RESUMEN
Cerebral amyloid angiopathy (CAA) is a type of cerebrovascular disorder characterised by the accumulation of amyloid within the leptomeninges and small/medium-sized cerebral blood vessels. Typically, cerebral haemorrhages are one of the first clinical manifestations of CAA, posing a considerable challenge to the timely diagnosis of CAA as the bleedings only occur during the later disease stages. Fluid biomarkers may change prior to imaging biomarkers, and therefore, they could be the future of CAA diagnosis. Additionally, they can be used as primary outcome markers in prospective clinical trials. Among fluid biomarkers, blood-based biomarkers offer a distinct advantage over cerebrospinal fluid biomarkers as they do not require a procedure as invasive as a lumbar puncture. This article aimed to provide an overview of the present clinical data concerning fluid biomarkers associated with CAA and point out the direction of future studies. Among all the biomarkers discussed, amyloid ß, neurofilament light chain, matrix metalloproteinases, complement 3, uric acid, and lactadherin demonstrated the most promising evidence. However, the field of fluid biomarkers for CAA is an under-researched area, and in most cases, there are only one or two studies on each of the biomarkers mentioned in this review. Additionally, a small sample size is a common limitation of the discussed studies. Hence, it is hard to reach a solid conclusion on the clinical significance of each biomarker at different stages of the disease or in various subpopulations of CAA. In order to overcome this issue, larger longitudinal and multicentered studies are needed.
RESUMEN
Introduction: High frequency of adverse drug reactions (ADRs) challenges multiple sclerosis (MS) treatment. This study aims to assess the nature and frequency of ADRs induced by MS medications in an observational cross-sectional study. Methods: ADRs of all outpatients who had seen a neurologist and had received at least one disease-modifying therapy (DMT) for MS during the last three months were investigated. Results: A total of 484 ADRs were detected in these patients. The preventability rate was 5.9%, and 0.61% of reactions were serious. Conclusion: The high frequency of adverse drug reactions in this study shows a strong need for strategy planning to increase patients' adherence to treatment. Highlights: Adverse drug reactions (ADRs) are common in MS patients using disease modifying therapies.Such ADRs are more common in women than men.Various brand names of biosimilar disease-modifying therapy (DMT)s may have a different ADR profile. Plain Language Summary: Multiple sclerosis (MS) is a condition that can be managed by using disease modifying medications. Such medication could trigger an adverse reaction in the patients., affecting their commitment to the treatment. By identifying these adverse reactions and educating the MS patients about these reactions and how the adverse effects can be managed, healthcare providers can improve the treatment process. This study recorded the adverse drug reactions in 250 MS patients who were receiving the medication for at least three months. Most of the patients (76.4%) experienced some kind of adverse reaction. A bigger proportion of women experienced adverse reactions than men. About 84% of these reactions occurred within the first 3 hours of receiving the medication. Depending on the medication's brand name, the rate of adverse drug reactions were different in some cases. The results of this study point out the fact that experiencing adverse drug reactions is common in MS patients and these experiences could be different for each medication with a different brand name. Therefore, it is important for the healthcare providers to inform the patients about such reactions and the patients should seek all the information they need to manage these adverse effects by consulting their physician.