(s)
- J I Rojas
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina.
| | - L Patrucco
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina
| | - J MIguez
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina
| | - V Sinay
- Instituto de Neurociencias, Fundación Favaloro, Argentina
| | | | - F Cáceres
- Neurosciences Institute of Buenos Aires (INEBA), Buenos Aires, Argentina
| | - N Fernandez Liguori
- Neurosciences Institute of Buenos Aires (INEBA), Buenos Aires, Argentina; Multiple Sclerosis Section Hospital E.Tornú, Buenos Aires, Argentina
| | - M L Saladino
- Neurosciences Institute of Buenos Aires (INEBA), Buenos Aires, Argentina; Multiple Sclerosis Section Hospital E.Tornú, Buenos Aires, Argentina
| | - N Deri
- Centro de Investigación DIABAID, Argentina
| | - G Jaacks
- Centro de Investigación DIABAID, Argentina
| | | | | | - J Correale
- Department of Neurology, Institute for Neurological Research Dr. Raúl Carrea, FLENI, Argentina
| | - M Fiol
- Department of Neurology, Institute for Neurological Research Dr. Raúl Carrea, FLENI, Argentina
| | - M C Ysrraelit
- Department of Neurology, Institute for Neurological Research Dr. Raúl Carrea, FLENI, Argentina
| | - A Carrá
- Hospital Británico Buenos Aires, Argentina
| | | | - A Martinez
- Hospital Británico Buenos Aires, Argentina
| | | | - S Bestoso
- Hospital Escuela "José F. De San Martín", Corrientes, Argentina
| | - J P Hryb
- Hospital General de Agudos Carlos G Durand, Buenos Aires, Argentina
| | - J L Di Pace
- Hospital General de Agudos Carlos G Durand, Buenos Aires, Argentina
| | - M B Perassolo
- Hospital General de Agudos Carlos G Durand, Buenos Aires, Argentina
| | | | - A Caride
- Hospital Alemán, Buenos Aires, Argentina
| | - P A Lopez
- Hospital Alemán, Buenos Aires, Argentina
| | - C Martinez
- Private Office, Private Office, Argentina
| | - E Reich
- Hospital Julio Mendez, Buenos Aires, Argentina
| | - E Cristiano
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina
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Ysrraelit MC, Gaitan MI, Lopez AS, Correale J. Impaired hypothalamic-pituitary-adrenal axis activity in patients with multiple sclerosis. Neurology 2008; 71:1948-54. [DOI: 10.1212/01.wnl.0000336918.32695.6b] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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