Browsing by Author "Yetkin, Mehmet Fatih"

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Characteristics of Pain in Patients With NMOSD and MOGAD: Impact on Mental Health, Sleep and Quality of Life
(Springer-Verlag Italia S.R.L., 2025) Koç, Emine Rabia; Sarıdaş, Furkan; Yetkin, Mehmet Fatih; Bilge, Nuray; Dinç, Yasemin; Oǧuz Akarsu, Emel; Lazrak, Sarra Elhamida
Neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein-associated disease (MOGAD) are autoimmune disorders frequently accompanied by chronic, often neuropathic, pain, which significantly impacts the quality of life, sleep, and mental health. This study evaluated the incidence and characteristics of neuropathic pain in 106 patients with NMOSD or MOGAD and assessed its effects on mental health, sleep quality, and overall quality of life. Using clinical evaluation and MRI findings to localize lesions, pain classification revealed that chronic pain was more common in NMOSD patients (78.4%) than in MOGAD patients (52.7%), with a significant impact on both groups. Patients with MOGAD who experienced neuropathic pain reported notably poorer sleep quality and higher anxiety and depression levels. Pain severity was strongly associated with spinal cord lesion length and thoracic location, particularly in MOGAD patients. Current treatments provide insufficient pain relief, highlighting the need for more effective management strategies. This study emphasized that neuropathic pain substantially diminishes both physical and mental well-being in NMOSD and MOGAD patients, highlighting the importance of personalized pain management approaches to improve quality of life and mental health in these populations. © 2025 Elsevier B.V., All rights reserved.
Recurring Disease Activity in Relapsing Remitting Multiple Sclerosis: the Multicenter Rda-Rms Study
(Elsevier Sci Ltd, 2024) Tunc, Abdulkadir; Yetkin, Mehmet Fatih; Seferoglu, Meral; Inanc, Yilmaz; Sivaci, Ali Ozhan; Turkoglu, Sule Aydin; Altun, Yasar
Background: This study investigates the gap in understanding the dynamics of recurring disease activity (RDA) in RRMS patients after fingolimod (FGL) treatment discontinuation. The aim is to investigate RDA in RRMS patients after stopping FGL, aiming to improve management and comprehension of disease progression post-treatment. Methods: In this multicenter, retrospective study, data from 172 of 944 RRMS patients aged 18-55, across nine centers in Turkey, who discontinued FGL treatment, were analyzed. The collected data included EDSS scores, annualized relapse rates (ARR), lymphocyte counts, and MRI findings, with follow-up assessments conducted at 6 months, 1 year, and up to 2 years. Results: RDA was observed in 31.9 % of patients, with incidences of rebound and reactivation at 20.3 % and 11.6 %, respectively. Factors like younger age, longer treatment duration, lower lymphocyte counts, and higher lesion burden increased RDA risk. Notably, 52.9 % of pregnant patients experienced RDA (16.4 % of the overall RDA group), with rebound occurring in six and reactivation in three. Patients with RDA had longer medication-free intervals and increased ARR. Discontinuation reasons varied, with disease progression linked to a lower RDA risk. Conclusion: Findings highlight the necessity for personalized management and vigilant monitoring after FGL discontinuation in RRMS patients, offering critical insights into RDA risk factors, and the complex interplay between treatment cessation, pregnancy, and disease progression.
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; Pul, Refik
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.
Schisandrin B Treatment After Disease Induction Slightly Improved Experimental Autoimmune Encephalomyelitis
(Sage Publications Ltd, 2023) Yetkin, Mehmet Fatih; Erdem, Serife; Azizoglu, Zehra Busra; Demir, Busra Seniz; Acikgoz, Eda; Cakir, Mustafa; Eken, Ahmet