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Moghadasi AN, Ebrahimi N, Haghparast E, Rastkar M, Mokhberdezfuli M, Ghajarzadeh M. The prevalence of multiple sclerosis (MS) in Oceania, a systematic review, and meta-analysis. Neurol Sci 2024; 45:75-82. [PMID: 37682389 DOI: 10.1007/s10072-023-07057-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/01/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Oceania is a continent, covering more than 8 million km2, with a population of more than 44 million people. In different countries landing in Oceania, various prevalence of MS has been reported, so we designed this systematic review and meta-analysis to estimate the pooled prevalence of MS in Oceania. METHODS We systematically searched PubMed, Scopus, EMBASE, Web of Science, and Google Scholar. We also searched references of included studies, and conference abstracts. The search was done on January 1, 2023, by two independent researchers. We extracted the name of the first author, country, publication year, prevalence period, number of study participants, total female and male population, disease duration, type of MS, mean duration of the disease, mean age at disease onset, mean Expanded Disability Status Scale (EDSS), and total female and male patients with MS. RESULTS A literature search revealed 81,044 records; after deleting duplicates, 38,260 records remained. One hundred and six full texts were evaluated, and finally, seventeen studies remained for systematic review. Most studies were done in Newcastle; eight studies were done in 1961, 8 in 1981, 2 in 1996, and 2 in 2001. In all other years, only one study was done. The pooled prevalence of MS in 1961 in Oceania was estimated as 19.85/100,000 (I2=70.3%, p=0.001). The pooled prevalence of MS in 1981 in Oceania was estimated as 39.07/100,000 (I2 =88%, p=0.001). CONCLUSIONS The result of this systematic review and meta-analysis shows that the prevalence of MS has increased dramatically during the timespan in Oceania.
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Affiliation(s)
- Abdorreza Naser Moghadasi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Narges Ebrahimi
- Department of Immunology, Isfahan University of Medical Science, Isfahan, Iran
- Multiple Sclerosis Research Group (MSRG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Elahe Haghparast
- Medical School, Isfahan University of Medical Science, Isfahan, Iran
| | - Mohsen Rastkar
- Student's Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdieh Mokhberdezfuli
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Ghajarzadeh
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA.
- Multiple Sclerosis Research Group (MSRG), Universal Scientific Education and Research Network (USERN), Tehran University of Medical Sciences, Tehran, Iran.
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Moravejolahkami AR, Hadi S, Hadi V, Mirghazanfari SM, Mohajeri M. Effects of Dietary Modification Based on Complementary and Alternative Iranian Medicine in Patients with Secondary-Progressive Multiple Sclerosis: A Randomized Controlled Clinical Trial. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:747-756. [PMID: 37307014 DOI: 10.1089/jicm.2023.0037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objectives: To evaluate the efficacy of dietary modifications based on complementary and alternative Iranian medicine (CAIM) in patients with secondary-progressive multiple sclerosis (SPMS). Design: In this randomized controlled trial, 70 SPMS patients were randomized to receive either a moderate-nature diet based on Persian medicine (as intervention) or usual diet plus health-related diet recommendations (as control) for 2 months. Serum high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), Expanded Disability Status Scale (EDSS), Modified Fatigue Impact Scale (MFIS), State-Trait Anxiety Inventory (STAI), Global Pain Scale (GPS), Gastrointestinal Symptom Rating Scale (GSRS), anthropometric measurements, and quality of life (QOL) were assessed at baseline and end of trial. Analysis of covariance was performed, and the results were adjusted for potential confounders using SPSS v.14. Results: All participants completed the study for 2 months. There were significant improvements across the mean changes of hs-CRP (-0.1 ± 0.2 mg/L for intervention vs. -0.01 ± 0.13 mg/L for control; padjusted = 0.012), MFIS (-11.0 ± 11.8 vs. -0.7 ± 9.9; padjusted <0.001), GSRS (-19.9 ± 16.3 to 1.2 ± 17.5; padjusted <0.001), GPS (padjusted = 0.032), and QOL (padjusted <0.05). No significant difference was observed across the ESR, EDSS, STAI, and anthropometric measurements. Conclusion: Dietary modifications based on CAIM may improve inflammation and clinical manifestations in SPMS patients. Nonetheless, further trials are required to confirm these findings. Clinical Trial Registration: IRCT20181113041641N2.
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Affiliation(s)
- Amir Reza Moravejolahkami
- Department of Health and Nutrition, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Saeid Hadi
- Department of Health and Nutrition, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Vahid Hadi
- Department of Health and Nutrition, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Sayid Mahdi Mirghazanfari
- Department of Physiology and Iranian Medicine, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Mohsen Mohajeri
- Department of Persian Medicine, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
- Department of Traditional Medicine, School of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran
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Asgari N, Ghaemi EA, Naeimi MH, Tahamtan A, Sechi LA, Zamani S. Cross-reactivity between Mycobacterium avium subspecies paratuberculosis 4027 peptide and Human IRF5 may contribute to Multiple Sclerosis in Iranian patients. Heliyon 2023; 9:e22137. [PMID: 38034802 PMCID: PMC10686849 DOI: 10.1016/j.heliyon.2023.e22137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 10/21/2023] [Accepted: 11/05/2023] [Indexed: 12/02/2023] Open
Abstract
Background The etiology of Multiple sclerosis (MS) is complicated and can be affected by several environmental factors, such as Mycobacterium avium subspecies paratuberculosis (MAP) infection in genetically predisposed individuals. The link between MAP and MS depends on host genetic and epigenetic aspects and population-based features that require further investigation. We aimed to study the possible role of MAP in triggering MS using molecular and serological methods. Materials and methods This case-control study examined 200 blood samples (100 MS patients and 100 HCs) to search for the MAP-specific IS900 gene. In addition, ELISA was conducted to determine the humoral response against MAP_402718-32 and its human IRF5424-434 peptide homolog. Results The frequency of MAP detection based on the molecular method in MS patients and HCs was 48 % and 13 %, respectively (p < 0.0001). The presence of antibodies against MAP_402718-32 and IRF5424-434 was 55 % and 65 % in MS patients versus 9 % and 7 % in HCs, respectively (p < 0.0001). A good correlation was observed between MAP_4027 and IRF5 antibodies (r = 0.5782, p < 0.0001), indicating that the same antibodies recognized common peptide epitopes. Conclusion Our research revealed a significant association between MAP and MS, highlighting the possible role of MAP as an important infection trigger factor of MS. It is hypothesized that cross-reactivity between MAP4027 and IRF5 may dysregulate immune homeostasis.
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Affiliation(s)
- Negar Asgari
- Neuroscience Research Center, Golestan University of Medical Sciences, Gorgan, Iran
- Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Ezzat Allah Ghaemi
- Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mohammad Hasan Naeimi
- Department of Neurology, Sayyad Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - Alireza Tahamtan
- Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Leonardo Antonio Sechi
- Azienda Ospedaliera Universitaria, Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43b, 07100, Sassari, Italy
| | - Samin Zamani
- Neuroscience Research Center, Golestan University of Medical Sciences, Gorgan, Iran
- Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
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4
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Zeineddine M, Al-Hajje A, Salameh P, Helme A, Thor MG, Boumediene F, Yamout B. Barriers to accessing multiple sclerosis disease-modifying therapies in the Middle East and North Africa region: A regional survey-based study. Mult Scler Relat Disord 2023; 79:104959. [PMID: 37651815 DOI: 10.1016/j.msard.2023.104959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/20/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) management varies markedly between different countries of the Middle East and North Africa (MENA) region based on the availability and accessibility of disease-modifying therapies (DMTs). OBJECTIVE To evaluate the accessibility to DMTs in each MENA country, identify barriers to treatment and make recommendations for improved access to DMTs across the region. METHODS This is a descriptive, survey-based study whereby we extracted data collected, between October 2019 and April 2020, for countries in the MENA region by the Multiple Sclerosis International Federation (MSIF) through their Atlas of MS survey. RESULTS 16 out of 19 countries in the MENA region were included in this study. Sudan and Syria did not have any originator DMTs approved. Interferons were the most widely low-efficacy originator approved DMTs. Three countries did not have any high efficacy DMTs approved. Moreover, follow-on DMTs were approved in half (50%) of the countries. Cost of treatment was the most important barrier, reported in nearly half (47%) of the MENA countries. CONCLUSION Although most MENA countries have access to DMTs, more than half of countries report problems with treatment continuation, highlighting the need for a targeted regional strategy to address the variations in access to MS treatments.
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Affiliation(s)
- Maya Zeineddine
- Inserm U1094, IRD U270, University Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Omega Health, Limoges, France; Neurology Institute, Harley Street Medical Center, Abu Dhabi, United Arab Emirates.
| | - Amal Al-Hajje
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon; National Institute of Public Health, Clinical Epidemiology and Toxicology (INSPECT-LB), Beirut, Lebanon
| | - Pascale Salameh
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon; National Institute of Public Health, Clinical Epidemiology and Toxicology (INSPECT-LB), Beirut, Lebanon; School of Medicine, Lebanese American University, Byblos, Lebanon; Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia 2417, Cyprus
| | - Anne Helme
- Multiple Sclerosis International Federation, London, United Kingdom
| | | | - Farid Boumediene
- Inserm U1094, IRD U270, University Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Omega Health, Limoges, France
| | - Bassem Yamout
- Neurology Institute, Harley Street Medical Center, Abu Dhabi, United Arab Emirates
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Shafiee A, Soltani H, Teymouri Athar MM, Jafarabady K, Mardi P. The prevalence of depression and anxiety among Iranian people with multiple sclerosis: A systematic review and meta-analysis. Mult Scler Relat Disord 2023; 78:104922. [PMID: 37597350 DOI: 10.1016/j.msard.2023.104922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/21/2023] [Accepted: 07/28/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND There is significant inconsistency regarding the prevalence rate of depression and anxiety among people with multiple sclerosis (MS) in Iran. We sought to conduct this comprehensive meta-analysis to assess the prevalence of depression and anxiety in Iranian multiple sclerosis patients. METHODS A systematic search was conducted on 14 March 2023 in PubMed/MEDLINE, Web of Science, Scopus, Embase, and Iranian national databases. All studies assessing the prevalence of depression and anxiety among Iranian people with MS were included. We used the NEWCASTLE-OTTAWA tool for quality assessment. We pooled the prevalence of individual studies using the random effect model. RESULTS Our systematic search showed 23 articles that meet the eligibility criteria. Most of the included studies were cross-sectional. The most used questionnaire to assess depression and anxiety were Beck Depression Inventory (BDI) and Hospital Anxiety and Depression Scale (HADS), respectively. The overall prevalence of depression and anxiety among Iranian people with MS was 47% (95%CI: 39%-55%%, I2 =94%) and 51% (95%CI: 36%-66%%, I2 =97%), respectively. The results of subgroup and meta-regression analyses showed assessment scale used and the province was significantly associated with the prevalence of the outcomes. Tehran had the most studies published on this topic. The prevalence of depression and anxiety was highest in Kermanshah province. The funnel plot and Egger's regression test did not show a significant source of funnel plot asymmetry for depression (p-value = 0.8138), and anxiety (p-value = 0.8259). CONCLUSION Our study indicates that a significant proportion of people with MS in Iran are affected by depression and anxiety.
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Affiliation(s)
- Arman Shafiee
- Department of Psychiatry and Mental Health, Alborz University of Medical Sciences, Karaj, Iran; Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
| | - Hedieh Soltani
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Kyana Jafarabady
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Parham Mardi
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
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Jafari Karegar S, Aryaeian N, Hajiluian G, Suzuki K, Shidfar F, Salehi M, Ashtiani BH, Farhangnia P, Delbandi AA. Ellagic acid effects on disease severity, levels of cytokines and T-bet, RORγt, and GATA3 genes expression in multiple sclerosis patients: a multicentral-triple blind randomized clinical trial. Front Nutr 2023; 10:1238846. [PMID: 37794975 PMCID: PMC10546207 DOI: 10.3389/fnut.2023.1238846] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/28/2023] [Indexed: 10/06/2023] Open
Abstract
Background Multiple sclerosis (MS) is a chronic autoimmune disease. Ellagic acid is a natural polyphenol and affects the fate of neurons through its anti-inflammatory and antioxidant properties. The present study aimed to investigate ellagic acid effects on disease severity, the expression of involved genes in the pathogenesis of MS, and the levels of related cytokines. Methods The present study was a triple-blind clinical trial. Eligible patients were randomly assigned to two groups: Ellagic acid (25 subjects) for 12 weeks, receiving 180 mg of Ellagic acid (Axenic, Australia) and the control group (25 subjects) receiving a placebo, before the main meals. Before and after the study, the data including general information, foods intake, physical activity, anthropometric data, expanded disability status scale (EDSS), general health questionnaire (GHQ) and pain rating index (PRI), fatigue severity scale (FSS) were assessed, as well as serum levels of interferon-gamma (IFNγ), interleukin-17 (IL-17), interleukin-4 (IL-4) and transforming growth factor-beta (TGF-β), nitric-oxide (NO) using enzyme-linked immunoassay (ELISA) method and expression of T-box transcription factor (Tbet), GATA Binding Protein 3 (GATA3), retinoic acid-related orphan receptor-γt (RORγt) and Glyceraldehyde-3-phosphate dehydrogenase (GAPDH) genes were determined using Real-Time Quantitative Reverse Transcription PCR (RT-qPCR) method. Findings Ellagic acid supplementation led to a reduction in IFNγ, IL-17, NO and increased IL-4 in the ellagic acid group, however in the placebo group no such changes were observed (-24.52 ± 3.79 vs. -0.05 ± 0.02, p < 0.01; -5.37 ± 0.92 vs. 2.03 ± 1.03, p < 0.01; -18.03 ± 1.02 vs. -0.06 ± 0.05, p < 0.01, 14.69 ± 0.47 vs. -0.09 ± 0.14, p < 0.01, respectively). Ellagic acid supplementation had no effect on TGF-β in any of the study groups (p > 0.05). Also, the Tbet and RORγt genes expression decreased, and the GATA3 gene expression in the group receiving ellagic acid compared to control group significantly increased (0.52 ± 0.29 vs. 1.51 ± 0.18, p < 0.01, 0.49 ± 0.18 vs. 1.38 ± 0.14, p < 0.01, 1.71 ± 0.39 vs. 0.27 ± 0.10, p < 0.01). Also, ellagic acid supplementation led to significant decrease in EDSS, FSS and GHQ scores (p < 0.05), and no significant changes observed in PRI score (p > 0.05). Conclusion Ellagic acid supplementation can improve the health status of MS patients by reduction of the inflammatory cytokines and Tbet and RORγt gene expression, and increment of anti-inflammatory cytokines and GATA3 gene expression.Clinical trial registration: (https://en.irct.ir/trial/53020), IRCT20120415009472N22.
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Affiliation(s)
- Sahar Jafari Karegar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Naheed Aryaeian
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ghazaleh Hajiluian
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Farzad Shidfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Salehi
- Department of Statistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Pooya Farhangnia
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali-Akbar Delbandi
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Immunology Research Center, Institute of Immunology and Infectious Disease, Iran University of Medical Sciences, Tehran, Iran
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Abolfazli R, Sahraian MA, Tayebi A, Kafi H, Samadzadeh S. Safety and Discontinuation Rate of Dimethyl Fumarate (Zadiva ®) in Patients with Multiple Sclerosis: An Observational Retrospective Study. J Clin Med 2023; 12:4937. [PMID: 37568338 PMCID: PMC10419910 DOI: 10.3390/jcm12154937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/16/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND This study evaluates the real-world safety and discontinuation rate of Zadiva® (generic product of dimethyl fumarate (DMF)) in Iranian patients with relapsing-remitting multiple sclerosis (RRMS), supplementing existing clinical evidence from randomized controlled trials. METHODS This retrospective observational study evaluated the real-world safety and discontinuation rate of DMF in RRMS patients from Amir A'lam referral hospital's neurology clinic. Data on safety, discontinuation rate, and clinical disease activity were collected retrospectively. The study aimed to assess the discontinuation rate, safety, and reasons for discontinuation, as well as the number of patients experiencing a relapse, MRI activity, and EDSS scores. RESULTS In total, 142 RRMS patients receiving DMF were included in the study, with 15 discontinuing treatment due to adverse events, lack of efficacy, or pregnancy. Notably, a significant reduction in relapse rates was observed, with 90.8% of patients remaining relapse-free throughout the study period. After 1 year of treatment with Zadiva®, only 17.6% of patients experienced MRI activity, whereas the EDSS score remained stable. CONCLUSIONS This study provides important real-world data on the safety and tolerability of Zadiva® in RRMS patients. The results indicate that Zadiva® is generally well tolerated and safe, with a low discontinuation rate due to adverse events or lack of efficacy. These findings suggest that Zadiva® is an effective and safe treatment option for RRMS patients in real-world practice.
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Affiliation(s)
- Roya Abolfazli
- Department of Neurology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran 11457-65111, Iran
| | - Mohammad Ali Sahraian
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran 19978-66837, Iran;
| | - Atefeh Tayebi
- Food Industry Engineering, Tehran Islamic Azad University of Medical Sciences, Tehran 19395-1495, Iran;
| | - Hamidreza Kafi
- Department of Medical, Orchid Pharmed Company, Tehran 19947-66411, Iran;
| | - Sara Samadzadeh
- Department of Neurology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran 11457-65111, Iran
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Unverstät zu Berlin, Experimental and Clinical Research Center, 13125 Berlin, Germany
- Department of Regional Health Research and Molecular Medicine, University of Southern Denmark, 5230 Odense, Denmark
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Daroudi R, Mousavi M, Shirazikhah M, Alizadeh Zarei M, Hendi H, Joghataei F, Darvishi A. Cost-utility analysis of multiple sclerosis rehabilitation in Iran. Expert Rev Pharmacoecon Outcomes Res 2023; 23:1129-1137. [PMID: 37614049 DOI: 10.1080/14737167.2023.2251689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/26/2023] [Accepted: 08/14/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Rehabilitation of Multiple Sclerosis (MS) is associated with various clinical, social and economic outcomes. We aimed to evaluate the cost-utility of MS multidisciplinary rehabilitation in Iran. RESEARCH DESIGN AND METHODS An economic evaluation was conducted using a Markov model designed to reflect the natural course of the disease and interventions. Parameters and variables were extracted from available evidence, and costs and outcomes were calculated from the social perspective. The base-case analysis considered a 5-year time horizon. Costs were estimated based on approved national standards for MS rehabilitation. Sensitivity analyses were also performed. RESULTS The average cost of the rehabilitation strategy was higher compared to the non-rehabilitation strategy, but it resulted in higher quality-adjusted life years (QALYs) values. The incremental cost-effectiveness ratio (ICER) was found to be $2,845.8 per QALY, indicating that the rehabilitation strategy is cost-effective. In the deterministic sensitivity analysis, extending the time horizon to 10 years made the rehabilitation strategy a dominant choice. Probabilistic sensitivity analysis results were consistent with the base-case findings. CONCLUSIONS The MS multidisciplinary rehabilitation proved to be a cost-effective strategy; however, the results were sensitive to the input values of the model. Increasing the time horizon increased the probability of rehabilitation being cost-effective.
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Affiliation(s)
- Rajabali Daroudi
- National Center for Health Insurance Research, Tehran, Iran
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mirtaher Mousavi
- Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Marzieh Shirazikhah
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mehdi Alizadeh Zarei
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Hendi
- Department of social welfare management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Faezeh Joghataei
- Department of social welfare management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ali Darvishi
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iranan
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Sharifiaghdas F, Narouie B, Taheri M, Jalali S, Shalbafan B, Azadvari M, Dadpour M, Rouientan H, Ahmadzade M, Hanafi Bojd H. Multiple sclerosis and lower urinary tract symptoms: A survey of prevalence, characteristic and urological evaluations. SAGE Open Med 2023; 11:20503121231178047. [PMID: 37384196 PMCID: PMC10293526 DOI: 10.1177/20503121231178047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/09/2023] [Indexed: 06/30/2023] Open
Abstract
Objective Most multiple sclerosis patients have urological complications such as lower urinary tract symptoms. This study was conducted to evaluate the prevalence of these symptoms and whether they result in a urological evaluation. Methods A cross-sectional study of 517 multiple sclerosis patients at Tehran's referral multiple sclerosis center and neurology clinics between 2018 and 2022 was performed. Data were collected through interviews after patients completed informed consent forms. Urological examinations, including urine analysis and ultrasonography, were evaluated as final assessments. The data were analyzed using descriptive and inferential statistical tests in Statistical Package for Social Science. Results Among all participants, the prevalence of lower urinary tract symptoms was 73% (n = 384), with urgency (44.8% n = 232) being the most common symptom. The prevalence of intermittency was significantly higher among women (p = 0.004). There was no gender-significant difference in terms of the prevalence of other symptoms (p > 0.050). Lower urinary tract symptoms were significantly correlated with age, clinical course, disease duration, and disability (p < 0.001). Additionally, 37.3% and 18.7% of patients with lower urinary tract symptoms, as well as 17.9% and 37.5% of patients with multiple sclerosis attacks, respectively, had undergone urine analysis and ultrasonography. Conclusion Multiple sclerosis patients rarely undergo urological evaluations during the course of their disease. Proper assessment is essential as these symptoms are among the most detrimental manifestations of this disease.
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Affiliation(s)
- Farzaneh Sharifiaghdas
- Department of Urology, Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behzad Narouie
- Department of Urology, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Maryam Taheri
- Department of Urology, Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saba Jalali
- Faculty of land and food systems, University of British Colombia Vancouver, Vancouver, Canada
| | - Bita Shalbafan
- Clinical Research Development Unit of Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohaddeseh Azadvari
- Department of Physical Medicine and Rehabilitation, Urology Research Center, Sina & Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Dadpour
- Department of Urology, Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamidreza Rouientan
- Department of Urology, Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohadese Ahmadzade
- Department of Urology, Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamideh Hanafi Bojd
- Department of Urology, Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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10
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Esfandiari F, Ghazaiean M, Darvishi-Khezri H, Baghbanian SM. Relationship between medical history and multiple sclerosis: A-case-control study. Medicine (Baltimore) 2023; 102:e33906. [PMID: 37335649 DOI: 10.1097/md.0000000000033906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
This project sought to explore the potential association between medical history and the development of multiple sclerosis (MS) by conducting a retrospective study. This population-based case-control study included 200 MS cases and 2 control groups of 200 patients and healthy individuals each. Data was collected through face-to-face interviews, medical file reviews, and an electronic checklist. Multivariable analysis was used to calculate odds ratios and 95% confidence intervals to estimate the risk of each medical history on MS occurrences. Of 600 participants, 381 (63.5%) individuals were female. The mean age of the participants was 36.5 ± 11.9 years. The adjusted risks of MS were 4.40; 95% CI: 1.73 to 11.1 for measles and 4.75; 95% CI: 2.05 to 11 for amoxicillin consumption. The adjusted MS odds for autoimmune disease including 4.63; 95% CI: 0.35 to 60.6 for psoriasis and 7.15; 95% CI: 1.87 to 27.2 for myasthenia gravis. On the other hand, the calculated adjusted odds of MS occurrence were 0.14; 95% CI: 0.03 to 0.69 for seizure and 0.17; 95% CI: 0.02 to 1.49 for epilepsy. This study suggested that individuals with autoimmune diseases should be monitored more closely, as they may be at an increased risk of developing other autoimmune conditions, particularly MS.
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Affiliation(s)
- Fatemeh Esfandiari
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mobin Ghazaiean
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hadi Darvishi-Khezri
- Thalassemia Research Center (TRC), Hemoglobinopathy Institute, Department of Research, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Ayoubi S, Asadigandomani H, Bafrani MA, Shirkoohi A, Nasiri M, Sahraian MA, Eskandarieh S. The National Multiple Sclerosis Registry System of Iran (NMSRI): aspects and methodological dimensions. Mult Scler Relat Disord 2023; 72:104610. [PMID: 36931079 DOI: 10.1016/j.msard.2023.104610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/26/2023] [Accepted: 03/06/2023] [Indexed: 03/11/2023]
Abstract
INTRODUCTION Multiple Sclerosis (MS) as one of the most common causes of disability around the world requires a uniform standardized information registry system to help policy-makers systematically plan for care quality improvements. The aim of this study is to verify aspects and methodological scopes of MS registry system in Iran. METHODS The National MS Registry System in Iran (NMSRI) is a population-based registry system that systemically identifies and collects all MS patients' data in a specific geographical area. It supports 22 medical science universities and 13 MS societies in 18 provinces of Iran. The information items taken from each patient to collect the data set and data are gathered from all available sources including public and private hospitals, clinics, neurologists' offices, and all MS societies. They are recorded in District Health Information System 2 (DHIS2) software. DISCUSSION The NMSRI is a successful system of collecting MS patients' data. It can lead to positive results, such as updating patients' data to receive new treatments, fair allocation of treatment budgets, and providing researchers with novel ideas to carry out research projects.
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Affiliation(s)
- Saeideh Ayoubi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Asadigandomani
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Melika Arab Bafrani
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Aryan Shirkoohi
- School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
| | - Mohamadreza Nasiri
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sahraian
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sharareh Eskandarieh
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Mirmosayyeb O, Ebrahimi N, Shekarian A, Afshari-Safavi A, Shaygannejad V, Barzegar M, Bagherieh S. Prevalence of dysphagia in patients with multiple sclerosis: A systematic review and meta-analysis. J Clin Neurosci 2023; 108:84-94. [PMID: 36630841 DOI: 10.1016/j.jocn.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 12/23/2022] [Accepted: 01/06/2023] [Indexed: 01/10/2023]
Abstract
BACKGROUND Dysphagia is a major disorder observed in patients with multiple sclerosis (MS), yet different prevalence rates are reported for it. Therefore, we designed this study to estimate the pooled prevalence of dysphagia in patients with MS. METHOD We searched PubMed, Scopus, EMBASE, Web of Science, and gray literature including references from the identified studies, reviews studies, and conference abstracts which were published up to May 2022. Articles that were relevant to our topic and could provide information regarding the prevalence of dysphagia among MS patients were included; however, articles with self-report screening strategies were excluded. RESULTS The literature search found 997 articles. After eliminating duplicates, 672 articles remained. Two conference abstracts were included for final analysis. A total of 11,266 MS cases and 5047 MS patients with dysphagia were included in the meta-analysis. The overall prevalence of dysphagia across all 54 studies was 44.8 % (95 % CI: [40.4 %-49.2 %]), with a high level of heterogeneity between countries (Q=; I2 = 94.96 %; p < 0.001). CONCLUSION The results of this systematic review shows that the prevalence of dysphagia in MS patients is 45% which is greatly higher compared to the general population.
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Affiliation(s)
- Omid Mirmosayyeb
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Narges Ebrahimi
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arman Shekarian
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Afshari-Safavi
- Department of Biostatistics and Epidemiology, Faculty of Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Vahid Shaygannejad
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahdi Barzegar
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sara Bagherieh
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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Ghadiri F, Sahraian MA, Razazian N, Ashtari F, Poursadeghfard M, Nabavi SM, Navardi S, Baghbanian SM, Shaygannejad V, Harirchian MH, Beladimoghadam N, Majdinasab N, Hosseini S, Azimi A, Kamali H, Sharifipour E, Hosseini Nejad Mir N, Bayati A, Nahayati MA, Heidari H, Mozhdehipanah H, Ghalyanchi Langroodi H, Jalali N, Ayoubi S, Asadollahzadeh E, Ebadi Z, Eskandarieh S, Naser Moghadasi A. Late-onset multiple sclerosis in Iran: A report on demographic and disease characteristics. Mult Scler Relat Disord 2023; 70:104493. [PMID: 36638768 DOI: 10.1016/j.msard.2022.104493] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 12/26/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Today, it is estimated that around 5% of multiple sclerosis (MS) patients are in the late-onset category (age at disease onset ≥ 50). Diagnosis and treatment in this group could be challenging. Here, we report the latest update on the characteristics of Iranian patients with late-onset MS (LOMS). METHODS This cross-sectional study used the information provided by the nationwide MS registry of Iran (NMSRI). The registrars from 14 provinces entered data of patients with a confirmed diagnosis of MS by neurologists. Patients with disease onset at or later than 50 years of age were considered LOMS. RESULTS Of 20,036 records, the late-onset category included 321 patients (1.6%). The age-standardized LOMS prevalence was around 75 per 100,000 people. 215 patients (67%) were female. Median Expanded Disability Status Scale (EDSS) was 3 (interquartile range: 1.5-5). The majority of the cases (56%) suffered from relapsing-remitting (RR) course while 20% were diagnosed with primary progressive (PP) MS. Significantly higher proportion of male sex, PPMS, and higher EDSS were seen in the late-onset group compared with early-onset and adult-onset cases (p-value < 0.05). Seventy-five (23%) patients did not receive any disease-modifying treatment. DISCUSSION The more prominent degenerative pathology of LOMS may be the underlying mechanism of the observed differences in comparison to non-LOMS. CONCLUSION There are substantial differences and knowledge gaps regarding LOMS which could be the subject of further research.
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Affiliation(s)
- Fereshteh Ghadiri
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sahraian
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazanin Razazian
- Department of Neurology, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fereshteh Ashtari
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Poursadeghfard
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Massood Nabavi
- Department of Regenerative Medicine, Royan Institute for Stem Cell Technology and Biology, Tehran, Iran
| | - Samira Navardi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Vahid Shaygannejad
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hossein Harirchian
- Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Beladimoghadam
- Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nastaran Majdinasab
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Samaneh Hosseini
- Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amirreza Azimi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hoda Kamali
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Ehsan Sharifipour
- Department of Neurology, School of Medicine, Neuroscience Research Center, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
| | - Nahid Hosseini Nejad Mir
- Department of Internal Medicine, School of Medicine, Shohadaye Ashayer Hospital, Lorestan, University of Medical Sciences, Khorramabad, Iran
| | - Asghar Bayati
- Department of Neurology, Shahrekord University of Medical Sciences and Health Services, Shahrekord, Iran
| | - Mohammad Ali Nahayati
- Department of Neurology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hora Heidari
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Nazanin Jalali
- Department of Neurology, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Saeideh Ayoubi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elnaz Asadollahzadeh
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Ebadi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sharareh Eskandarieh
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Abdorreza Naser Moghadasi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Assessment of Retinal Nerve Fiber Layer (RNFL) and Retinal Ganglion Cell Layer (RGCL) Thickness in Radiologically Isolated Syndrome (RIS). ARCHIVES OF NEUROSCIENCE 2023. [DOI: 10.5812/ans-130575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Background: Three-thirds of people with radiologically isolated syndrome (RIS) develop multiple sclerosis (MS) within five years following their first brain magnetic resonance imaging (MRI). Subclinical applications of optical coherence tomography (OCT) include measuring the thickness of different retinal layers and monitoring the progression of visual pathway atrophy and neurodegeneration in relation to the progress of the entire brain. Objectives: Our OCT study was conducted in individuals with RIS to evaluate the thickness of the macular retinal nerve fiber layer (mRNFL) and the retinal ganglion cell layer (RGCL). Methods: In this study, 22 patients with RIS and 23 healthy individuals healthy control (HC) were enrolled. The control group and the RIS subjects underwent retinal imaging with OCT. Results: Total mRNFL thickness was 110.34 ± 13.71 μm in the RIS patients and 112.10 ± 11.23 μm in the HC group. Regional analysis of the mRNFL showed that the difference in thickness was more prominent in the superior quadrant. In regards to ganglion cell layer (GCL)++ thickness, the RIS and HCs population showed statistically significant differences in the nasal (P = 0.041), inferior (P = 0.040), and superior (P = 0.045) quadrants. The nasal (P = 0.041) quadrant showed the highest reduction in thickness compared to other regions of the GCL++. Meanwhile, no significant reduction was seen in GCL+ thickness (P-value > 0.05). When the thickness of the retinal layer of the right eye was compared to that of the left eye of the RIS group, no statistically significant differences were found (P-value > 0.05). Conclusions: Compared to the control group, the RIS group had a lower mean thickness of mRNFL and GCL++, indicating retinal neuroaxonal loss.
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Association of Disease-Modifying Therapies with COVID-19 Susceptibility and Severity in Patients with Multiple Sclerosis: A Systematic Review and Network Meta-Analysis. Mult Scler Int 2022; 2022:9388813. [PMID: 36187599 PMCID: PMC9519336 DOI: 10.1155/2022/9388813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/03/2022] [Indexed: 12/24/2022] Open
Abstract
Background We conducted this study to assess the effect of disease-modifying therapies (DMTs) on coronavirus disease (COVID-19) susceptibility and severity in people with multiple sclerosis (MS). Methods Available studies from PubMed, Scopus, EMBASE, Web of Science, and gray literature, including reference lists and conference abstracts, were searched from December 1, 2019, to July 26, 2021. We included cross-sectional, case-control, and cohort studies assessing the association of DMTs with risk of contracting COVID-19 or its outcomes in MS patients on univariate or multivariate regression analyses. We conducted a network meta-analysis (NMA) to compare the risk of COVID-19 and developing severe infection across DMTs. Results Out of the initial 3893 records and 1883 conference abstracts, a total of 10 studies were included. Pairwise comparisons showed that none of the DMTs meaningfully affect the risk of acquiring infection. There was significant total heterogeneity and inconsistency across this NMA. In comparison with no DMT, dimethyl fumarate (0.62 (0.42, 0.93)), fingolimod (0.55 (0.32, 0.94)), natalizumab (0.50 (0.31, 0.81)), and interferon (0.42 (0.22, 0.79)) were associated with a decreased risk of severe COVID-19; but, rituximab was observed to increase the risk (1.94 (1.20, 3.12)). Compared to rituximab or ocrelizumab, all DMTs were associated with a decreased risk. Pairwise comparisons showed no differences across other DMTs. Interferon and rituximab were associated with the lowest and highest risks of severe COVID-19. Conclusion Our study showed an increased risk of severe COVID-19 in patients on rituximab and ocrelizumab. No association with COVID-19 severity across other DMTs was observed.
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Mirmosayyeb O, Ebrahimi N, Barzegar M, Afshari-Safavi A, Bagherieh S, Shaygannejad V. Olfactory dysfunction in patients with multiple sclerosis; A systematic review and meta-analysis. PLoS One 2022; 17:e0266492. [PMID: 35439251 PMCID: PMC9017946 DOI: 10.1371/journal.pone.0266492] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/22/2022] [Indexed: 01/02/2023] Open
Abstract
Background The importance and prevalence of olfactory dysfunction is recently gaining attention in patients with multiple sclerosis (MS) as a result of their chronic inflammatory disease, yet different prevalence rates are reported for it. Therefore, we have designed this systematic review to estimate the pooled prevalence of olfactory dysfunction in patients with MS. To our knowledge, this is the first systematic review and meta-analysis on the prevalence of olfactory dysfunction in MS patients. Methods We searched PubMed, Scopus, EMBASE, Web of Science, ProQuest, and gray literature including references from the identified studies, review studies, and conference abstracts which were published up to January 2021. Articles that were relevant to our topic and could provide information regarding the prevalence of olfactory dysfunction, or the scores of smell threshold, discrimination, or identification (TDI) among MS patients and healthy individuals were included. The pooled prevalence was calculated using a random-effects model and a funnel plot and Egger’s regression test were used to see publication bias. Results The literature search found 1630 articles. After eliminating duplicates, 897 articles remained. Two conference abstracts were included for final analysis. A total of 1099 MS cases and 299 MS patients with olfactory dysfunction were included in the analysis. The pooled prevalence of olfactory dysfunction in the included studies was 27.2%. Also, the overall TDI score in MS patients was lower than that in the control group, and the level of Threshold, Discrimination, and Identification per se were lower in MS compared with control respectively. Conclusion The results of this systematic review show that the prevalence of olfactory dysfunction in MS patients is high and more attention needs to be drawn to this aspect of MS.
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Affiliation(s)
- Omid Mirmosayyeb
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Narges Ebrahimi
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahdi Barzegar
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Afshari-Safavi
- Department of Biostatistics and Epidemiology, Faculty of Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Sara Bagherieh
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- * E-mail:
| | - Vahid Shaygannejad
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Bagherieh S, Ghoshouni H, Bostan F, Afshari-Safavi A, Badihian S, Barzegar M, Shaygannejad V, Mirmosayyeb O. Incidence, Prevalence, and Characteristics of Heart Failure Among Patients with Multiple Sclerosis; A Systematic Review and Meta-Analysis. Mult Scler Relat Disord 2022; 59:103665. [DOI: 10.1016/j.msard.2022.103665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/17/2022] [Accepted: 02/03/2022] [Indexed: 11/24/2022]
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Noormohammadi M, Ghorbani Z, Naser Moghadasi A, Saeedirad Z, Shahemi S, Ghanaatgar M, Rezaeimanesh N, Hekmatdoost A, Ghaemi A, Razeghi Jahromi S. MIND Diet Adherence Might be Associated with a Reduced Odds of Multiple Sclerosis: Results from a Case–Control Study. Neurol Ther 2022; 11:397-412. [PMID: 35094301 PMCID: PMC8857348 DOI: 10.1007/s40120-022-00325-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 01/13/2022] [Indexed: 12/17/2022] Open
Abstract
Introduction The Mediterranean Dietary Approaches to the Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) diet has been shown to have beneficial neuroprotective effects. The purpose of this research was to evaluate the link between the MIND diet adherence and multiple sclerosis (MS), a degenerative neurological illness. Methods In a hospital-based case–control setting, 77 patients with relapsing–remitting multiple sclerosis (RRMS) and 148 healthy individuals were recruited. A validated 168-item semi-quantitative food frequency questionnaire was used to assess participants’ dietary intakes and the MIND diet score. A logistic regression model was used to evaluate the association between MIND diet adherence and MS. Results There was significant difference between RRMS and control groups in the median (Q1-Q3) of age (years, P value < 0.001), body mass index (BMI) (kg/m2, P value < 0.001), and total intake of calories (kcal, P value = 0.032), carbohydrates (g, P value = 0.003), animal-based protein (g, P value = 0.009), and fiber (g, P value = 0.001). Adherence to the MIND diet was associated with a reduced odds of MS [adjusted odds ratio (aOR) = 0.10, 95 percent confidence interval (95% CI) = 0.01–0.88, P for trend = 0.001]. MS odds was significantly lower in the last tertile of green leafy vegetables (aOR = 0.02, 95% CI = 0.00–0.21, P value < 0.001), other vegetables (aOR = 0.17, 95% CI = 0.04–0.73, P value = 0.001), butter and stick margarine (aOR = 0.20, 95% CI = 0.06–0.65, P value = 0.008), and beans (aOR = 0.05, 95% CI = 0.01–0.28, P value < 0.001) consumption. While it was significantly higher in the last tertile of cheese (aOR = 4.45, 95% CI = 1.70–11.6, P value = 0.003), poultry (aOR = 3.95, 95% CI = 1.01–15.5, P value = 0.039), pastries and sweets (aOR = 13.9, 95% CI = 3.04–64.18, P value < 0.001), and fried/fast foods (aOR = 32.8, 95% CI = 5.39–199.3, P value < 0.001). Conclusion The MIND diet and its components, including green leafy vegetables, other vegetables, and beans, seem to decrease the odds of MS; besides butter and stick margarine, the MIND diet's unhealthy components seem to have the same protective effects, while pastries and sweets, cheese, poultry, and fried/fast foods have an inverse effect. Supplementary Information The online version contains supplementary material available at 10.1007/s40120-022-00325-z.
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Affiliation(s)
- Morvarid Noormohammadi
- Student Research Committee, Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Zeinab Ghorbani
- Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine,, Guilan University of Medical Sciences, Rasht, Iran
- Department of Clinical Nutrition, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Abdorreza Naser Moghadasi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Saeedirad
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sahar Shahemi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Milad Ghanaatgar
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasim Rezaeimanesh
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azita Hekmatdoost
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Ghaemi
- Department of Virology, Pasteur Institute of Iran, Tehran, Iran
| | - Soodeh Razeghi Jahromi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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