Browsing by Author "Tuncer, Asli"

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Comparative Efficacy of Rituximab Versus Azathioprine in the Treatment of MOG Antibody-Associated Disease (MOGAD)
(Elsevier, 2025) Sen, Sedat; Kurtuncu, Murat; Demir, Serkan; Gunduz, Tuncay; Demirel, Ezgi; Tutuncu, Melih; Tuncer, Asli
Background: Azathioprine (AZA) and rituximab (RTX) are frequently used drugs in the treatment of Myelin Oligodendrocyte Glycoprotein Associated Disease (MOGAD). Objectives: The aim of this study was to evaluate the efficacy and safety data of AZA and RTX treatments in MOGAD. Methods: Patients diagnosed according to the 2023 MOGAD diagnostic criteria and receiving AZA or RTX treatment were included in the study. Results: In 142 patients included in the study, the female/male value was 1.2. The rate of OCB positivity in MOGAD patients was 22.6 %. Patients on RTX had higher EDSS values than patients on AZA. However, the RTX group demonstrated a more pronounced improvement in disability, reflected by a greater negative trend in the Delta EDSS values. The attack-free rate was 78 % in the RTX group and 68 % in the AZA group during their treatment period. Both groups had no difference in the time of the first attack. The main factor affecting the time to first attack was having a higher EDSS at the time of treatment initiation. The survival analysis found that EDSS scores improved significantly in patients treated with RTX. Conclusion: Although survival analyses for both treatments appear to be similar, using RTX provides better EDSS scores.
A Rare Central Nervous System Involvement Due To Ctla-4 Gene Defect
(Turkish Neuropsychiatry Assoc-turk Noropsikiyatri dernegi, 2022) Rovshanov, Sahib; Gocmen, Rahsan; Barista, Ibrahim; Cagdas, Deniz; Uner, Aysegul; Cilingir, Vedat; Tuncer, Asli
Cytotoxic T-lymphocyte antigen-4 (CTLA-4) haploinsufficiency is the defect of one of the checkpoint inhibitory molecules and defined as a primary immunodeficiency characterized by immune dysregulation. A 26-year-old female with a history of autoimmune hemolytic anemia, autoimmune thrombocytopenia, and hypogammaglobulinemia was admitted with an inability to walk, urinary hesitancy, and bowel incontinence. Neurological examination revealed mild weakness, pyramidal, and deep sensorial involvement of the left lower extremity. Brain MRI revealed periventricular, juxtacortical, and cerebellar inflammatory lesions. Thoracic spinal MRI showed a longitudinaly extensive cord lesion. Additionally, thoracal CT showed parenchymal opacities and bilateral hilar lymph nodes. The biopsy from mediastinal lymph nodes and lung parenchyma demonstrated a low-grade lymphoproliferation and grade 1 "Lymphomatoid granulomatosis". Detailed laboratory analyses indicated the diagnosis of `'common variable immunodeficiency''. Next-generation sequencing with primary immunodeficiency panel revealed a heterozygous mutation in CTLA4 (c.436G>A(p.G146R)(p.Gly146Arg)). After molecular diagnosis, abatacept therapy was started as a targeted therapeutic approach with subcutaneous immunoglobulin therapy.
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