Economic impact of the new oral treatments for multiple sclerosis. / Impacto económico de las nuevas terapias orales en esclerosis múltiple.

INTRODUCTION: Multiple sclerosis (MS) is a chronic disease affecting the central nervous system and is characterised by inflammation, demyelination, gliosis, and axonal damage. The introduction of dimethyl fumarate and teriflunomide has led to an increase in the number of alternative first-line therapies for MS. The objective of this study was to evaluate the economic impact of the incorporation of new oral therapies at the reference unit (CSUR) at Hospital Universitario Puerta de Hierro Majadahonda. MATERIALS AND METHODS: We performed a retrospective observational study including patients diagnosed with MS, who underwent treatment with disease-modifying drugs in 2015 and were followed up for a minimum mean time of one year. Data were collected from patients' electronic clinical histories and the pharmacy service's programme for dispensing drugs to outpatients. RESULTS: Evaluating the cost of changing 125 patients' treatment from other drugs to dimethyl fumarate and teriflunomide, and comparing this with the cost that would have resulted from maintaining their previous treatment, demonstrated a total saving of €169,107.31 over the study period. CONCLUSIONS: In addition to contributing new therapeutic alternatives, dimethyl fumarate and teriflunomide produced an economic saving in MS treatment at our hospital.

[Phenomena and syndrome of subclavian steal. Two cases]. / Fenómeno y síndrome del robo de la subclavia. A propósito de dos casos.

INTRODUCTION: The phenomenon of subclavian steal is a frequent haemodynamic phenomenon which rarely causes symptoms in the vertebrobasilar territory. When this does occur, it is known as the subclavian steal syndrome. CLINICAL CASES: We describe two patients with the syndrome of left subclavian steal diagnosed by doppler. In one of them, symptoms appeared after exercise of the left arm. Various aspects of the syndrome are discussed in relation to diagnosis and indications for treatment. CONCLUSIONS: The subclavian steal syndrome is a condition which can be reliably diagnosed using doppler and the treatment of which should be decided individually in each case.