First case of Primary Progressive Multiple Sclerosis treated with Ocrelizumab in Peru
DOI:
https://doi.org/10.20453/rnp.v86i3.4570Keywords:
Multiple Sclerosis, Multiple Sclerosis, Chronic Progressive, Rare Diseases, Health Services AccessibilityAbstract
Multiple Sclerosis is a chronic, demyelinating, autoimmune, neuroinflammatory disease. Known as the most common cause of non-traumatic neurological disability in young adults. Ten per cent of patients with Multiple Sclerosis are diagnosed with the Primary Progressive form (PPMS) which, until the emergence of the anti-CD20 monoclonal
antibody Ocrelizumab, had no specific therapy. The first case treated with Ocrelizumab in the Peruvian publichealthcare system is reported. The patient presented an acceptable tolerability and an adequate clinical response, as measured by the EDSS scale. Of note, under Peruvian legislation, Multiple Sclerosis is considered a rare disease
and, therefore, requires an ad hoc evaluation for the authorization of public funding for specific therapies.
References
Dendrou CA, Fugger L, Friese MA. Immunopathology of multiple sclerosis. Nat Rev Immunol [Internet].
; 15(9): 545-558. Disponible en: https://www. nature.com/articles/nri3871
Kufukihara K, Nakahara J. [Primary progressive multiple sclerosis]. Brain Nerve [Internet]. 2021; 73(5): 458-465. Disponible en: https://webview.isho. jp/journal/detail/abs/10.11477/mf.1416201786
Manouchehrinia A, Tanasescu R, Tench CR, Constantinescu CS. Mortality in multiple sclerosis:
meta-analysis of standardised mortality ratios. J Neurol Neurosurg Psychiatry [Internet]. 2016; 87(3): 324-331.
Disponible en: https://jnnp.bmj.com/content/87/3/324
Ontaneda D. Progressive multiple sclerosis. Contin Minneap Minn [Internet]. 2019; 25(3): 736-752.
Disponible en: https://journals.lww.com/continuum/ Abstract/2019/06000/Progressive_Multiple_
Sclerosis.11.aspx 5. Thompson AJ, Banwell BL, Barkhof F, Carroll WM,
Coetzee T, Comi G, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria.
Lancet Neurol [Internet]. 2018; 17(2): 162-173. Disponible en: https://www.thelancet.com/journals/
laneur/article/PIIS1474-4422(17)30470-2/fulltextPrimer caso de esclerosis múltiple primaria progresiva tratada con ocrelizumab en el Perú 76 Rev Neuropsiquiatr. 2023;86(2): 72-76
Rauer S, Hoshi MM, Pul R, Wahl M, Schwab M, Haas J, et al. Ocrelizumab treatment in patients
with primary progressive multiple sclerosis: shortterm safety results from a compassionate use
programme in Germany. Clin Neurol Neurosurg [Internet]. 2020; 197: 106142. Disponible en:
https://www.sciencedirect.com/science/article/pii/ S0303846720304856?via%3Dihub
Baldassari LE, Fox RJ. Therapeutic advances and challenges in the treatment of progressive multiple
sclerosis. Drugs [Internet]. 2018; 78(15): 1549- 1566. Disponible en: https://link.springer.com/
article/10.1007/s40265-018-0984-5
Moreno Gómez M del M, García Romanos F. Caso clínico: presentación atípica de esclerosis múltiple
en una paciente de 42 años. Aten Primaria Práctica [Internet]. 2021; 3(1): 100082. Disponible en:
https://www.sciencedirect.com/science/article/pii/S260507302100002X?via%3Dihub
Gajofatto A, Turatti M, Benedetti MD. Primary progressive multiple sclerosis: current therapeutic
strategies and future perspectives. Expert Rev Neurother [Internet]. 2017; 17(4): 393-406.
Disponible en: https://www.tandfonline.com/doi/ab s/10.1080/14737175.2017.1257385?journalCode=ie
rn20
Ghiasian M, Faryadras M, Mansour M, Khanlarzadeh E, Mazaheri S. Assessment of delayed diagnosis and
treatment in multiple sclerosis patients during 1990- 2016. Acta Neurol Belg [Internet]. 2021; 121(1):
-204. Disponible en: https://link.springer.com/ article/10.1007/s13760-020-01528-7
Wolinsky JS, Arnold DL, Brochet B, Hartung HP, Montalban X, Naismith RT, et al. Long-term followup from the ORATORIO trial of ocrelizumab for primary progressive multiple sclerosis: a post-hoc analysis from the ongoing open-label extension of the randomised, placebo-controlled, phase 3 trial. Lancet Neurol [Internet]. 2020; 19(12): 998-1009. Disponible en: https://www.thelancet.com/journals/ laneur/article/PIIS1474-4422(20)30342-2/fulltext
Decreto Supremo n.o 004-2019-SA, que aprueba el Reglamento de la Ley n.° 29698, Ley que declara de
interés nacional y preferente atención el tratamiento de personas que padecen enfermedades raras o
huérfanas. Lima, 21 de febrero de 2019. Disponible en: https://www.gob.pe/institucion/minsa/normaslegales/262729-004-2019-sa
RNP is distributed under a 