RESUMO
One of the biggest challenges in multiple sclerosis (MS) is the definition of treatment response/failure in order to optimize treatment decisions in affected patients. The objective of this consensus was to review how disease activity should be assessed and to propose recommendations on the identification of treatment failure in RRMS patients in Argentina. METHODS: A panel of experts in neurology from Argentina, dedicated to the diagnosis and care of MS patients, gathered both virtually and in person during 2016 and 2017 to carry out a consensus recommendation on the identification of treatment failure in RRMS patients. To achieve consensus, the methodology of "formal consensus-RAND/UCLA method" was used. RESULTS: Recommendations were established based on published evidence and the expert opinion. Recommendations focused on disease management, disease activity markers and treatment failure identification were determined. Main consensus were: ≥2 relapses during the first year of treatment and/or ≥3 new or enlarged T2 or T1 GAD+ lesions and/or sustained increase of ≥2 points in EDSS or ≥100% in T25FW defines treatment failure in RRMS patients. CONCLUSIONS: The recommendations of this consensus guidelines attempts to optimize the health care and management of patients with MS in Argentina.
Assuntos
Consenso , Esclerose Múltipla Recidivante-Remitente , Falha de Tratamento , Argentina/epidemiologia , Avaliação da Deficiência , Humanos , Esclerose Múltipla Recidivante-Remitente/diagnóstico , Esclerose Múltipla Recidivante-Remitente/epidemiologia , Esclerose Múltipla Recidivante-Remitente/terapiaRESUMO
UNLABELLED: The objective of the study was to assess the cost of multiple sclerosis (MS) patients in Argentina categorized by disease severity using a societal perspective. METHOD: Cross-sectional study including MS patients from 21 MS centers in 12 cities of Argentina. Patients were stratified by disease severity using the expanded disability status scale (EDSS) (group 1 with EDSS score between 0 and 3; group 2 with EDSS >3 and <7; group 3 with EDSS ≥7). Direct and indirect costs were analyzed for the second quarter of 2012 from public sources and converted to US Dollars. RESULTS: 266 patients were included. Mean annual cost per MS patient was USD 36,025 (95%CI 31,985-38,068) for patients with an EDSS between 0-3; USD 40,705 (95%CI 37,199-46,300) for patients with EDSS >3 and <7, and USD 50,712 (95%CI 47,825-62,104) for patients with EDSS ≥7. CONCLUSIONS: This is the first Argentine study evaluating the costs of MS considering disease severity.
Assuntos
Efeitos Psicossociais da Doença , Esclerose Múltipla/economia , Avaliação das Necessidades , Adolescente , Adulto , Distribuição por Idade , Idoso , Argentina , Estudos Transversais , Humanos , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Fatores Socioeconômicos , Estatísticas não Paramétricas , Inquéritos e Questionários , Adulto JovemRESUMO
The objective of the study was to assess the cost of multiple sclerosis (MS) patients in Argentina categorized by disease severity using a societal perspective. Method: Cross-sectional study including MS patients from 21 MS centers in 12 cities of Argentina. Patients were stratified by disease severity using the expanded disability status scale (EDSS) (group 1 with EDSS score between 0 and 3; group 2 with EDSS >3 and <7; group 3 with EDSS ≥7). Direct and indirect costs were analyzed for the second quarter of 2012 from public sources and converted to US Dollars. Results: 266 patients were included. Mean annual cost per MS patient was USD 36,025 (95%CI 31,985-38,068) for patients with an EDSS between 0-3; USD 40,705 (95%CI 37,199-46,300) for patients with EDSS >3 and <7, and USD 50,712 (95%CI 47,825-62,104) for patients with EDSS ≥7. Conclusions: This is the first Argentine study evaluating the costs of MS considering disease severity. .
El objetivo del estudio fue evaluar el costo de los pacientes con esclerosis múltiple (EM) en Argentina categorizados por severidad de la enfermedad. Método: Estudio de corte transversal que incluyó pacientes con EM en 12 ciudades de Argentina. Los pacientes se estratificaron según expanded disability status scale (EDSS) (grupo 1 EDSS entre 0 y 3; grupo 2 EDDS >3 y <7; grupo 3 EDSS ≥7). Los costos directos e indirectos fueron analizados para el segundo trimestre de 2012 y convertidos a dólares estadounidenses. Resultados: 266 pacientes fueron incluidos. El coste medio anual por paciente con EM fue de USD 36,025 (31,985-38,068 IC95%) para los pacientes con un EDSS entre 0-3; USD 40,705 (37,199-46,300 IC95%) para los pacientes con EDSS >3 y <7 y USD 50,712 (47,825-62,104 IC95%) para los pacientes con EDSS ≥7. Conclusiones: Primer estudio argentino evaluar los costes de la EM considerado la gravedad de la enfermedad. .
