Real-world effectiveness of fingolimod in Polish group of patients with relapsing-remitting multiple sclerosis.

OBJECTIVES: Fingolimod is indicated for the treatment of relapsing-remitting multiple sclerosis (RRMS) patients with highly aggressive disease characterized by frequent relapses and active magnetic resonance imaging. Its efficacy has been demonstrated in three large phase III trials, used in the regulatory submissions throughout the world. Fingolimod in licensed in Europe since 2011 but with a growing number of disease-modifying drugs (DMD) becoming available for RRMS, it is important to gather real-world evidence data regarding long-term effectiveness in treated patients with MS. The aim of this study was to assess fingolimod effectiveness in a real life Polish group of RRMS patients receiving fingolimod as second line treatment. PATIENTS AND METHODS: The observational study with retrospective data collection was performed at 13 sites that were asked to document eligible patients in consecutive chronological order to avoid selection bias. Demographic and clinical data from 253 adult patients with RRMS treated with fingolimod were analyzed. RESULTS: Mean treatment time with fingolimod was 42 months. Relapses reduction during 3 years treatment period was observed (2.0 v 0.2) and majority of patients were free of relapses. Mean EDSS score was stable during the time of observation. The proportion of patients who were free from any clinical disease activity, i.e. without relapses and disability progression, was over 70%. During the first and second year of observation significant reduction of new MRI lesions was observed. CONCLUSION: In the Polish group of patients with RRMS treated with fingolimod, the majority of them showed freedom from relapses, disability progression and reduction of new MRI lesions. Switching from injectable immunomodulatory drugs to fingolimod is associated with fewer relapses and lower disability progression.

Internet Usage by Polish Patients With Multiple Sclerosis: A Multicenter Questionnaire Study.

BACKGROUND: The internet is a source of knowledge and medium widely used in services that facilitate access to information and networking. Multiple sclerosis (MS) patients find the possibility of acquiring information relating to their condition particularly rewarding. OBJECTIVE: We aimed to identify Polish MS patients' preferences by analyzing a percentage of internet users and determining the most common search subjects and patients' approach to information on the internet. Disability connected with the condition, its duration, and other factors that influence patients' internet use were examined along with instances of relations established through the internet and their durability. METHODS: The study examined 1045 patients (731 women, 314 men) treated in 10 Polish MS centers, of whom 932 (89.19%) declared to be internet users. Their average age was 40.65 (SD 11.06) and average MS duration was 9.08 (SD 6.97) years. The study used a proprietary survey on information seeking, the range of searched subjects, and internet usage frequency. RESULTS: The majority of the patients (494/932, 53.0%) used the internet 6-7 times per week and 4.3% (40/932) declared they spent minimum 2 hours per day. The most commonly searched subjects were world news (604/932, 72.9% of patients using the internet); 60.8% (504/932) searched for information on their condition, particularly for new treatment methods (562/932, 67.8%) and the course of illness (520/932, 62.7%). One's sex had no impact on internet usage (female vs male, odds ratio [OR] 1.13, 95% CI 0.72-1.77), although a patient's age might, at varying degrees. We found several significant associations using a .05 significance level: a patient with higher education used the internet 9 times more often than one with primary education (OR 8.64, 95% CI 3.31-22.57); lasting relationships increased chances of internet usage by 10-fold compared to widowers (OR 0.12, 95% CI 0.05-0.31); living in a city with a population over 100,000 increased chances by nearly 6 times compared with the countryside (OR 5.59, 95% CI 2.72-11.48); the relapsing-remitting MS type saw a 2-fold increase compared with the primary progressive MS type (OR 0.47, 95% CI 0.29-0.75); and those needing assistance were 2 times less likely to use the internet than patients who could move independently (OR 0.53, 95% CI 0.31-0.89). More than half of the patients (489/932, 52.5%) did not discuss the information found on the internet with their neurologists; 15.9% (148/932) believed that relationships established through the internet can be stable. CONCLUSIONS: The majority of Polish patients use the internet as a crucial information source on their condition and innovative treatment methods. The internet can be helpful in establishing new relationships, which are usually short-lived. Polish patients do not frequently discuss the information gathered on the internet with their doctors.

[The duration of the symptoms of carpal tunnel syndrome to the diagnosis]. / Czas trwania objawów zespolu ciesni kanalu nadgarstka do postawienia rozpoznania.

UNLABELLED: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. Efficacy of the surgical treatment is dependent on the severity of median nerve injury. THE AIM OF STUDY: To determine the average duration of symptoms to diagnosis CTS. MATERIAL AND METHODS: Survey study conceming the duration of symptoms of CTS to establishing the diagnosis was conducted between 192 consecutive patients with CTS referred to the Electrophysiology Laboratory of the Military Institute of Medicine for the confirmatory EMG testing. The questionnaire included question concerning the duration of symptoms of neuropathy of the median nerve and the selected epidemiological data, i.e., gender, age, place of residence, profession, comorbidities, specialization of referring physician. Nerve conduction parameters of median and ulnarnerves were assessed by means of study ENG/EMG (amplitude, conduction velocity and final latency in motor fibers). Some of the patients had performed comparative tests of the median nerve and ulnar or radial nerves. On the basis of these values the severity of carpal tunnel syndrome was determined according to the Padua's classification. RESULTS: In the group of women surveyed duration of symptoms until diagnosis was on average 39,6 months (from 1 month to 20 years), while in men this time was on average 37.4 months (from I month to 7 years). CONCLUSIONS: The results of this study indicate that the average duration of symptoms CTS until diagnosis is long and can have a negative impact on the results of treatment.