Real-life evidence of treatment with alemtuzumab in patients diagnosed with relapsing-remitting multiple sclerosis in Colombia.

BACKGROUND: Physical disability, cognitive impairment, depression, and fatigue are poorly understood in Latin American patients with multiple sclerosis following alemtuzumab infusion. OBJECTIVES: To describe Sustained changes in physical disability in an average 22-month follow-up period after alemtuzumab infusion, and which demographical or clinical variables modulate change in EDSS, and adverse events, changes in cognition, fatigue, and depressive symptoms after an average 15-month follow-up period. METHOD: Retrospective cohort observational study. Following the review of medical records, 23 patients with Relapsing Remitting Multiple Sclerosis treated with alemtuzumab were identified; of these, 17 had a baseline neuropsychological assessment and 12 had at least one follow-up neuropsychological assessment. RESULTS: Most of the patients presented a low level of physical disability, depression, fatigue, and cognitive impairment, which was more pronounced in the processing speed and visuospatial memory at baseline. Fifteen of 23 (65.2%) of patients showed disability improvement, 7 (30.1%) patients remained stable, and 1 (4.3%) patient worsened, and change was not influenced by age or baseline disability score. Twenty (87%) patients remained free of clinical relapses. Performance improved on the BVMT-R visual memory test, 9 (75%) remained stable or improved on the BICAMS, and 66.6% perceived decreased fatigue on the d-FIS. Adverse events occurred in 7 (30.1%) of patients, the most common were opportunistic infections in 2 (8.6%) patients, and one 29-year-old patient presented papillary thyroid carcinoma after infusion of the second course of alemtuzumab. CONCLUSIONS: Results suggest that treatment with alemtuzumab has a beneficial impact on disability, cognitive impairment, and perception of fatigue. The percentage and type of adverse events observed in the cohort are similar to those reported for other real-life studies.

Análisis retrospectivo de las enfermedades parasitarias del mono ardilla (Saimiri sciureus) en dos condiciones ex situ en el noroccidente de los Andes suramericanos / Retrospective analysis of the squirrel monkey’s (saimiri sciureus) parasitic diseases in two ex situ conditions in the northwestern Andes in South America / Análise retrospectiva das doenças parasitárias do macaco-de-cheiro (Saimiri sciureus) em duas condições ex situ no noroeste dos Andes sul-americanos

El mono ardilla (Cebidae: Saimiri sciureus) es una especie de primate neotropical. La mayor susceptibilidad a la presencia de parásitos en estos primates se puede deber a las condiciones ex situ a las que se encuentran sometidos, en donde se exponen a diferentes factores ambientales y de manejo. A partir de las historias clínicas de una población de 94 Saimiri sciureusdel Parque Zoológico Jaime Duque (PZJD) y de la Unidad de Rescate y Rehabilitación de Animales Silvestres (Urras), instituciones ubicadas al noroccidente de los Andes suramericanos, se determinó la presencia de los parásitos diagnosticados en estas dos condiciones (exhibición y rehabilitación, respectivamente), estableciendo la posible asociación con la edad, el sexo, la sintomatología y los medicamentos. Se utilizaron histogramas y prueba de chi cuadrado para definir las diferencias de parásitos en estos dos lugares y poder determinar la mayor frecuencia presente en Saimiri sciureus. Por otro lado, el limitado conocimiento y los estudios parasitológicos de estos primates delimitan la gestión pública y dificultan el establecimiento de posibles zoonosis.

The squirrel monkey (Cebidae: Saimiri sciureus) is a species of Neotropical primate. The increased susceptibility to the presence of parasites in these primates may be due to the ex situ conditions to which they are subjected, and where they are exposed to different environmental and managerial factors. The presence of the parasites diagnosed in these two conditions (exhibition and rehabilitation, respectively) was determined based on the medical records of a population of 94 Saimiri sciureus from the Jaime Duque Zoo (PZJD) and the Wild Animal Rescue and Rehabilitation Unit (Urras), both institutions located at the northwestern part of the Andes in South America, thus establishing the possible association with age, gender, symptomatology and medicine. Histograms and chi-squared tests were used to define the parasite differences in these two places and to determine the most frequent ones in Saimiri sciureus. On the other hand, the limited knowledge and parasitological studies of these primates delimitate public management and hinder the establishment of possible zoonoses.

O macaco-de-cheiro (Cebidae: Saimiri sciureus) é uma espécie de primata neotropical. A maior suscetibilidade à presença de parasitas nestes primatas pode-se dever as condições ex situ às que se encontram submetidos, onde são expostos a diferentes fatores ambientais e de manejo. A partir das histórias clínicas de uma população de 94 Saimiri sciureus do Parque Zoológico Jaime Duque (PZJD) e da Unidade de Resgate e Reabilitação de Animais Silvestres (Urras), instituições localizadas ao noroeste dos Andes sul-americanos, determinou-se a presença dos parasitas diagnosticados nestas duas condições (exibição e reabilitação, respectivamente), estabelecendo a possível associação com a idade, o sexo, a sintomatologia e os medicamentos. Foram utilizados histogramas e prova de qui-quadrado para definir as diferenças de parasitas nestes dois lugares, e poder determinar a maior frequência presente em Saimiri sciureus. Por outro lado, o limitado conhecimento e os estudos parasitológicos destes primatas delimitam a gestão pública e dificultam o estabelecimento de possíveis zoonoses.