DAGOBERTO CALLEGARO

(Fonte: Lattes)
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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina

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Autor: APOSTOLOS-PEREIRA, Samira Luisa × Autor e Coautores FMUSP-HC Normalizados: ANA BEATRIZ AYROZA GALVAO RIBEIRO GOMES × Autor e Coautores FMUSP-HC Normalizados: SAMIRA LUISA DOS APOSTOLOS PEREIRA × Tipo de produção: article ×

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  • article 4 Citação(ões) na Scopus
    Long-term safety of azathioprine for treatment of neuromyelitis optica spectrum disorders
    (2021) GOMES, Ana Beatriz Ayroza Galvao Ribeiro; PITOMBEIRA, Milena Sales; SATO, Douglas Kazutoshi; CALLEGARO, Dagoberto; APOSTOLOS-PEREIRA, Samira Luisa
    Background: Azathioprine is a common first-line therapy for neuromyelitis optica spectrum disorder (NMOSD). Objective: The aim of this study was to determine whether long-term treatment (>10 years) with azathioprine is safe in NMOSD. Methods: We conducted a retrospective medical record review of all patients at the School of Medicine of the University of Sao Paulo (Sao Paulo, Brazil) who fulfilled the 2015 international consensus diagnostic criteria for NMOSD and were treated with azathioprine for at least 10 years. Results: Out of 375 patients assessed for eligibility, 19 were included in this analysis. These patients' median age was 44 years (range=28-61); they were mostly female (17/19) and AQP4-IgG seropositive (18/19). The median disease duration was 15 years (range=10-39) and most patients presented a relapsing clinical course (84.2%). The median duration of treatment was 11.9 years (range=10.0-23.8). The median annualized relapse rates (ARR) pre- and post-treatment with azathioprine were 1 (range=0.1 2) and 0.1 (range=0-0.35); p=0.09. Three patients (15.7%) had records of adverse events during the follow-up, which consisted of chronic B12 vitamin deficiency, pulmonary tuberculosis and breast cancer. Conclusion: Azathioprine may be considered a safe agent for long-term treatment (>10 years) of NMOSD, but continuous vigilance for infections and malignancies is required.
  • article 7 Citação(ões) na Scopus
    Management of central nervous system demyelinating diseases during the coronavirus disease 2019 pandemic: a practical approach
    (2020) APOSTOLOS-PEREIRA, Samira Luisa; SILVA, Guilherme Diogo; DISSEROL, Caio Cesar Diniz; FEO, Lucas Bueno; MATOS, Aline de Moura Brasil; SCHOEPS, Vinicius Andreoli; GOMES, Ana Beatriz Ayroza Galvao Ribeiro; BOAVENTURA, Mateus; MENDES, Maria Fernanda; CALLEGARO, Dagoberto
    Background: The novelcoronavirus disease 2019(COVID-19) pandemic poses a potential threattopatients with autoimmune disorders, including multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). Such patients are usually treated with immunomodulatory or immunosuppressive agents, which may tamper with the organism's normal response to infections. Currently, noconsensus has been reached on how to manage MS and NMOSD patients during the pandemic. Objective: To discuss strategies to manage those patients. Methods: We focus on how to 1) reduce COVID-19 infection risk, such as social distancing, telemedicine, and wider interval between laboratory testing/imaging; 2) manage relapses, such as avoiding treatment of mild relapse and using oral steroids; 3) manage disease-modifying therapies, such as preference for drugs associated with lower infection risk (interferons, glatiramer, teriflunomide, and natalizumab) and extended-interval dosing of natalizumab, when safe; 4) individualize the chosen MS induction-therapy (anti-CD20 monoclonal antibodies, alemtuzumab, and cladribine); 5) manage NMOSD preventive therapies, including initial therapy selection and current treatment maintenance; 6) manage MS/NMOSD patients infected with COVID-19. Conclusions: In the future, real-world case series of MS/NMOSD patients infected with COVID-19 will help us define the best management strategies. For the time being, we rely on expert experience and guidance.