Fereshteh Ghadiri; Omid Mirmosayyeb; Mohammad Ali Sahraian; Abdorreza Naser Moghadasi; Mahsa Ghajarzadeh
Articles in Press, Accepted Manuscript, Available Online from 13 March 2023
Abstract
Background: Fingolimod is approved in relapsing-remitting multiple sclerosis (RRMS) with the recommended dose of 0.5 mg daily. To tackle possible adverse events, some clinicians may reduce the dose of fingolimod, mainly in the alternate-day form. We systematically reviewed the literature for efficacy ...
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Background: Fingolimod is approved in relapsing-remitting multiple sclerosis (RRMS) with the recommended dose of 0.5 mg daily. To tackle possible adverse events, some clinicians may reduce the dose of fingolimod, mainly in the alternate-day form. We systematically reviewed the literature for efficacy measures of this method.Methods: PubMed (Medline®), Web of Science, Embase, Scopus, and the Cochrane Library databases were searched until April 9, 2021. Clinical studies (other than case reports and case series), in English, were included. Then, publications concerning alternate dose fingolimod (including every other day, every two or three days) were selected. Those studies concerning reduced daily dose (any daily dose less than 0.5 mg/day) were excluded to focus on alternate dosing.Results: Four observational studies were included. Data on Ohtani et al. study were limited. Three other studies were of good quality based on the Newcastle-Ottawa Scale. A total of 296 patients on the standard dose were compared to 276 patients on the alternate dosage. The most common reason for switching to the alternate dose was lymphopenia, followed by elevated liver enzymes. Two studies concluded that the alternate dosing could be a safe, yet effective strategy in patients with intolerable adverse effects of daily dose. However, Zecca et al. warned about the high possibility of disease reactivation. Due to the differences in outcome measures of the studies, meta-analysis was not applicable.Conclusion: This systematic review highlights the ambiguity of evidence on safety and efficacy of alternate dosing of fingolimod, encouraging further research on the subject.
Omid Mirmosayyeb; Mahdi Barzegar; Nasim Nehzat; Soroush Najdaghi; Behnaz Ansari; Vahid Shaygannejad
Abstract
Background: Multiple sclerosis (MS) is a common autoimmune inflammatory disease in the central nervous system (CNS) without exact pathology. Environmental factors such as infections have a causal or protective role in MS. Helicobacter pylori (HP) is one of the infections in digestive diseases and previous ...
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Background: Multiple sclerosis (MS) is a common autoimmune inflammatory disease in the central nervous system (CNS) without exact pathology. Environmental factors such as infections have a causal or protective role in MS. Helicobacter pylori (HP) is one of the infections in digestive diseases and previous studies reported controversial findings of this infection role in MS. So, we conducted this study to assess the frequency of HP infection in patients with MS in comparison to the healthy population. Methods: This cross-sectional study was undertaken between 2015 and 2019. 191 participants including 58 patients with clinically isolated syndrome (CIS), 57 patients with relapsing-remitting MS (RRMS), 39 patients with secondary progressive MS (SPMS), and 39 age- and sex-matched healthy controls (HCs) were tested for the presence of HP immunoglobulin G (IgG) and IgM antibodies (Abs) in their serum sample. Results: The frequency of HP IgG seropositivity in patients with SPMS was significantly higher than patients with CIS [Odds ratio (OR): 6.333, 95% confidence interval (CI): 2.522-15.906, P < 0.001], patients with RRMS (OR: 4.583, 95% CI: 1.842-11.407, P = 0.001), and HCs (OR: 8.485, 95% CI: 3.058-23.540, P < 0.001). We did not find a significant difference among other study groups regarding IgG seropositivity. No significant difference among groups regarding HP IgM seropositivity was evident. On univariate model, Expanded Disability Status Scale (EDSS) score (OR: 1.038, 95% CI: 1.038-1.460, P = 0.017) and SPMS (OR: 4.583, 95% CI: 1.842-11.407, P = 0.001) were predictor for HP IgG seropositivity. On multivariate model, only SPMS had higher risk for HP IgG seropositivity compared to RRMS (OR: 5.554, 95% CI: 1.327-23.253, P = 0.019). We did not find a significant association between clinical and demographic variables with HP IgM seropositivity. Conclusion: Based on our findings, progressive MS and HP infection may have association. Further longitudinal studies with large sample size are needed to determine the role of HP infection in MS.
Mehri Salari; Mahdi Barzegar; Masoud Etemadifar; Omid Mirmosayyeb
Volume 17, Issue 2 , April 2018, , Pages 71-77
Abstract
Background: Parkinson's disease (PD), the second most prevalent neurodegenerative disorder, has been related with weight loss and energy balance. Some studies showed that leptin might be playing an important role in satiety, energy balance and immune response. The aim of this study was to evaluate serum ...
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Background: Parkinson's disease (PD), the second most prevalent neurodegenerative disorder, has been related with weight loss and energy balance. Some studies showed that leptin might be playing an important role in satiety, energy balance and immune response. The aim of this study was to evaluate serum leptin level in patients with PD and its association with clinical severity.Methods: In this cross-sectional study, 35 patients with PD and 51 healthy controls (HCs), matched for age, sex and body mass index (BMI), were recruited. Serum leptin level was measured and clinical characteristics and demographic data of patients were recorded.Results: The mean age of patients with PD and HCs were 59.80 ± 11.40 and 62.18 ± 11.60 years, respectively. Serum leptin concentration was not statistically different between patients with PD and HCs (21.1 ± 23.1 ng/ml vs 25.9 ± 21.8 ng/ml, P = 0.280). There was no relation between plasma level of leptin and clinical severity of patients with PD.Conclusion: Our findings suggest that serum level of leptin is neither implicated in the pathogenesis of PD, nor decreases as disease progresses.
Mehri Salari; Omid Mirmosayyeb; Masoud Etemadifar; Vahid Shaygannejad; Fariborz Khorvash; Mohammad Reza Najafi; Fereshteh Ashtari; Ahmad Chitsaz
Volume 17, Issue 1 , January 2018, , Pages 6-10
Abstract
Background: Parkinson’s disease (PD) is the second most common neurodegenerative disorder. Its worldwide incidence rate varies between 18 and 418 cases per 100000 annually. This cross-sectional study was carried out with the aim to identify the clinical characteristics and demographic features of a ...
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Background: Parkinson’s disease (PD) is the second most common neurodegenerative disorder. Its worldwide incidence rate varies between 18 and 418 cases per 100000 annually. This cross-sectional study was carried out with the aim to identify the clinical characteristics and demographic features of a huge number of patients with PD in Isfahan, Iran.Methods: The study was conducted on 987 patients with PD in Isfahan city and checklists were used to evaluate the demographic features and clinical characteristics of the patients.Results: The mean age of the patients at the time of sampling was 65.40 ± 11.90 years. The study results indicated that the rate of PD among men with 67.3% was twice that of women with 32.7%. The mean duration of the disease was 4.91 ± 4.60 years.Conclusion: This study showed a considerable rate of PD among the individuals in Isfahan city. In addition, the incidence ratio of men to women was more than the previous studies.
Mehri Salari; Ahmad Chitsaz; Masoud Etemadifar; Mohammad Reza Najafi; Omid Mirmosayyeb; Maryam Bemanalizadeh; Fatemeh Panahi; Hosna Mirzajani
Volume 16, Issue 3 , July 2017, , Pages 118-124
Abstract
Background: Parkinson’s disease (PD) is diagnosed on the basis of motor symptoms, but non-motor symptoms (NMS) have high prevalence in PD and often antecede motor symptoms for years and cause severe disability. This study was conducted to determine the prevalence of NMS in patients with PD.Methods: ...
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Background: Parkinson’s disease (PD) is diagnosed on the basis of motor symptoms, but non-motor symptoms (NMS) have high prevalence in PD and often antecede motor symptoms for years and cause severe disability. This study was conducted to determine the prevalence of NMS in patients with PD.Methods: This cross-sectional study was performed in Isfahan, Iran, on patients with PD. The prevalence of NMS was evaluated by the NMS questionnaire, the NMS scale, and Parkinson's disease questionnaire-39 (PDQ-39). The Mini-Mental Status Examination (MMSE) was used for assessing cognition.Results: A total of 81 patients, including 60 men and 21 women, were recruited for this study. The prevalence of NMS was 100%, and the most commonly reported symptom was fatigue (87.7%); there was a strong correlation between NMS and the quality of life (QOL) of patients with PD (P < 0.001).Conclusion: This study showed that NMS are highly prevalent in the PD population and adversely affect QOL in these patients. Early diagnosis and treatment can improve QOL and can help in disability management of patients with PD.
Fariborz Khorvash; Nafiseh Esmaeil; Omid Mirmosayyeb; Nahid Eskandari; Homayoon Salimian
Volume 15, Issue 4 , October 2016, , Pages 232-234
