Risk Acceptance in Multiple Sclerosis Patients on Natalizumab TreatmentReportar como inadecuado




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Objective

We aimed to investigate the ability of natalizumab NTZ-treated patients to assume treatment-associated risks and the factors involved in such risk acceptance.

Methods

From a total of 185 patients, 114 patients on NTZ as of July 2011 carried out a comprehensive survey. We obtained disease severity perception scores, personality traits’ scores, and risk-acceptance scores RAS so that higher RAS indicated higher risk acceptance. We recorded JC virus status JCV+-, prior immunosuppression, NTZ treatment duration, and clinical characteristics. NTZ patients were split into subgroups A-E, depending on their individual PML risk. Some 22 MS patients on first-line drugs DMD acted as controls.

Results

No differences between treatment groups were observed in disease severity perception and personality traits. RAS were higher in NTZ than in DMD patients p<0.01. Perception of the own disease as a more severe condition tended to predict higher RAS p=0.07. Higher neuroticism scores predicted higher RAS in the NTZ group as a whole p=0.04, and in high PML-risk subgroups A-B p=0.02. In low PML-risk subgroups C-E, higher RAS were associated with a JCV+ status p=0.01. Neither disability scores nor pre-treatment relapse rate predicted RAS in either group.

Conclusions

Risk acceptance is a multifactorial phenomenon, which might be partly explained by an adaptive process, in light of the higher risk acceptance amongst NTZ-treated patients and, especially, amongst those who are JCV seropositive but still have low PML risk, but which seems also intimately related to personality traits.



Autor: Carmen Tur , Mar Tintoré, Ángela Vidal-Jordana, Denis Bichuetti, Pablo Nieto González, María Jesús Arévalo, Georgina Arramb

Fuente: http://plos.srce.hr/



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