Evidence map›Paper›PMID 31768280›Full record

ArticleSurgical neurology international2019

Impact of delayed treatment on exacerbations of multiple sclerosis among Puerto Rican patients.

Sara Zarei, Irvin Maldonado, Laura Franqui-Dominguez, Cristina Rubi, Yanibel Tapia Rosa, Cristina Diaz-Marty, Guadalupe Coronado, Marimer C Rivera Nieves, Golnoush Akhlaghipour, Angel Chinea

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In one paragraph

Article in Surgical neurology international, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Sara ZareiDepartment of Neurology, San Juan Bautista School of Medicine, Caguas, Puerto Rico, USA.
Irvin MaldonadoDepartment of Neurology, San Juan Bautista School of Medicine, Caguas, Puerto Rico, USA.
Laura Franqui-DominguezDepartment of Neurology, San Juan Bautista School of Medicine, Caguas, Puerto Rico, USA.
Cristina RubiCaribbean Neurological Center, Guaynabo, USA.
Yanibel Tapia RosaDepartment of Neurology, San Juan Bautista School of Medicine, Caguas, Puerto Rico, USA.
Cristina Diaz-MartyDepartment of Neurology, San Juan Bautista School of Medicine, Caguas, Puerto Rico, USA.
Guadalupe CoronadoDepartment of Neurology, San Juan Bautista School of Medicine, Caguas, Puerto Rico, USA.
Marimer C Rivera NievesDepartment of Neurology, San Juan Bautista School of Medicine, Caguas, Puerto Rico, USA.
Golnoush AkhlaghipourDepartment of Neurology, University of California, Los Angeles, California, USA.
Angel ChineaCaribbean Neurological Center, Guaynabo, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere are limited data on multiple sclerosis (MS) patients in underserved groups, including Puerto Rico. In this study, we analyzed the characteristic of MS symptoms and number of relapses in Puerto Rican patients. We then compare these characteristics with MS patients from the US. The number of MS relapses is highly correlated with the treatment onset and adherence. Patients in Puerto Rico have been experiencing lengthy treatment delay. We will discuss the possible causes of such delay and its impact on MS prognosis.

methodsThis retrospective cohort study consisted of the evaluation of 325 medical records from MS patients attending the Caribbean Neurological Center from 2014 to 2019. We gathered symptoms and comorbidities data as binary objects. The treatment delay was calculated based on the mean value of days between diagnosis and treatment onset for these groups of patients.

resultsWe found that on average, the treatment delay for MS patients in Puerto Rico (PR) to receive their medication was 120 days. The most common MS subtype was relapsing-remitting 72.8%, with a mean of 1.684 relapses per year. Initial symptoms were sensory 54%, visual 33.1%, motor 28.8%, coordination 23.2%, fatigue 9.7%, memory 7.3%, depression 6.5%, urinary 4.9%, gastrointestinal 2.4%, and sexual dysfunction 1.6%. The most common comorbidities were hypertension 18.4%, asthma 13.6%, and thyroid disease 12.8%. When we compared the comorbidities between the two populations, immune thrombocytopenia had the highest percent change with the value of almost 200% (0.001% of US patient vs. 0.8% of Puerto Rican MS patients).

conclusionPatients from Puerto Rico had a 33% higher relapse rate compared to the one reported for MS patients in the US. This higher rate may be related to the long delay in receiving their medications. They also had a higher rate of complex comorbidities such as immune thrombocytopenia or thyroid disease. Our findings provide a proof of concept that delay in receiving medications can increase the number of relapses and complex comorbidities among MS patients.

Indexed as

Adverse impact of multiple sclerosis treatment delayMultiple sclerosis comorbiditiesMultiple sclerosis symptomsMultiple sclerosis treatmentPuerto Rican multiple sclerosis patientsPuerto Rico health- care system

Identifiers

PMID31768280
PMCPMC6826276

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.