Burcu Yüksel, Fatma Kurtuluş, Abidin Erdal

Antalya Eğitim ve Araştırma Hastanesi multipl skleroz polikliniğinin oral tedavi deneyimi

Amaç: Bu çalışmanın amacı Sağlık Bilimleri Üniversitesi Antalya Eğitim ve Araştırma Hastanesi multipl skleroz (MS) polikliniğinin oral tedavi deneyimini paylaşmak, hastalar için uygun tedaviyi seçmenin önemini vurgulamaktır. Gereç ve yöntem: 2012-2018 yılları arasında MS polikliniğinde en az 6 aydır düzenli takip edilen 550 hastanın dosyası retrospektif olarak incelendi. Demografik veriler, daha öncesinde kullanmakta olduğu tedaviler ve hangi sebeple (relaps sıklığında artış, progresyon, MR aktivasyonu, hasta isteği, önceki ilaca bağlı yan etki) oral tedavi tercih edildiği, hastalık süreleri ve ne kadar süredir oral tedavi kullanmakta oldukları, hastalık dizabilitesini ölçen Expanded Disability Status Scale (EDSS) skorları kaydedildi. Bulgular: 2010 McDonald kriterlerine göre kesin MS tanısı alan 550 hasta çalışmaya dahil edildi. 108 (%19,6) hasta oral tedavilerden (fingolimod, dimetilfumarat ya da teriflunomid) birini kullanmaktaydı. 53 hasta (%49,1) fingolimod, 34 hasta (%31,5) dimetilfumarat, 21 hasta (%19,4) teriflunomid kullanmaktaydı. En fazla atak sıklığında artış nedeniyle oral tedavi tercih edildiği saptandı. Sonuç: Oral tedavi kulanım oranımız Türkiye ortalamasının altında olsa da bulgularımız, tedavi değişimi yaptığımızda tedavi penceresi içinde kaldığımızı göstermektedir.

Anahtar Kelimeler:

multipl skleroz, fingolimod, dimetilfumarat, oral tedavi, teriflunomid

Oral treatment experience in multiple sclerosis at Antalya Training and Research Hospital

Purpose: Our aim was to share our oral treatment experience in multiple sclerosis and how we decided to choose the right treatment for our patients.Materials and methods: We analyzed multiple sclerosis patients who were admitted to neurology clinic between 2012-2018. Demographic features, treatments that were used before initiating oral therapies, in which conditions the treatments were changed to oral therapies (increased relaps rate, progression, activation on magnetic resonance imaging, patient’s choice, adverse events with the previous treatment), the duration of the disease and the oral treatment, Expanded Disability Status Scale (EDSS) scores were all recorded.Results: 550 patients with a definite clinical diagnosis of MS according to the 2010 McDonald criteria were enrolled. 108 (19.6%) patients were receiving oral treatment for multiple sclerosis. 53 patients (49.1%) were receiving fingolimod, 34 patients (31.5%) were receiving dimethylfumarate, 21 patients (19.4%), were receiving teriflunomide. The most evident cause for changing the treatment was the increased relaps rate. Conclusion: Although the ratio (19.6%) seemed to be lower than the ratio from whole Turkey (41%), the timing of the treatment change have been shown to be in therapeutic window.

Keywords:

multiple sclerosis, oral treatment, fingolimod, dimethylfumarate, teriflunomide,

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