P426 TELEMONITORING FOR THE SAFE MANAGEMENT OF NEW THERAPIES IN PATIENTS WITH MULTIPLE SCLEROSIS: THE RITMO PROJECT

Abstract

Back in 2012 AIFA authorized the use of Fingolimod in patients with multiple sclerosis; due to possible adverse effects, continuous ECGraphic monitoring is mandatory during the first 6 hours after the administration of the first dose of the drug. Health Telematic Network, in collaboration with the Department of Cardiology of the University of Brescia, has provided a remote telemonitoring system based on the TelMed Telemedicine platform accessible from the computers of the departments, currently in use in 42 hospital departments participating in the project “Nuove Reti Sanitarie” of the General Directorate of Health of the Lombardy Region for the monitoring of patients with chronic heart failure and COPD; the patients were subjected to continuous ECG monitoring through a system consisting of the central unit IntelliVue M130, monitor IntelliVue MP2 and the traces were managed through the application WEBACCESS of the central unit M3150; the monitoring allowed the continuous recording of the ECG, the detection of arrhythmias in real time and the storage of any alarm detected; the WEBACCESS application allowed the cardiologist (local and remote HTN) to view in real time the traces and any alarm detected and stored; in case of detection of arrhythmias, the cardiologist liaised with the Neurology department to discuss the specific case and the necessary measures. Results: 21258 ECGraphic monitors were analyzed, in a total of 6865 patients (2282 males - mean age 44 years, 4583 females - mean age 45 years); drug-related side effects occurred in 30% of cases as sinus bradycardia, atrioventricular conduction disturbances in 3% of cases (first degree atrioventricular block 1.6%, transient episodes of second and third degree atrioventricular block in 1.4% of cases) and. QT interval prolongation in 9.8% of cases. Adverse events, transient and reversible, were immediately recognized and treated according to the AIFA recommendations for the use of the drug, allowing treatment for all patients monitored. Conclusions: The use of Fingolimod has provided satisfactory clinical results with a high safety profile; the use of continuous telemonitoring has allowed to extend the number of subjects treated and to manage effectively and in real time the few side effects encountered.