1,720,996 research outputs found
SWITCHING THERAPIES ANALYSIS IN MULTIPLE SCLEROSIS PATIENTS
Full text linkIntroduction: disease-modifying treatments (DMTs) for relapsing multiple sclerosis (MS) have been available starting from the 1990s. Since then, the therapeutic landscape has progressively expanded, so the choice of MS treatment to date is challenging and switching of immunotherapies is often required. The aims of this study were i) to describe and analyse in a real-world setting the reasons of DMTs switches in the court of patients belonging to the MS Centre at the IRCCS Mondino; and ii) to provide real-life insights into currently applied therapeutic strategies.
Patients and methods: non-interventional, retro-prospective study, which included MS patients actively referred to the MS Center at IRCCS Mondino, who switched DMT in the years 1994–2020. The key outcome variable was the main reason to switch DMT, as documented in medical charts based on failure of therapy, safety, patient’s wish/tolerability, adverse events (AEs), pregnancy planning, and other.
Results: of the total of 355 enrolled MS patients, 68.75% (242) were female and mean age of MS onset was 30.29 years old (± 9.26). A total of 682 switches occurred in this population. The main reason to DMT switch was treatment failure, defined as the presence of clinical or radiological MS activity (43.32%) followed by patient’s wish/tolerability (25.36%), safety (13%), other (9%), adverse events (6%) and pregnancy planning (4%). Reasons for DMT switching differed by year of switch (p < 0.002).
Discussion: the method I followed, which is unique in the recent literature, has to be considered an alternative and complementary approach to standard real-world evidence analysis, typically focusing on single treatment (or treatments) rather than the patient and the very event. This study improved current awareness on these dynamics, better characterizing everyday practice switch trends with the ultimate goal of improving disease management and patient care
Disability and mortality in a cohort of MS patients: how the real-world scenario is changed
No full textImpact of multiple sclerosis comorbidities on quality of life and job activity
No full textBackground: Multiple sclerosis (MS) is frequently accompanied by comorbid conditions. Objectives: This study aimed to determine the prevalence of key comorbid conditions in people with multiple sclerosis (pwMS) and assess their impact on quality of life and work-related activities. Methods: A cross-sectional study involving 755 pwMS from two third-level Italian MS centers was conducted. Comorbidities were identified from medical records, and quality of life was assessed using the EQ-5D-3L questionnaire. Work-related challenges were evaluated using the Multiple Sclerosis Questionnaire for Job Difficulties (MSQ-Job). Results: 53.8% of pwMS had at least one comorbidity. Hypertension, depression, and anxiety were the most prevalent. Comorbidity presence was associated with reduced quality of life scores in almost all EQ-5D-3L domains and greater job difficulties in all but one MSQ-Job domain. Conclusion: Comorbidities in pwMS are prevalent and have a profound influence on quality of life and work-related activities. This comprehensive study offers new insights into the role of comorbidities in MS within the Italian context, emphasizing the need for a multidisciplinary approach in MS management. Further research is crucial to deepen our understanding of these findings in the broader Italian MS community
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
What's new about oral treatments in Multiple Sclerosis? Immunogenetics still under question
No full textMultiple Sclerosis (MS) is a chronic pathology affecting the Central Nervous System characterized by inflammatory processes that lead to demyelination and neurodegeneration. In MS treatment, disease modifying therapies (DMTs) are essential to reduce disease progression by suppressing the inflammatory response responsible for promoting lesion formation. Recently, in addition to the classical injectable DMTs like Interferons and Glatiramer acetate, new orally administered drugs have been approved for MS therapy: dimethyl fumarate, teriflunomide and fingolimod. These drugs act with different mechanisms on the immune system, in order to suppress the harmful inflammatory process. An additional layer of complexity is introduced by the influence of polymorphic gene variants in the Human Leukocyte Antigen region on the risk of developing MS and its progression. To date, pharmacogenomic studies have mainly focused on the patient's response following admission of injectable drugs. Therefore, greater consideration must be made to pharmacogenomics with a view to developing more effective and personalized therapies. This review aims to shed light on the mechanism of action of the new oral drugs dimethyl fumarate, teriflunomide and fingolimod, taking into account both the importance of immunogenetics in drug response and pharmacogenomic studies
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