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  • Küçük Resim
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    Corrigendum to “The role of oligoclonal band count and IgG index in treatment response and disease activity in multiple sclerosis” [Multiple Sclerosis and Related Disorders 83 (2024) 105391]
    (Elsevier Sci Ltd, 2025) Taşkıran, Esra; Terzi, Murat; Helvacı, Elif Merve; Eser, Meltem Zeycan; Avcı, Bahattin; Faruk, Turan Ömer; Yetkin, Mehmet Fatih; Çam, Mustafa
    [No abstract available]
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    Safety and Efficacy of Cladribine in Patients Discontinuing Fingolimod Due to Elevated Transaminase Levels: The FinClad Study
    (Elsevier Sci Ltd, 2025) Sonmez, Meryem Tuba; Yetkin, Mehmet Fatih; Mehdiyev, Duygu Arslan; Koseoglu, Mesrure; Mungan, Semra; Kale, Nilufer; Terzi, Murat
    Background: Elevated liver enzymes pose a significant challenge for patients with multiple sclerosis (pwMS) undergoing treatment with fingolimod. Cladribine has demonstrated comparable efficacy with a more favorable safety profile in terms of hepatotoxicity risk. However, there is still limited data regarding the transition from fingolimod to cladribine for patients with elevated transaminase levels. Objective: The objective of this study is to evaluate the safety and short-term efficacy of cladribine in pwMS who are discontinuing fingolimod due to elevated liver enzyme levels. Methods: This retrospective, multicenter study included 45 pwMS who transitioned from fingolimod to cladribine because their AST/ALT levels were greater than three times the upper limit of normal. Clinical data, liver function tests, and disease activity parameters were collected at predefined time points. Disease activity was assessed based on relapse rates and radiological findings, which included new or enlarging T2 lesions and gadolinium-enhancing lesions. Results: Both AST and ALT levels normalized and remained within the normal range after transition to cladribine (p < 0.001) with no reports of liver-related adverse events. During three months of follow-up, 86.7 % of patients maintained effective disease control, five patients had relapses, and one showed signs of radiological activity. A longer washout period was significantly associated with the presence of disease activity (p = 0.011). Conclusion: Cladribine emerges as a safe and effective option for pwMS discontinuing fingolimod due to hepatotoxicity concerns. To optimize treatment outcomes, implementing shorter washout periods alongside close monitoring is essential to prevent disease reactivation.
  • Küçük Resim
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    The role of oligoclonal band count and IgG index in treatment response and disease activity in multiple sclerosis
    (Elsevier Sci Ltd, 2024) Taşkıran, Esra; Terzi, Murat; Helvacı, Elif Merve; Eser, Meltem Zeycan; Avcı, Bahattin; Faruk, Turan Ömer; Yetkin, Mehmet Fatih; Çam, Mustafa
    Background/aim Multiple sclerosis (MS) is an inflammatory demyelinating central nervous system (CNS) disease. Among the paraclinical tests, brain and spinal Magnetic Resonance Imaging (MRI) is primarily involved in the diagnosis process, and cerebrospinal fluid (CSF) analysis is fundamental in diagnosing MS and the differential diagnosis. A positive relationship was demonstrated between oligoclonal band (OCB) positivity, CSF band number and immunoglobulin G(IgG) index. The study aimed to evaluate whether the number of OCB can predict disease activity and determine a correlation with the IgG index. Methods Our study included 401 MS patients who had relapsing-remitting multiple sclerosis (RRMS), primary progressive multiple sclerosis (PPMS), secondary progressive multiple sclerosis (SPMS), clinic isolated syndrome (CIS), radiologic isolated syndrome (RIS), Neuromyelitis optica spectrum disorder (NMOSD) and Acute disseminated encephalomyelitis (ADEM) with OCB number groups of 2–4, 4–8, 8–12, and 12 and above. Results No significant correlation was observed between IgG index, pre-and post-treatment EDSS (Expanded Disability Status Scale Scores) and disease-modifying therapies (DMT). Drug response was better in the patient group with band number between 2 and 8 and post-treatment EDSS scores were lower (1.62±0.44). Conclusion The study results suggested that band number may be as valuable as the IgG index and a predictive biomarker for disease activity.