Epidemiology of multiple sclerosis in the Middle East: A systematic review and meta analysis

Nasr, Z.; Etemadifar, Masoud; Khalili, Behrang

doi:10.1016/j.msard.2014.09.164

Cited by 2 publications

(3 citation statements)

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“…Misconceptions relating to the practicability of completing a pregnancy are common among patients with MS [1][2][3][4][5][6][7][8][9][10][11][12], and patients should be counselled carefully that their MS has no impact on their ability to conceive, to carry the pregnancy to term, and to give birth to a healthy neonate [20]. In the authors' experience, patients are often concerned that they will pass on their MS to the children.…”

Section: Preconception Counsellingmentioning

confidence: 99%

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Disease-Modifying Drugs and Family Planning in People with Multiple Sclerosis: A Consensus Narrative Review from the Gulf Region

et al. 2020

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Most disease-modifying drugs (DMDs) are contraindicated in pregnancy. Management of MS is especially challenging for pregnant patients, as withdrawal of DMDs leave the patient at risk of increased disease activity. We, a group of experts in MS care from countries in the Arab Gulf, present our consensus recommendations on the management of MS in these patients. Where possible, a patient planning pregnancy can be switched to a DMD considered safe in this setting. Interferon β now can be used during pregnancy, where there is a clinical need to maintain treatment, in addition to glatiramer acetate. Natalizumab (usually to 30 weeks’ gestation for patients with high disease activity at high risk of relapse and disability progression) may also be continued into pregnancy. Cladribine tablets and alemtuzumab have been hypothesised to act as immune reconstitution therapies (IRTs). These drugs provide a period of prolonged freedom from relapses for many patients, but the patient must be prepared to wait for up to 20 months from initiation of therapy before becoming pregnant. If a patient becomes pregnant while taking fingolimod, and requires continued DMD treatment, a switch to interferon β or natalizumab after a variable washout period may be prescribed, depending on the level of disease activity. Women who wish to breastfeed should be encouraged to do so, and interferon β may also be used during breastfeeding. There is a lack of data regarding the safety of using other DMDs during breastfeeding.

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Section: Preconception Counsellingmentioning

confidence: 99%

“…These trends in the epidemiology of MS are evident in the authors' countries in the Gulf region, as elsewhere [5][6][7]. Large families are the norm in the Middle East, and cultural issues relating to contraception (and termination of a pregnancy exposed to a potentially unsafe therapy) must be discussed carefully [8,9].…”

Section: Introductionmentioning

confidence: 99%

Disease-Modifying Drugs and Family Planning in People with Multiple Sclerosis: A Consensus Narrative Review from the Gulf Region

et al. 2020

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“…The perception that MS was minimally or non-existent in places with non-Caucasian populations was reinforced by the 1970 observation from Alter and Olivares [13] on the prevalence in Mexico as “one of the lowest in the world” (1.6/100,000). During the last part of the 20th century and the first decades of the current epoch, epidemiologic studies have shown a notable increase in prevalence in Latin American countries [14], including Mexico [15], and the Middle East [16], while frequencies remain elevated in North America and some European countries. On the American continent, the increasing presence of the disease is now evident in populations that were hypothetically “resistant” to the disease.…”

Section: The Global Emergence Of Msmentioning

confidence: 99%

Multiple Sclerosis: A Global Concern with Multiple Challenges in an Era of Advanced Therapeutic Complex Molecules and Biological Medicines

Rivera

2018

Biomedicines

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Multiple sclerosis (MS) has become a common neurological disorder involving populations previously considered to be infrequently affected. Genetic dissemination from high- to low-risk groups is a determining influence interacting with environmental and epigenetic factors, mostly unidentified. Disease modifying therapies (DMT) are effective in treating relapsing MS in variable degrees; one agent is approved for primary progressive disease, and several are in development. In the era of high-efficacy medications, complex molecules, and monoclonal antibodies (MAB), including anti-VLA4 (natalizumab), anti-CD52 (alemtuzumab), and anti-CD20 (ocrelizumab), obtaining NEDA (no evidence of disease activity) becomes an elusive accomplishment in areas of the world where access to MS therapies and care are generally limited. Countries’ income and access to public MS care appear to be a shared socioeconomic challenge. This disparity is also notable in the utilization of diagnostic tools to adhere to the proposed elements of the McDonald Criteria. The impact of follow-on medications (“generics”); injectable non-biological complex drugs (NBCD), oral sphingosine-1-phosphate receptor modulators, and biosimilars (interferon 1-a and 1-b), utilized in many areas of the world, is disconcerting considering these products generally lack data documenting their efficacy and safety. Potential strategies addressing these concerns are discussed from an international point of view.

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Epidemiology of multiple sclerosis in the Middle East: A systematic review and meta analysis

Cited by 2 publications

References 0 publications

Disease-Modifying Drugs and Family Planning in People with Multiple Sclerosis: A Consensus Narrative Review from the Gulf Region

Disease-Modifying Drugs and Family Planning in People with Multiple Sclerosis: A Consensus Narrative Review from the Gulf Region

Multiple Sclerosis: A Global Concern with Multiple Challenges in an Era of Advanced Therapeutic Complex Molecules and Biological Medicines

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