|
Assessment of Total Side Effects of Oral Agents for the Treatment of Relapsing–Remitting Multiple Sclerosis Patients in Imam Khomeini Clinic in Hamadan
|
M Ghiasian1    , N Lashkari2 , M Mohammadi3 , Y Mohammadi4 , M Soleimani5 , R Mahjub6 , S Ataei 7 |
1- Department of Neurology, Hamadan University of Medical Sciences, Hamadan, Iran
2- Department of Clinical Pharmacy, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran
3- Department of Pharmacology & Toxicology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran,
4- Social Determinants of Health Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
5- Department of Pharmaceutical Biotechnology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran
6- Department of Pharmaceutics and Pharmaceutical Biotechnology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran
7- Department of Clinical Pharmacy, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran , s.ataei2017@gmail.com |
|
|
Abstract: (610 Views) |
Background & aim: Three oral drugs, including fingolimod, dimethyl fumarate, and teriflunomide, which are clinically approved for the therapy of relapsing–remitting multiple sclerosis (RRMS) were reviewed in this work. The present study aimed to recognize the side effects of the oral drugs in RRMS patients who were consulted in neurology clinic in west of Iran.
Methods: The study population of the present prospective observational study conducted in 2016-2017 were patients with relapsing-remitting MS referred to Imam Khomeini Hospital (RA). Three hundred patients with RRMS were randomly assigned to three treatment groups. The first group received fingolimod, the second group received dimethyl fumarate, and the third group received teriflunomide. The response to treatment assessed at 1, 3, 6, 12, and 24 months after the start of treatment. Eventually, the frequency of adverse effects characterized for each group and the collected data compared in each treatment group. The collected data were analyzed using ANOVA statistical tests.
Results: The findings of the present study revealed that the most common clinical complications were neurological (21.8%) and gastrointestinal complications (15.6%). The most common laboratory complications were liver (12.9%) and cardiovascular complications (10.3%). Moreover, the lowest clinical complications were musculoskeletal (4.6%) and endocrine complications (3%) and lowest laboratory complications were macular edema (0.6%).
Conclusion: In the present study, fingolimod had the most side effects and triflunomide had the least side effects. Dimethyl fumarate was stopped due to the severity of side effects and triflunomide was continued.
|
|
| Keywords: Multiple sclerosis, Fingolimod, Teriflunomid, Dimethyl Fumarate, Clinical research, Adverse effects |
|
|
Full-Text [PDF 398 kb]
(103 Downloads)
|
Type of Study: Research |
Subject:
Special
Received: 2023/03/22 | Accepted: 2023/12/5 | Published: 2024/01/13
|
|
|
|
|
|
|
| References |
1. Jones AP, Kermode AG, Lucas RM, Carroll WM, Nolan D, Hart P. Circulating immune cells in multiple sclerosis. Clinical & Experimental Immunology. 2017;187(2):193-203. [ DOI:10.1111/cei.12878] [ PMID] [ ] 2. Iranmanesh S, Tirgari B, Tofighi M, Forouzi MA. Spiritual wellbeing and perceived uncertainty in patients with multiple sclerosis in south-east Iran. International Journal of Palliative Nursing. 2014;20(10):483-92. [ DOI:10.12968/ijpn.2014.20.10.483] [ PMID] 3. Taraghi Z, Ilali E, Abedini M, Zarvani A, Khoshnama I, Mohammadpour R, et al. Quality of life among multiple sclerosis patients. Iran Journal of Nursing. 2007;20(50):51-9. 4. Currie R. Spasticity: a common symptom of multiple sclerosis. Nursing Standard (through 2013). 2001;15(33):47. [ DOI:10.7748/ns2001.05.15.33.47.c3021] [ PMID] 5. Shiri V, Emami M, Shiri E. Investigating the relationship between selective attention and cognitive flexibility with balance in patients with relapsing-remitting multiple sclerosis. Archives of Rehabilitation. 2018;18(4):296-305. [ DOI:10.21859/jrehab.18.4.4] 6. O'Connor P, Comi G, Freedman M, Miller A, Kappos L, Bouchard J, et al. the MRI-AC in Houston, Texas. Long-term safety and efficacy of teriflunomide: nine-year follow-up of the randomized TEMSO study. Neurology. 2016;86(10):920-30. [ DOI:10.1212/WNL.0000000000002441] [ PMID] [ ] 7. Bomprezzi R. Dimethyl fumarate in the treatment of relapsing-remitting multiple sclerosis: an overview. Therapeutic advances in neurological disorders. 2015;8(1):20-30. [ DOI:10.1177/1756285614564152] [ PMID] [ ] 8. Rosenkranz T, Novas M, Terborg C. PML in a patient with lymphocytopenia treated with dimethyl fumarate. New England journal of medicine. 2015;372(15):1476-8. [ DOI:10.1056/NEJMc1415408] [ PMID] 9. Nicholas J, Boster A, Wu N, Yeh W-S, Fay M, Kendter J, et al. Comparison of disease-modifying therapies for the management of multiple sclerosis: analysis of healthcare resource utilization and relapse rates from US insurance claims data. PharmacoEconomics-open. 2018;2(1):31-41. [ DOI:10.1007/s41669-017-0035-2] [ PMID] [ ] 10. Phillips JT, Hutchinson M, Fox R, Gold R, Havrdova E. Managing flushing and gastrointestinal events associated with delayed-release dimethyl fumarate: experiences of an international panel. Multiple sclerosis and related disorders. 2014;3(4):513-9. [ DOI:10.1016/j.msard.2014.03.003] [ PMID] 11. Arvin AM, Wolinsky JS, Kappos L, Morris MI, Reder AT, Tornatore C, et al. Varicella-zoster virus infections in patients treated with fingolimod: risk assessment and consensus recommendations for management. JAMA neurology. 2015;72(1):31-9. [ DOI:10.1001/jamaneurol.2014.3065] [ PMID] [ ] 12. Solaro C, Gamberini G, Masuccio FG. Depression in multiple sclerosis: epidemiology, aetiology, diagnosis and treatment. CNS drugs. 2018;32(2):117-33. [ DOI:10.1007/s40263-018-0489-5] [ PMID] 13. Soelberg Sorensen P. Safety concerns and risk management of multiple sclerosis therapies. Acta Neurologica Scandinavica. 2017;136(3):168-86. [ DOI:10.1111/ane.12712] [ PMID] 14. Shear N. Litt's Drug Eruption & Reaction Manual: CRC Press; 2017. [ DOI:10.1201/b20727] 15. Abdar M, Ebrahimifar P, Etemadifar M. The outbreak fingolimod cardiovascular side effects in relapsing-remitting multiple sclerosis patient: A longitudinal study in an Iranian population. ARYA atherosclerosis. 2016;12(6):274. 16. Camm J, Hla T, Bakshi R, Brinkmann V. Cardiac and vascular effects of fingolimod: mechanistic basis and clinical implications. American heart journal. 2014;168(5):632-44. [ DOI:10.1016/j.ahj.2014.06.028] [ PMID] 17. Zhang Z, Zeng C, Peng B. Adsorption properties of magnetic carbon nanotubes for patulin removal from aqueous solution systems. Food Control. 2019;102:1-10. [ DOI:10.1016/j.foodcont.2019.02.038] 18. Turaka K, Bryan JS. Does fingolimod in multiple sclerosis patients cause macular edema? Journal of neurology. 2012;259(2):386-8. [ DOI:10.1007/s00415-011-6367-4] [ PMID] 19. Akiyama H, Suzuki Y, Hara D, Shinohara K, Ogura H, Akamatsu M, et al. Improvement of macular edema without discontinuation of fingolimod in a patient with multiple sclerosis: A case report. Medicine. 2016;95(29). [ DOI:10.1097/MD.0000000000004180] [ PMID] [ ] |
|
| Send email to the article author |
|
|
|
| Add your comments about this article |
|
|
|
|
Ghiasian M, Lashkari N, Mohammadi M, Mohammadi Y, Soleimani M, Mahjub R et al . Assessment of Total Side Effects of Oral Agents for the Treatment of Relapsing–Remitting Multiple Sclerosis Patients in Imam Khomeini Clinic in Hamadan. armaghanj 2024; 29 (1) :112-124 URL: http://armaghanj.yums.ac.ir/article-1-3407-en.html
|
