Guía de Práctica Clínica para el Diagnóstico y Tratamiento de Esclerosis Múltiple en Adultos.

Vizcarra, Darwin; Cruz, Ana Gibertoni; Rojas, Eiliana Montero; Mori, Nicanor; Caparó, César; Castañeda, Carlos C; Castro, Sheila Gómez De; Gavidia, Jorge M; González, Oscar; Huertas, Marco; Meza‐Vega, Maria; Montalván, Víctor; Rivara, Alda; Adrianzén, Fiorella; Duque, Kevin R.; Servan, Sebastian A.; Villafuerte, Brian J; Vizcarra, Joaquín A.; Zamudio, Rodrigo; Neira, Elsa R; Carrá, Adriana; Fernández, Óscar; Rivera, Víctor M.

doi:10.20453/rnp.v82i4.3646

Cited by 4 publications

(6 citation statements)

References 59 publications

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“…There are several DMT for RRMS treatment ( 14 , 36 , 37 ). However, specific tests are needed before initiating treatment.…”

Section: Resultsmentioning

confidence: 99%

“…Patients with RRMS are young and present a chronic and disabling evolution, making it necessary to perform a multidisciplinary approach. This disease is characterized by an often-unpredictable course making diagnosis difficult and the choice of the adequate DMT for each patient challenging ( 1 , 14 , 54 ).…”

Section: Discussionmentioning

confidence: 99%

“…In 2019, the Peruvian Society of Neurology published a clinical guideline for managing patients with MS to provide neurologists with a valid, updated tool to treat these patients in a comprehensive manner ( 14 ). However, a more practical and user-friendly tool was needed to achieve greater acceptance among Peruvian neurologists, thus standardizing the management of Peruvian patients based on quality external information adapted to our context by a group of thematic experts.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Pathway for the Diagnosis and Management of Patients With Relapsing–Remitting Multiple Sclerosis: A First Proposal for the Peruvian Population

et al. 2021

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Background: Relapsing–remitting multiple sclerosis (RRMS) is a subtype of degenerative inflammatory demyelinating disease of multifactorial origin that affects the central nervous system and leads to multifocal neurological impairment.Objectives: To develop a clinical pathway (CP) for the management of Peruvian patients with RRMS.Methods: First, we performed a literature review using Medline, Embase, Cochrane, ProQuest, and Science direct. Then, we structured the information as an ordered and logical series of five topics in a defined timeline: (1) How should MS be diagnosed? (2) How should a relapse be treated? (3) How should a DMT be initiated? (4) How should each DMT be used? and (5) How should the patients be followed?Results: The personnel involved in the care of patients with RRMS can use a series of flowcharts and diagrams that summarize the topics in paper or electronic format.Conclusions: We propose the first CP for RRMS in Peru that shows the essential steps for diagnosing, treating, and monitoring RRMS patients based on an evidence-based medicine method and local expert opinions. This CP will allow directing relevant clinical actions to strengthen the multidisciplinary management of RRMS in Peru.

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“…There are several DMT for RRMS treatment ( 14 , 36 , 37 ). However, specific tests are needed before initiating treatment.…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Pathway for the Diagnosis and Management of Patients With Relapsing–Remitting Multiple Sclerosis: A First Proposal for the Peruvian Population

et al. 2021

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“…El rol que cumplen los exámenes auxiliares es como ayuda para el diagnóstico diferencial de esclerosis múltiple. Entre los exámenes auxiliares se encuentran las imágenes por RMN, los potenciales evocados somatosensoriales y el análisis de líquido cefalorraquídeo (Vizcarra et al, 2019).…”

Section: Síntomasunclassified

Esclerosis múltiples

Morales Coloma,

Prieto Ulloa,

Naranjo Guerrero

et al. 2023

RECIMUNDO

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La esclerosis múltiple (EM) es una enfermedad inflamatoria crónica del sistema nervioso central (SNC), con carácter autoinmune, desmielinizante, que impide el funcionamiento normal de la sinapsis. Lo que acarrea déficits motores y sensitivos que pueden durar días o semanas y ser total o parcialmente reversibles. La presente investigación se enmarca dentro de una metodología de tipo bibliográfica documental. Ya que es un proceso sistematizado de recolección, selección, evaluación y análisis de la información, que se ha obtenido mediante medios electrónicos en diferentes repositorios y buscadores tales como Google Académico, Science Direct, Pubmed, entre otros, empleando para ellos los diferentes operadores booleanos y que servirán de fuente documental, para el tema antes planteado. Por ser la esclerosis múltiple una patología autoinmune, necesita un tratamiento focalizado en la persona, con el objetivo de lograr el mayor bienestar posible, ya que la esclerosis múltiple puede presentarse de 4 formas diferentes y no necesariamente el manejo debe ser el mismo, ya que también hay que considerar las comorbilidades que ya tenga el paciente, el tratamiento puede estar enfocado en inmunosupresores, AINES, corticoesteroides, entre otros. En cuanto al diagnóstico los criterios de McDonald son los universalmente aceptados, la sintomatología puede ser diversa, pudiendo generar fatiga, problemas cognitivos, problema de visión, dolor en articulaciones, entre otros.

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“…There is no definitive cure for MS to date; hence, treatment aims at modifying the natural course of the disease. In the last decade, there has been a rapid development in the investigation of new disease-modifying therapies (DMTs) for patients with MS ( 10 ).…”

Section: Sensitivity Analysismentioning

confidence: 99%

The budgetary impact of alemtuzumab in multiple sclerosis in Quito, Ecuador. Payer’s perspective

Pastor-Quirós

Correa-Díaz²

2021

Grhta

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Introduction: Multiple sclerosis is a neurological condition that causes disabilities and is most common in young adults. It imposes high financial costs affecting the quality of life of patients, families, and society. It is critical to measure the budgetary impact of new technologies to treat this disease. Objective: The aim of the article is to estimate the budgetary impact of introducing alemtuzumab as an escalation therapy in patients diagnosed with Recurrent Remitting Multiple Sclerosis and treated in Quito, Ecuador. Materials and methods: A cohort of 85 patients receiving treatment with disease-modifying therapies was used, within a 5-year timeframe, between 2021 and 2025. The baseline scenario, including the percentages of administration of the different drugs, is compared with the alternative scenario, including alemtuzumab. The cost assessment included only direct medical resources. To obtain local resources for management of the disease, a neurologist and clinical expert who treats most of the patients in Quito was consulted. Results: Considering a cohort of 85 patients with active Recurrent Remitting Multiple Sclerosis, the average global budget impact in 5 years would be USD 10,603,230.00 in the base case and USD 9,995,817.00 in the alemtuzumab scenario. Conclusion: The inclusion of alemtuzumab as escalation therapy represents budgetary savings over the next 5 years (2021-2025).

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Guía de Práctica Clínica para el Diagnóstico y Tratamiento de Esclerosis Múltiple en Adultos.

Cited by 4 publications

References 59 publications

Clinical Pathway for the Diagnosis and Management of Patients With Relapsing–Remitting Multiple Sclerosis: A First Proposal for the Peruvian Population

Clinical Pathway for the Diagnosis and Management of Patients With Relapsing–Remitting Multiple Sclerosis: A First Proposal for the Peruvian Population

Esclerosis múltiples

The budgetary impact of alemtuzumab in multiple sclerosis in Quito, Ecuador. Payer’s perspective

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