[Usefulness of electronic drug registers: Spanish register of patients treated with fingolimod (Gilenya ®)]

Rev Neurol. 2014 Jan 16;58(2):77-83.
[Article in Spanish]

Abstract

Introduction: This study outlines the design of an electronic register of patients with multiple sclerosis who began treatment with fingolimod in Spain. The system is intended to serve as a tool to monitor its utilisation in daily clinical practice and thus allow optimisation of the way it is used.

Aims: To establish the profile of patients with multiple sclerosis undergoing treatment with fingolimod and to determine the effectiveness and safety of this treatment in daily clinical practice.

Development: An observation-based, retrospective and prospective, multi-centre registry is set up, which will be active for five years. Forty neurologists working in Spain will participate in the project. Patients treated with fingolimod who fulfil the selection criteria will be included in the study. The effectiveness variables that will be evaluated are: disability measured by means of the Expanded Disability Status Scale, the rate of attacks, T1 gadolinium-enhancing lesions and new lesions in T2, and the percentage of patients who were free of activity and those who require concomitant treatments. The tolerability variables that will be evaluated are: the rate of patients who present events and adverse reactions, respectively, with a separate analysis of those presenting after the first dose or that are related to the fingolimod risk management plan and the treatment dropout rate.

Conclusions: New pharmaceuticals that have only recently been commercialised require more information about their effectiveness and safety, beyond the controlled environment of a clinical trial. Initiatives involving electronic registries such as the Gilenya register are a solution that can respond to such needs by providing information in the shortest possible time about the most suitable management in order to be able to make the best and most efficient use of it.

Title: Utilidad de los registros electronicos de medicamentos: registro español de pacientes tratados con fingolimod (Gilenya ®).

Introduccion. Se describe el diseño de un registro electronico de los pacientes con esclerosis multiple que inician tratamiento con fingolimod en España, que se plantea como una herramienta para monitorizar su manejo en la practica clinica habitual que permita optimizar su uso. Objetivos. Conocer el perfil de los pacientes con esclerosis multiple en tratamiento con fingolimod y determinar la efectividad y seguridad de este tratamiento en la practica clinica habitual. Desarrollo. Se establece un registro observacional, retrospectivo y prospectivo, multicentrico, que estara activo durante cinco años. Participaran 40 neurologos de España. Se incluiran pacientes tratados con fingolimod que cumplan los criterios de seleccion. Las variables de efectividad que se evaluaran son: la discapacidad medida mediante la escala ampliada del estado de discapacidad, la tasa de brotes, las lesiones captantes de gadolinio en secuencia T1 y las lesiones nuevas en secuencia T2, y el porcentaje de pacientes libres de actividad y aquellos que requieran tratamientos concomitantes. Las variables de seguridad que se evaluaran son: la tasa de pacientes que presenten acontecimientos y reacciones adversas, respectivamente, analizandose separadamente aquellos que se presenten tras la primera dosis o relacionados con el plan de manejo del riesgo de fingolimod, y la tasa de abandonos del tratamiento. Conclusiones. Los nuevos farmacos de reciente comercializacion requieren mayor informacion acerca de su efectividad y seguridad, mas alla del entorno controlado de un ensayo clinico. Las iniciativas de registros electronicos como el registro Gilenya son la solucion para dar respuesta a dicha necesidad, proporcionando informacion en el menor tiempo posible acerca del manejo mas adecuado para conseguir su uso mas optimo y eficiente posible.

Publication types

  • English Abstract
  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain / drug effects
  • Brain / pathology
  • Confidentiality
  • Drug Prescriptions / statistics & numerical data
  • Drug Utilization
  • Electronic Health Records*
  • Fingolimod Hydrochloride
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use*
  • Informed Consent
  • Magnetic Resonance Imaging
  • Multiple Sclerosis / drug therapy*
  • Multiple Sclerosis / pathology
  • Patient Dropouts
  • Practice Patterns, Physicians'
  • Product Surveillance, Postmarketing / methods*
  • Product Surveillance, Postmarketing / statistics & numerical data
  • Propylene Glycols / adverse effects
  • Propylene Glycols / therapeutic use*
  • Prospective Studies
  • Registries*
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Socioeconomic Factors
  • Spain
  • Sphingosine / adverse effects
  • Sphingosine / analogs & derivatives*
  • Sphingosine / therapeutic use
  • Treatment Outcome

Substances

  • Immunosuppressive Agents
  • Propylene Glycols
  • Fingolimod Hydrochloride
  • Sphingosine