Browsing by Author "Siva, Aksel"

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Real-World Effectiveness and Safety of Eculizumab in AQP4-IgG Neuromyelitis Optica Spectrum Disorder
(Springer Heidelberg, 2026) Koc, Emine Rabia; Yetkin, Mehmet Fatih; Saridas, Furkan; Turan, Omer Faruk; Sevim, Serhan; Terzi, Murat; Siva, Aksel
Objective: To evaluate the real-world effectiveness and safety of eculizumab in patients with AQP4-IgG-positive neuromyelitis optica spectrum disorder (NMOSD) and to identify predictors of disability outcomes.MethodsThis multinational, retrospective cohort study analyzed data from 46 patients across 26 centers. The outcomes included the annualized relapse rate (ARR), relapse-free status, change in expanded disability status scale (EDSS) scores, and adverse events. To identify predictors of EDSS improvement or worsening, patients were stratified into subgroups (improved vs. stable/worsened) at each follow-up time point and compared based on demographic, clinical, and radiological variables.ResultsThis retrospective cohort study included 46 patients with AQP4-IgG-positive NMOSD from 26 centers, followed for a mean of 27.3 months. The mean ARR significantly decreased from 1.1 in the 2 years pre-treatment to 0.1 during eculizumab therapy. The relapse-free rate increased from 6.5% pre-treatment to 80.4%. Mean EDSS scores improved from 4.2 at baseline to 3.6 at 24 months. The presence of area postrema syndrome was associated with a favorable prognosis, while the presence of spinal attacks was associated with a poor prognosis at 12 months. Adverse events occurred in 7 patients (18.9%), leading to permanent discontinuation in only two.ConclusionEculizumab demonstrated robust real-world effectiveness in reducing relapse rates and stabilizing disability, with an acceptable safety profile. Clinical outcomes may be influenced by attack phenotype, underscoring the importance of early intervention.
Real-World Effectiveness and Safety of Eculizumab in Aqp4-IgG Positive Neuromyelitis Optica Spectrum Disorder: A Multicenter Observational Study
(Sage Publications Ltd, 2025) Koc, Emine Rabia; Yetkin, Mehmet Fatih; Saridas, Furkan; Turan, Omer Faruk; Sevim, Serhan; Terzi, Murat; Siva, Aksel
Vaccination Strategies in Individuals With Multiple Sclerosis: Delphi Consensus
(Sage Publications Ltd, 2024) Cinar, Bilge Piri; Tuncer, Asli; Cetinkaya, Levent; Aluclu, Ufuk; Beckmann, Yesim; Boz, Cavid; Siva, Aksel
Vaccination Strategies in Multiple Sclerosis Patients With Delphi Methodology: A Turkish Consensus
(Asean Neurological Assoc, 2025) Cinar, Bilge Piri; Tuncer, Asli; Cetinkaya, Levent; Akbas, Oguz; Agalar, Canan; Aluclu, Mehmet Ufuk; Siva, Aksel
Background: Both the presence of multiple sclerosis (MS) and the use of immunomodulatory therapy for this disease can change the vaccine response in individuals with MS. In this study, due to the lack of guidelines for vaccination of MS patients in our country, the aim was to create a Delphi consensus on vaccination practices and vaccine types in MS patients. Methods: The Real-time Delphi technique, a more structured and predefined version of the traditional Delphi study was used to ensure a comprehensive research process. The stages of the structured online Delphi application process, which includes repeated rounds, (three rounds) are applied. Fifteen participants are sufficient to achieve homogeneous outcomes according to expertise criteria and in this study, the group comprised 31 experts who met these criteria and participated in all stages. Results: The assessment of the level of consensus among panelists revealed that there was "almost perfect consensus" on 16 items and "significant consensus" on 12 items. When examining the items in which the panelists did not reach a consensus, it was found that there was "minor consensus (slight-1)" on 1 item, and there was "no consensus (indicate poor-0)" on 2 items. Conclusion: We wanted to share a "country" practice and our current recommendations on vaccination strategies, by making use of articles containing country-based recommendations and working-group recommendations, as well as our national experiences.