Browsing by Author "Karabudak, Rana"
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Publication Comparative analysis of fingolimod versus teriflunomide in relapsing-remitting multiple sclerosis(Elsevier Sci Ltd, 2019-11-01) Boz, Cavit; Terzi, Murat; Ozer, Bilge; Türkoğlu, Recai; Karabudak, Rana; Efendi, Hüsnü; Soysal, Aysun; Sevim, Serhan; Altintaş, Ayse; Kurne, Aslı; Akcali, Aylin; Akman, Gülşen; Yüceyar, Nur; Balci, Belgin Petek; Ekmekci, Özgül; Karahan, Serap Zengin; Demirkıran, Meltem; Altunrende, Burcu; Gözübatik Çelik, Gökçen; Kale, Nilüfer; Köseoğlu, Meşrure; Özakbaş, Serkan; Turan, Ömer Faruk; TURAN, ÖMER FARUK; Bursa Uludağ Üniversitesi/Tıp Fakültesi; JHM-3244-2023Background: Fingolimod and teriflunomide are commonly used in the treatment of relapsing-remitting multiple sclerosis (RRMS). These have not been compared in controlled trials, but only in observational studies, with inconclusive results. Comparison of their effect on relapse and disability in a real-world setting is therefore needed.Objectives: The objective of this study was to compare the efficacy of fingolimod and teriflunomide in reducing disease activity in RRMS.Methods: This multicenter, retrospective observational study was carried out with prospectively collected data from 15 centers. All consecutive RRMS patients treated with teriflunomide or fingolimod were included. Data for relapses, Expanded Disability Status Scale (EDSS) scores and brain magnetic resonance imaging (MRI) scans were collected. Patients were matched using propensity scores.Annualized relapse rates (ARR), disability accumulation, percentage of patients with active MRI and treatment discontinuation over a median 2.5-year follow-up period were compared.Results: Propensity score matching retained 349 out of 1388 patients in the fingolimod group and 349 out 678 in the teriflunomide group for final analyses. Mean ARR decreased markedly from baseline after 1 and 2 years of treatment in both the fingolimod (0.58-0.17 after 1 year and 0.11 after 2 years, p < 0.001) and teriflunomide (0.56-0.29 after 1 year and 0.31 after 2 years, p < 0.001) groups. Mean ARR was lower in fingolimod-treated patients than in those treated with teriflunomide at years 1 (p = 0.02) and 2 (p = 0.004). Compared to teriflunomide, the fingolimod group exhibited a higher percentage of relapse-free patients and a lower percentage of MRI-active patients after 2.5-year follow-up. Disability worsening was similar between the two groups. Patients were less likely to discontinue fingolimod than teriflunomide (p < 0.001).Conclusion: Fingolimod was associated with a better relapse control and lower discontinuation rate than teriflunomide. The two oral therapies exhibited similar effects on disability outcomes.Publication Differences between general neurologists and multiple sclerosis specialists in the management of multiple sclerosis patients: A national survey(Aves, 2019-12-01) Kurtuncu, Murat; Tuncer, Aslı; Uygunoğlu, Uğur; Çalışkan, Zeynep; Kokenli Paksoy, Ayşenur; Efendi, Hüsnü; Sağduyu Kocaman, Ayşe; Özcan, Cemal; Terzi, Murat; Saip, Sabahattin; Karabudak, Rana; Siva, Aksel; Turan, Ömer Faruk; TURAN, ÖMER FARUK; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; JHM-3244-2023Introduction: The management of multiple sclerosis (MS) has become more complicated after the introduction of new diagnostic and treatment options. Despite the abundance of guidelines, the experience of physicians still plays a major role in the management of patients. This study aimed to define differences in behavior patterns between general neurologists (GNs) and MS specialists (MSSs).Methods: We conducted a survey of 36 questions to 318 neurologists, including 33 MSSs. The survey covered topics including laboratory investigations, pregnancy, and treatment.Results: Our study found many differences between GNs and MSSs in terms of management, the most important being treatment initiation and switching. GNs had a tendency to initiate treatment later than MSSs however, they tended to switch treatment faster. Our study also showed that GNs ordered magnetic resonance imaging (MRI) more frequently than MSSs, even if patients were clinically stable. Moreover, although GNs more frequently relied on MRI, they did not consider brain atrophy as an important measure in the follow-up of their patients. Furthermore, GNs considered replacement therapy less often than MSSs, even in patients with vitamin D deficiency.Discussion: Our study revealed important discrepancies between the management patterns of GNs and MSSs in MS patients. These findings suggest the need for a national education program for GNs on MSSs.