Serkan Ozakbas

Dokuz Eylul University | DEÜ · Faculty of Medicine

Background: The prognostic significance of non-disabling relapses in people with relapsing-remitting multiple sclerosis (RRMS) is unclear. Objective: To determine whether early non-disabling relapses predict disability accumulation in RRMS. Methods: We redefined mild relapses in MSBase as 'non-disabling', and moderate or severe relapses as 'di...

Background: In the absence of evidence from randomised controlled trials, observational data can be used to emulate clinical trials and guide clinical decisions. Observational studies are, however, susceptible to confounding and bias. Among the used techniques to reduce indication bias are propensity score matching and marginal structural models....

Background: This study assessed the effect of patient characteristics on the response to disease modifying therapy (DMT) in in multiple sclerosis (MS). Methods: We extracted data from 61,810 patients from 135 centres across 35 countries from the MSBase registry. The selection criteria were: clinically isolated syndrome or definite MS; follow-up...

Background Fingolimod, natalizumab, and ocrelizumab are commonly used in the second-line treatment of relapsing-remitting multiple sclerosis (RRMS). However, these have only been compared in observational studies, not in controlled trials, with limited and inconclusive results being reported. A comparison of their effect on relapse and disability i...

Background: Patients with relapsing-remitting multiple sclerosis (RRMS) who experience relapses on a first-line therapy (interferon, glatiramer acetate, dimethyl fumarate, or teriflunomide; collectively, "BRACETD") often switch to another therapy, including natalizumab or fingolimod. Here we compare the effectiveness of switching from a first-line...

Background Restless legs syndrome (RLS) is a sensory-motor disorder characterized by an uncomfortable sensation in the lower extremity, triggered by sitting and lying positions and release with motion. There is strong evidence that RLS prevalence is higher in persons with multiple sclerosis (MS, pwMS) than in the general population. Current literat...

Background: Effectiveness of cladribine tablets, an oral disease-modifying treatment (DMT) for multiple sclerosis (MS), was established in clinical trials and confirmed with real-world experience. Objectives: Use real-world data to compare treatment patterns and clinical outcomes in people with MS (pwMS) treated with cladribine tablets versus ot...

Background To compare the effectiveness and treatment persistence of ocrelizumab, cladribine and natalizumab in patients with relapsing–remitting multiple sclerosis switching from fingolimod. Methods Using data from MSBase registry, this multicentre cohort study included subjects who had used fingolimod for ≥6 months and then switched to ocrelizum...

Background and Objectives Patients with pediatric-onset multiple sclerosis (POMS) typically experience higher levels of inflammation with more frequent relapses and reach irreversible disability at a younger age than adult-onset patients. There have been few randomized placebo-controlled clinical trials of multiple sclerosis (MS) disease-modifying...

Background Early recognition of markers of faster disability worsening in paediatric-onset multiple sclerosis (MS) is a key requisite of personalised therapy for children with MS at the earliest possible time. Objective To identify early predictors of rapid disability accrual in patients with paediatric-onset MS. Methods Using the global MSBase r...

Background and objectives: Certain demographic and clinical characteristics, including the use of some disease-modifying therapies (DMTs), are associated with severe acute respiratory syndrome coronavirus 2 infection severity in people with multiple sclerosis (MS). Comprehensive exploration of these relationships in large international samples is...

Objectives To evaluate the rate of return of disease activity after cessation of multiple sclerosis (MS) disease-modifying therapy. Methods This was a retrospective cohort study from two large observational MS registries: MSBase and OFSEP. Patients with relapsing-remitting MS who had ceased a disease-modifying therapy and were followed up for the...

Objectives and aims : Disease modifying therapies used in multiple sclerosis can decrease humoral response after COVID-19 vaccines. This problem must be adequately addressed because new variants evolve, and COVID-19 still poses a risk to patients with comorbidities and immunosuppression. We aimed to evaluate the antibody response after the third do...

Background Epstein-Barr virus is considered a risk factor for the development of multiple sclerosis, and recent findings reveal infected plasma -cells in meningeal ectopic lymphoid deposits. Activation of the dormant virus could be responsible for the multiple sclerosis exacerbation Aims To compare Epstein-Barr nuclear IgG (EBNA IgG) titer in newl...

Background Interferon-β, a disease-modifying therapy (DMT) for MS, may be associated with less severe COVID-19 in people with MS. Results Among 5,568 patients (83.4% confirmed COVID-19), interferon-treated patients had lower risk of severe COVID-19 compared to untreated, but not to glatiramer-acetate, dimethyl-fumarate, or pooled other DMTs. Conc...

Background Natalizumab and fingolimod are used as high-efficacy treatments in relapsing–remitting multiple sclerosis. Several observational studies comparing these two drugs have shown variable results, using different methods to control treatment indication bias and manage censoring. The objective of this empirical study was to elucidate the impac...

Background There is no information about the effects and usability of rehabilitation during corticosteroid treatment. This randomized clinical trial was conducted to evaluate and compare the effects and safety of exergaming and conventional rehabilitation (CR) on persons with multiple sclerosis (MS, pwMS) during corticosteroid treatment. Methods Th...

Background: Prevention of disability over the long-term is the main treatment goal in multiple sclerosis (MS), however, randomized clinical trials evaluate only short-term treatment effects on disability. This study aimed to define criteria for 6-month confirmed disability progression events of MS with a high probability of resulting in sustained...

Background and Objectives The severity of multiple sclerosis (MS) varies widely among individuals. Understanding the determinants of this heterogeneity will help clinicians optimize the management of MS. The aim of this study was to investigate the association between latitude of residence, ultraviolet B radiation exposure (UVB) and the severity of...

Purpose To translate Preference-Based Multiple Sclerosis Index (PBMSI) into Turkish, investigate its psychometric properties and differences between its two scoring algorithms: PBMSI-Rating Scale (PBMSI-RS) and PBMSI-Standard Gamble (PBMSI-SG). Methods An expert committee supervised the translation process. Psychometric properties were evaluated i...

Background The MSBase prediction model of treatment response leverages multiple demographic and clinical characteristics to estimate hazards of relapses, confirmed disability accumulation (CDA), and confirmed disability improvement (CDI). The model did not include Multiple Sclerosis Severity Score (MSSS), a disease duration-adjusted ranked score of...

Background Even though the prevalence of restless leg syndrome in multiple sclerosis (MS) is known to vary between 12.5% and 60%, the underlying pathophysiological mechanism remains unclear. Aim This study aims to investigate the relationship between spinal cord lesions and restless leg syndrome in MS. Materials and Methods In total, 959 persons wi...

Background: Multiple sclerosis (MS) is an immune-mediated disorder of the central nervous system. DMTs effectively reduce the annual relapse rate-thus reducing disease activity-and, to a lesser extent, some DMTs prevent disease progression in some people with MS. Monitoring the efficacy of DMTs with no evidence disease activity (NEDA) provides an...

Background: Disease-modifying therapy could weaken the immune system and decrease the immune response to vaccines. It is essential to know which vaccine is more protective against SARS-CoV-2 in the multiple sclerosis population. Objective: To assess immune response after messenger RNA BNT162b2 (Pfizer/BioNTech) and inactivated Sinovac vaccines in p...

Background Examining leisure-time physical activity in people with multiple sclerosis (PwMS) from different environmental backgrounds might increase understanding and awareness of inactivity in PwMS. Therefore, the study objective was twofold; to compare the level of physical activity in PwMS in Israel and Turkey and to examine the relationship bet...

Objective: Previous studies have reported that people with obesity have slower walking speed, poor balance control, and more energy expenditure during gait than patients without obesity. However, little is known about the effect of obesity on walking and balance control in people with multiple sclerosis (MS). This study aimed to investigate the ass...

Objective: The mandatory restrictions during the Coronavirus disease-2019 (COVID-19) pandemic in regular physical activity and exercise affected the daily life of millions of people. Changes due to the COVID-19 outbreak in persons with multiple sclerosis (pwMS) are unknown. Therefore, this study aimed to examine the effects of the COVID-19 outbreak...

Objective: Falls and spasticity are among the most prevalent complaints in persons with multiple sclerosis (pwMS). Limited evidence exists on the direct relationship between lower limb spasticity and falls in pwMS. This study aimed to explore the association between lower limb spasticity, walking, and falls in pwMS. Materials and Methods: Thirty-ni...

Background COVID-19 is a multisystemic infection with variables consequences depending on individual and comorbid conditions. The course and outcomes of COVID-19 during neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disorders (MOGAD) are not clearly known. Objective/Methods The aim of th...

OBJECTIVE Restless legs syndrome is one of the most reported sleep disorders in multiple sclerosis (MS). The study aims to investigate the possible factors related to the occurrence and severity of restless legs syndrome in persons with MS (pwMS) comparing with healthy controls. METHODS This is a case-control study that included 447 pwMS and 57 hea...

Background Coronavirus disease of the 2019 pandemic caused much fear among people with chronic diseases and those on immunosuppressant treatment because of spreading knowledge that the infection has a fatal course in these populations. People with Multiple Sclerosis on ocrelizumab treatment share this fear too. We aimed to investigate treatment and...

Background People with multiple sclerosis (MS) are a vulnerable group for severe COVID- 19, particularly those taking immunosuppressive disease-modifying therapies (DMTs). We examined the characteristics of COVID-19 severity in an international sample of people with MS. Methods Data from 12 data-sources in 28 countries were aggregated (sources cou...

IntroductionNatalizumab has proved to be more effective than fingolimod in reducing disease activity in relapsing-remitting multiple sclerosis (RRMS). Whether this association is universal for all patient groups remains to be determined.Objective The aim of this study was to compare the relative effectiveness of natalizumab and fingolimod in RRMS s...

Background Short-term outcomes of optic neuritis (ON) have been well characterized. Limited data exists on longer-term visual outcomes in patients who present with ON. The large MSBase registry allows for characterization of long-term visual outcomes after ON. Methods Via the MSBase Registry, data on patients from 41 centers was collected during r...

Background: Examining physical activity in people with multiple sclerosis (PwMS) from different environmental backgrounds might increase understanding and awareness of inactivity in PwMS. Objectives: To compare the level of physical activity in PwMS in Israel and Turkey and to examine the relationship between the level of physical activity with com...

Objective To investigate pregnancy-related disease activity in a contemporary multiple sclerosis (MS) cohort. Methods Data were obtained from the MSBase Registry. Term/preterm pregnancies conceived from 2011-2019 were included (modern cohort). Annualised relapse rates (ARR) were calculated before, during and after pregnancy. Predictors of intrapar...

Background Methodological challenges limit the use of brain atrophy and lesion burden measures in the follow-up of multiple sclerosis (MS) patients on clinical routine datasets. Objective To determine the feasibility of T2-FLAIR-only measures of lateral ventricular volume (LVV) and salient central lesion volume (SCLV), as markers of disability pro...

Objective To compare the clinical effectiveness of high- and low-efficacy treatments in patients with recently active and inactive secondary progressive multiple sclerosis (SPMS) after accounting for therapeutic lag. Methods Patients treated with high- (natalizumab, alemtuzumab, mitoxantrone, ocrelizumab, rituximab, cladribine, fingolimod) or low-...

Background The multiple sclerosis (MS) landscape has changed over the past two decades across the world and in the Middle East. The Middle East is an ethnically diverse region located between 12° and 42° of latitude and 35° and 54° of longitude and varying altitudes. The magnitude of the shifts observed in the epidemiology and management of MS diff...

Background Natalizumab and fingolimod were the first preparations recommended for disease breakthrough in priorly treated relapsing-remitting multiple sclerosis. Of three published head-to-head studies two showed that natalizumab is the more effective to prevent relapses and EDSS worsening. Methods By re-analyzing original published results from M...

Background and objectives: Research in Multiple Sclerosis (MS) has recently focused on extracting knowledge from real-world clinical data sources. This type of data is more abundant than data produced during clinical trials and potentially more informative about real-world clinical practice. However, this comes at the cost of less curated and cont...

Background: The pandemic of the new type of corona virus infection 2019 [Covid19] also affect people with Multiple Sclerosis (pwMS). Currently, the accumulating information on the effects of the infection regarding the demographic and clinical characteristics of the disease, as well as outcomes within different DMTs¸ enable us to have better practi...

Objective To investigate pregnancy-related disease activity in a contemporary multiple sclerosis (MS) cohort. Methods Using data from the MSBase Registry, we included pregnancies conceived after 31 Dec 2010 from women with relapsing-remitting MS or clinically isolated syndrome. Predictors of intrapartum relapse, and postpartum relapse and disabili...

INTRODUCTION: Impairment in the lower extremity function and mobility is a symptom often among people with multiple sclerosis (pwMS), even in the absence of clinical disability. Fatigue is one of the most common symptoms reported by at least 80% of pwMS during any disease. This study investigated the relationship between fatigue and lower extremity...

INTRODUCTION: There is scarce data on the utility of the short version of the Activities-specific Balance Confidence Scale in persons with multiple sclerosis (pwMS). Thus, this study aimed to expand the validity of the ABC-6 scale and compare it with the original version of the 16-item ABC scale (ABC-16) in pwMS. METHODS: In total, 156 patients wer...

Background The pandemic of the new type of corona virus infection 2019 [Covid-19] also affect people with Multiple Sclerosis (pwMS). Currently, the accumulating information on the effects of the infection regarding the demographic and clinical characteristics of the disease, as well as outcomes within different DMTs¸ enable us to have better practi...

Background Neuromyelitis optica spectrum disorders (NMOSD) are a group of antibody‐mediated chronic inflammatory diseases of the central nervous system. Rituximab is a monoclonal antibody that leads to a reduction in disease activity. Objectıve To evaluate the efficacy of rituximab as monotherapy in NMOSD and to determine whether the efficacy vari...

Background People with multiple sclerosis (MS) are a vulnerable group for severe COVID-19, particularly those taking immunosuppressive disease-modifying therapies (DMTs). We examined the characteristics of COVID-19 severity in an international sample of people with MS. Methods Data from 12 data-sources in 28 countries were aggregated. Demographic...

Background Cognitive reserve (CR) is the ability to counteract brain damage through differential recruitment of brain networks. Besides, it has also been observed that lifetime intellectual enriching skills reduce the effect of disease burden on cognitive status. The Cognitive Reserve Index questionnaire (CRIq), which is a method for the quantitati...

Background Falls are common in persons with Multiple Sclerosis (pwMS) and lead to destructive results, specifically with increasing disability. However, there is only scarce data investigating prevalence and determinants of falls in pwMS without a clinical disability. Therefore, this study aimed to investigate proportion of fallers and related fact...

Background A delayed onset of treatment effect, termed therapeutic lag, may influence the assessment of treatment response in some patient subgroups. Objectives The objective of this study is to explore the associations of patient and disease characteristics with therapeutic lag on relapses and disability accumulation. Methods Data from MSBase, a...

Objective The Manual Ability Measure-36 (MAM-36) has been used to assess subjective upper limb function in people with several neurological and non-neurological diseases. Besides, the MAM-36 is one of the most commonly used patient-reported outcome measures (PROMs) in people with multiple sclerosis (pwMS). The aim was to translate and conduct cross...

Research in Multiple Sclerosis (MS) has recently focused on extracting knowledge from real-world clinical data sources. This type of data is more abundant than data produced during clinical trials and potentially more informative about real-world clinical practice. However, this comes at the cost of less curated and controlled data sets. In this wo...

Objective: Impaired balance is one of the most important risk factors for falls in persons with multiple sclerosis (pwMS). The aim was to evaluate balance and gait performance in pwMS with the absence of clinical disability (pwMS-AD) compared with pwMS with minimal disability (MD) and healthy controls (HC). Materials and Methods: Nineteen pwMS-AD w...

Objective: To compare the effectiveness of glatiramer acetate (GA) vs intra-muscular Interferon beta-1a (IFNbeta-1a)), we applied a previously published statistical method, aimed at identifying patients' profiles associated with efficacy of treatments. Methods: Data from 2 independent multiple sclerosis datasets, a randomized study (the CombiRx...

In multiple sclerosis, treatment start or switch is prompted by evidence of disease activity. Whilst immunomodulatory therapies reduce disease activity, the time required to attain maximal effect is unclear. In this study we aimed to develop a method that allows identification of the time to manifest fully and clinically the effect of multiple scle...

Objective The purpose was to investigate the effects of yoga and clinical Pilates training on walking, respiratory muscle strength, cognition, and quality of life and compare the effects of two popular exercise methods in persons with multiple sclerosis (pwMS). Methods Twenty-eight pwMS (Pilates group = 16, yoga group = 12) received the program on...

Background The magnetic resonance imaging in multiple sclerosis (MAGNIMS) score combines relapses and magnetic resonance imaging (MRI) lesions to predict disability outcomes in relapsing–remitting multiple sclerosis (RRMS) treated with interferon-β. Objective To validate the MAGNIMS score and extend to other disease-modifying therapies (DMTs). To...

Background Cerebellar and brainstem symptoms are common in early stages of multiple sclerosis (MS) yet their prognostic values remain unclear. Objective The aim of this study was to investigate long-term disability outcomes in patients with early cerebellar and brainstem symptoms. Methods This study used data from MSBase registry. Patients with e...

Patients with the 'aggressive' form of multiple sclerosis accrue disability at an accelerated rate, typically reaching Expanded Disability Status Score (EDSS) ≥ 6 within 10 years of symptom onset. Several clinicodemographic factors have been associated with aggressive multiple sclerosis, but less research has focused on clinical markers that are pr...

Background Balance confidence is considered a psychological element of falls and balance-demanding activities. The relationship of balance confidence with physical factors has been investigated; however, psychosocial correlates are not well known. The aim was to investigate the relationship between balance confidence and physical and psychosocial f...

Smoking is associated with increased multiple sclerosis (MS) risk. In addition, some studies have reported that smoking is associated with anxiety and depression. However, the associations between smoking, walking, and fatigue are needed to be investigated. The objective was to investigate the associations between cigarette smoking and walking, fat...

Background : Developments in rehabilitation technology such as video-based exergaming contributes to the treatment process as well as to increase the active participation of persons with multiple sclerosis (pwMS). The aim was to investigate the effect of video-based exergaming training on upper extremity and cognitive function as well as core stabi...

Background: Aquaporin-4-IgG positive (AQP4-IgG+) Neuromyelitis Optica Spectrum Disorder (NMOSD) is an uncommon central nervous system autoimmune disorder. Disease outcomes in AQP4-IgG+NMOSD are typically measured by relapse rate and disability. Using the MSBase, a multi-centre international registry, we aimed to examine the impact immunosuppressiv...

Amaç: Klinik izole sendromda (KİS) bilişsel profil sıklıkla bilgi işleme ve çalışma belleği yetersizliği ile karakterizedir. Bu çalışmada; KİS’li bireylerdeki bilişsel etkilenmenin özelliklerini ve sıklığını sağlıklı kontrollerle karşılaştırarak araştırmak amaçlanmıştır. Gereç ve Yöntem: Hastalara PASAT, COWAT, Stroop testi, RAVLT, Benton Çizgi Yö...

Objectives: Premenstrual worsening has been often complained by patients with multiple sclerosis (MS). However, there is no quantitative study in the literature regarding premenstrual worsening and there are only a few studies for its reasons. In diseases such as MS, which there are limited evidence about the etiology and the triggers, detection o...