Contributions
Abstract: EP1382
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - MS symptoms
Background: The prevalence of trigeminal neuralgia (TN) in the Multiple Sclerosis (MS) population has been reported to be between 1 and 6%, which is 20-fold higher than in the general population. To date, there is a lack of robust scientific evidence on the optimal medical/surgical treatment of patients.
Objective: Aim of the present Italian, cross-sectional, multicentre survey was to gather information on the current treatment modalities and options of MS-related TN across Italian MS centres.
Methods and Materials: Neurologists members of the RIREMS (Rising Researchers in MS) group were asked to fill out a questionnaire on the management of MS-related TN at their MS centre. Collected data included: medications prescribed at any time and as a first choice, availability of surgical options, number of patients with TN seen in the previous two years and proportion of these who had undergone surgery.
Results: Twenty-two MS centres completed the questionnaire. The median number of patients with TN per centre was 11 (interquartile range: 7-20), equal to 1.2% (0.8-2.8%) of all patients seen in the preceding two years. The most frequent first-choice symptomatic treatments were opioids (in 27% of centres), intravenous (27%) and oral (27%) steroids. First-choice preventive treatments were carbamazepine (in 77% of centres) and oxcarbazepine (23%). Carbamazepine was prescribed at least once by all centers, followed by pregabalin (96% of centres), gabapentin (91%) and oxcarbazepine (77%). A median of 24% (13-33%) of patients per center had undergone at least one surgical procedure and, of these, 27% underwent at least one repeat surgical procedure. Microvascular decompression was the most commonly available procedure (in 59% of centres), followed by percutaneous balloon compression (27%), glycerol rhizotomy (27%), radiofrequency thermocoagulation (27%) and gamma knife stereotactic radiosurgery (23%). Surgical procedures were unavailable in six centres (27%). TN pain exacerbations were considered MS relapses and treated with intravenous steroids by 52% of centres. Two centres (9%) use a visual analog scale to assess response to treatment.
Conclusion: Medical treatment approach to MS-related TN was fairly homogeneous throughout Italian centres, while the frequency and types of available surgical procedures, which were unavailable in almost one third of centers, varied considerably. None of the centers use pain scoring questionnaires to assess response to treatment.
Disclosure: DF has served on advisory boards for Biogen, Roche and Novartis and has received travel grants and/or speaker honoraria from MerckSerono, Teva, Biogen, Sanofi-Genzyme and Novartis. PA has served on advisory boards and/or has received travel grants and/or speaker honoraria from MerckSerono, Roche, Teva Italia, Biogen, Mylan, Almirall, Sanofi-Genzyme and Novartis.
RL received travel funding and speaker or consultancy honoraria from Biogen, Novartis, Sanofi , Teva, Roche, Merck
MC: honoraria for research or speaking from Sanofi-Genzyme, Merck-Serono, Biogen Idec, Bayer, Novartis Pharma and funds for travel from Sanofi-Genzyme, Merck-Serono, Biogen Idec, Teva, Novartis Pharma, Roche and Bayer.
RF has nothing to disclose
CC: advisory board and/or speaker honoraria from Novartis, TEVA, Biogen, Merck Serono, Genzyme.
GDL has served on advisory boards and/or has received travel grants and/or speaker honoraria from MerckSerono, Roche, Teva Italia, Biogen, Almirall, Sanofi-Genzyme and Novartis
DP has received honoraria for consultancy and/or speaking from Biogen Idec, Merck-Serono, Sanofi-Aventis, TEVA, Bayer-Schering, Novartis and Genzyme
PR has served on advisory boards for Biogen, Roche, TEVA, Sanophy-Genzyme, Merck, and Novartis and has received travel grants and/or speaker honoraria from Merck Serono, Teva, Biogen, Sanofi, Genzyme and Novartis.
AlG has served on advisory boards for Merck. He has received travel support from Biogen and Merck. He has received research support from Merck, Novartis, and Teva
SLF attended advisory boards and/or has received travel grants and/or speaker honoraria from MerckSerono, Teva Italia, Biogen, Sanofi-Genzyme and Novartis
PC has served on advisory boards and/or has received travel grants and/or speaker honoraria from Merck Serono, Teva Italia, Biogen, Almirall, Novartis, Sanofi-Genzyme
CT has served on advisory boards and/or has received travel grants and/or speaker honoraria from Merck Serono, Roche, Teva Italia, Biogen, Almirall, Novartis, Sanofi-Genzyme.
IP has nothing to disclose
An G: speaker and consulting fees from Biogen, Sanofi-Genzyme, Merck Serono and Teva
FP has nothing to disclose.
VC has nothing to disclose.
MDF participated to advisory boards and received speaker/writing honoraria and funding for traveling from: Bayer, Biogen Idec, Genzyme, Merck, Novartis, Roche and Teva.
GTM has served on advisory boards and/or received travel grants and speaker honoraria from Almirall, Biogen, Merck Serono, Novartis and Teva
VN has served on advisory boards for Biogen, Teva, Sanofi-Genzyme and MerckSerono and has received travel grants and/or speaker honoraria from MerckSerono, Teva, Biogen, Sanofi-Genzyme Roche and Novartis.
MR has served has received travel grants and/or speaker honoraria from Merck Serono, Teva Italia, Biogen, Novartis, Sanofi-Genzyme
VT has nothing to disclose
MCB served on advisory boards and/or has received travel grants and/or speaker honoraria from Merck, Roche, Teva Italia, Biogen, Almirall, Sanofi-Genzyme and Novartis.
EC has served on advisory boards and/or has received travel grants and/or speaker honoraria from Bayer, Merck, Roche, Teva, Biogen, Almirall, Novartis, Genzyme.
CG has served on advisory boards and/or has received travel grants and/or speaker honoraria from Merck Serono, Roche, Teva Italia, Biogen, Almirall, Novartis, Sanofi-Genzyme.
CS has served on advisory boards and/or has received travel grants and/or speaker honoraria from Merck Serono, Roche, Teva Italia, Biogen, Almirall, Sanofi-Genzyme.
Abstract: EP1382
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - MS symptoms
Background: The prevalence of trigeminal neuralgia (TN) in the Multiple Sclerosis (MS) population has been reported to be between 1 and 6%, which is 20-fold higher than in the general population. To date, there is a lack of robust scientific evidence on the optimal medical/surgical treatment of patients.
Objective: Aim of the present Italian, cross-sectional, multicentre survey was to gather information on the current treatment modalities and options of MS-related TN across Italian MS centres.
Methods and Materials: Neurologists members of the RIREMS (Rising Researchers in MS) group were asked to fill out a questionnaire on the management of MS-related TN at their MS centre. Collected data included: medications prescribed at any time and as a first choice, availability of surgical options, number of patients with TN seen in the previous two years and proportion of these who had undergone surgery.
Results: Twenty-two MS centres completed the questionnaire. The median number of patients with TN per centre was 11 (interquartile range: 7-20), equal to 1.2% (0.8-2.8%) of all patients seen in the preceding two years. The most frequent first-choice symptomatic treatments were opioids (in 27% of centres), intravenous (27%) and oral (27%) steroids. First-choice preventive treatments were carbamazepine (in 77% of centres) and oxcarbazepine (23%). Carbamazepine was prescribed at least once by all centers, followed by pregabalin (96% of centres), gabapentin (91%) and oxcarbazepine (77%). A median of 24% (13-33%) of patients per center had undergone at least one surgical procedure and, of these, 27% underwent at least one repeat surgical procedure. Microvascular decompression was the most commonly available procedure (in 59% of centres), followed by percutaneous balloon compression (27%), glycerol rhizotomy (27%), radiofrequency thermocoagulation (27%) and gamma knife stereotactic radiosurgery (23%). Surgical procedures were unavailable in six centres (27%). TN pain exacerbations were considered MS relapses and treated with intravenous steroids by 52% of centres. Two centres (9%) use a visual analog scale to assess response to treatment.
Conclusion: Medical treatment approach to MS-related TN was fairly homogeneous throughout Italian centres, while the frequency and types of available surgical procedures, which were unavailable in almost one third of centers, varied considerably. None of the centers use pain scoring questionnaires to assess response to treatment.
Disclosure: DF has served on advisory boards for Biogen, Roche and Novartis and has received travel grants and/or speaker honoraria from MerckSerono, Teva, Biogen, Sanofi-Genzyme and Novartis. PA has served on advisory boards and/or has received travel grants and/or speaker honoraria from MerckSerono, Roche, Teva Italia, Biogen, Mylan, Almirall, Sanofi-Genzyme and Novartis.
RL received travel funding and speaker or consultancy honoraria from Biogen, Novartis, Sanofi , Teva, Roche, Merck
MC: honoraria for research or speaking from Sanofi-Genzyme, Merck-Serono, Biogen Idec, Bayer, Novartis Pharma and funds for travel from Sanofi-Genzyme, Merck-Serono, Biogen Idec, Teva, Novartis Pharma, Roche and Bayer.
RF has nothing to disclose
CC: advisory board and/or speaker honoraria from Novartis, TEVA, Biogen, Merck Serono, Genzyme.
GDL has served on advisory boards and/or has received travel grants and/or speaker honoraria from MerckSerono, Roche, Teva Italia, Biogen, Almirall, Sanofi-Genzyme and Novartis
DP has received honoraria for consultancy and/or speaking from Biogen Idec, Merck-Serono, Sanofi-Aventis, TEVA, Bayer-Schering, Novartis and Genzyme
PR has served on advisory boards for Biogen, Roche, TEVA, Sanophy-Genzyme, Merck, and Novartis and has received travel grants and/or speaker honoraria from Merck Serono, Teva, Biogen, Sanofi, Genzyme and Novartis.
AlG has served on advisory boards for Merck. He has received travel support from Biogen and Merck. He has received research support from Merck, Novartis, and Teva
SLF attended advisory boards and/or has received travel grants and/or speaker honoraria from MerckSerono, Teva Italia, Biogen, Sanofi-Genzyme and Novartis
PC has served on advisory boards and/or has received travel grants and/or speaker honoraria from Merck Serono, Teva Italia, Biogen, Almirall, Novartis, Sanofi-Genzyme
CT has served on advisory boards and/or has received travel grants and/or speaker honoraria from Merck Serono, Roche, Teva Italia, Biogen, Almirall, Novartis, Sanofi-Genzyme.
IP has nothing to disclose
An G: speaker and consulting fees from Biogen, Sanofi-Genzyme, Merck Serono and Teva
FP has nothing to disclose.
VC has nothing to disclose.
MDF participated to advisory boards and received speaker/writing honoraria and funding for traveling from: Bayer, Biogen Idec, Genzyme, Merck, Novartis, Roche and Teva.
GTM has served on advisory boards and/or received travel grants and speaker honoraria from Almirall, Biogen, Merck Serono, Novartis and Teva
VN has served on advisory boards for Biogen, Teva, Sanofi-Genzyme and MerckSerono and has received travel grants and/or speaker honoraria from MerckSerono, Teva, Biogen, Sanofi-Genzyme Roche and Novartis.
MR has served has received travel grants and/or speaker honoraria from Merck Serono, Teva Italia, Biogen, Novartis, Sanofi-Genzyme
VT has nothing to disclose
MCB served on advisory boards and/or has received travel grants and/or speaker honoraria from Merck, Roche, Teva Italia, Biogen, Almirall, Sanofi-Genzyme and Novartis.
EC has served on advisory boards and/or has received travel grants and/or speaker honoraria from Bayer, Merck, Roche, Teva, Biogen, Almirall, Novartis, Genzyme.
CG has served on advisory boards and/or has received travel grants and/or speaker honoraria from Merck Serono, Roche, Teva Italia, Biogen, Almirall, Novartis, Sanofi-Genzyme.
CS has served on advisory boards and/or has received travel grants and/or speaker honoraria from Merck Serono, Roche, Teva Italia, Biogen, Almirall, Sanofi-Genzyme.