Serveur d'exploration sur les pandémies grippales

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Management challenges for chronic dysimmune neuropathies during the COVID-19 pandemic

Identifieur interne : 000375 ( Hal/Curation ); précédent : 000374; suivant : 000376

Management challenges for chronic dysimmune neuropathies during the COVID-19 pandemic

Auteurs : Yusuf Rajabally [Royaume-Uni] ; H Stephan Goedee [Pays-Bas] ; Shahram Attarian [France] ; Hans-Peter Hartung [Allemagne]

Source :

RBID : Hal:inserm-02559603

English descriptors

Abstract

Since March 2020, the COVID-19 pandemic has led to the need to re-think the delivery of services to patients with chronic dysimmune neuropathies. Telephone/video consultations have become widespread but have compounded concerns about objective evaluation. Therapeutic decisions need, more than ever before, to be considered in the best interests of both patients, and society, while not denying function-preserving/restoring treatment. Immunoglobulin therapy and plasma exchange, for those treated outside of the home, expose patients to the hazards of hospital or outpatient infusion centers. Steroid therapy initiation and continuation pose increased infectious risk. Immunosuppressant therapy similarly becomes highly problematic, with the risks of treatment continuation enhanced by uncertainties regarding duration of the pandemic. The required processes necessitate considerable time and effort especially as resources and staff are re-deployed to face the pandemic, but are essential for protecting this group of patients and as an integral part of wider public health actions.


Url:
DOI: 10.1002/mus.26896

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Hal:inserm-02559603

Le document en format XML

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<funder>Y.A.R. has received speaker/consultancy honoraria from CSL Behring, LFB, Grifols, BPL, Octapharma, and Kedrion, has received educational sponsorships from LFB, CSL Behring and Baxter and has obtained research grants from CSL Behring and LFB; H.S.G. has received research grants from Prinses Beatrix Spierfonds (W.OR14.08 and W.OR17-21), and received speaker fee/travel grants from Shire/Baxalta.S.A. has received speaker/consultancy honoraria from LFB, Alnylam, Akcea, Pfizer, Pharnext, Sanofi, and Biogen, has received educational sponsorships from LFB, and has obtained research grants from and LFB and Pfizer. H.P.H. received fees for serving on steering committees and advisory boards from CSL Behring, LFB, Octapharma, Roche, UCB.</funder>
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<p>Since March 2020, the COVID-19 pandemic has led to the need to re-think the delivery of services to patients with chronic dysimmune neuropathies. Telephone/video consultations have become widespread but have compounded concerns about objective evaluation. Therapeutic decisions need, more than ever before, to be considered in the best interests of both patients, and society, while not denying function-preserving/restoring treatment. Immunoglobulin therapy and plasma exchange, for those treated outside of the home, expose patients to the hazards of hospital or outpatient infusion centers. Steroid therapy initiation and continuation pose increased infectious risk. Immunosuppressant therapy similarly becomes highly problematic, with the risks of treatment continuation enhanced by uncertainties regarding duration of the pandemic. The required processes necessitate considerable time and effort especially as resources and staff are re-deployed to face the pandemic, but are essential for protecting this group of patients and as an integral part of wider public health actions.</p>
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