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Disease-modifying treatment and disability progression in subclasses of patients with primary progressive MS: results from the Big MS Data Network
J. Lorscheider, A. Signori, S. Subramaniam, P. Benkert, S. Vukusic, M. Trojano, J. Hillert, A. Glaser, R. Hyde, T. Spelman, M. Magyari, F. Elberling, L. Pontieri, N. Koch-Henriksen, PS. Sørensen, O. Gerlach, A. Prat, M. Girard, S. Eichau, P....
Language English Country England, Great Britain
Document type Journal Article
NLK
ProQuest Central
from 1944-07-01 to 6 months ago
Nursing & Allied Health Database (ProQuest)
from 1944-07-01 to 6 months ago
Health & Medicine (ProQuest)
from 1944-07-01 to 6 months ago
Psychology Database (ProQuest)
from 1944-07-01 to 6 months ago
- MeSH
- Multiple Sclerosis, Chronic Progressive * drug therapy physiopathology MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Disability Evaluation MeSH
- Disease Progression MeSH
- Registries MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
BACKGROUND: Effectiveness of disease-modifying treatment (DMT) in people affected by primary progressive multiple sclerosis (PPMS) is limited. Whether specific subgroups may benefit more from DMT in a real-world setting remains unclear. Our aim was to investigate the potential effect of DMT on disability worsening among patients with PPMS stratified by different disability trajectories. METHODS: Within the framework of the Big MS Data network, we merged data from the Observatoire Français de la Sclérose en Plaques, the Swedish and Italian MS registries, and MSBase. We identified patients with PPMS that started DMT or were never treated during the observed period. Subpopulations with comparable baseline characteristics were selected by propensity score matching. Disability outcomes were analysed in time-to-recurrent event analyses, which were repeated in subclasses with different disability trajectories determined by latent class mixed models. RESULTS: Of the 3243 included patients, we matched 739 treated and 1330 untreated patients with a median follow-up of 3 years after pairwise censoring. No difference in the risk of confirmed disability worsening (CDW) was observed between the groups in the fully matched dataset (HR 1.11, 95% CI 0.97 to 1.23, p=0.127). However, we found a lower risk for CDW among the class of treated patients with an aggressive disability trajectory (n=360, HR 0.68, 95% CI 0.50 to 0.92, p=0.014). CONCLUSIONS: In line with previous studies, our data suggest that DMT does not ameliorate disability worsening in PPMS, in general. However, we observed a beneficial effect of DMT on disability worsening in patients with aggressive predicted disability trajectories.
Academic MS Center Zuyd Department of Neurology Zuyderland Medical Center Sittard Geleen Netherlands
Amiri Hospital Kuwait City Kuwait
Centre Hospitalier Universitaire de Rennes Rennes France
Centre Integre de Sante et de Services Sociaux des Laurentides Saint Jerome Quebec Canada
CHU de Montpellier MS Unit University of Montpellier Montpellier France
CHU Lille CRCSEP Lille Université de Lille Lille France
Clinical Neuroscience Karolinska Institute Stockholm Sweden
Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark
Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
Department of Clinical Research University Hospital Basel Basel Switzerland
Department of Health Sciences Section of Biostatistics University of Genoa Genova Italy
Department of Neurology Centre Hospitalier Universitaire de Toulouse Toulouse France
Department of Neurology Hôpital Saint Vincent de Paul Lille France
Department of Neurology Nancy University Hospital Université de Lorraine Nancy France
Department of Neurology The Alfred Hospital Melbourne Victoria Australia
Department of Neurology University Hospital Basel Basel Switzerland
Department of Neurosciences Box Hill Hospital Box Hill Victoria Australia
Eastern Health Clinical School Monash University Melbourne Victoria Australia
Eugène Devic EDMUS Foundation against multiple sclerosis Lyon France
Hôpital Notre Dame CHUM and Universite de Montreal Montreal Quebec Canada
Hospital Universitario Virgen Macarena Sevilla Spain
Hotel Dieu de Levis Levis Quebec Canada
Hunter Medical Research Institute University of Newcastle Newcastle New South Wales Australia
Hunter New England Health John Hunter Hospital Newcastle New South Wales Australia
Independent Healthcare and Real World Evidence Consultant Zug Switzerland
MSBase Foundation Melbourne Victoria Australia
Neurocentre Magendie Université de Bordeaux Bordeaux France
Neurology AP HP Hôpital de la Pitié Salpêtrière Paris France
Neurology Galdakao Hospital Spain Spain
Neurosciences Hospital Universitari Germans Trias i Pujol Barcelona Spain
Service de Neurologie CHU de Bordeaux Bordeaux France
References provided by Crossref.org
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- $a Lorscheider, Johannes $u Department of Neurology, University Hospital Basel, Basel, Switzerland johannes.lorscheider@usb.ch $u Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University of Basel, Basel, Switzerland $1 https://orcid.org/0000000311002506
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- $a Disease-modifying treatment and disability progression in subclasses of patients with primary progressive MS: results from the Big MS Data Network / $c J. Lorscheider, A. Signori, S. Subramaniam, P. Benkert, S. Vukusic, M. Trojano, J. Hillert, A. Glaser, R. Hyde, T. Spelman, M. Magyari, F. Elberling, L. Pontieri, N. Koch-Henriksen, PS. Sørensen, O. Gerlach, A. Prat, M. Girard, S. Eichau, P. Grammond, D. Horakova, C. Ramo-Tello, I. Roos, K. Buzzard, J. Lechner Scott, JL. Sánchez-Menoyo, R. Alroughani, J. Prévost, J. Kuhle, O. Gray, G. Mathey, L. Michel, J. Ciron, J. De Sèze, E. Maillart, A. Ruet, P. Labauge, H. Zephir, A. Kwiatkowski, A. van der Walt, T. Kalincik, H. Butzkueven, Italian MS Register, Observatoire Français de la Sclérose en Plaques (OFSEP), MSBase Study Group, Swedish MS Registry, Big MS Data Network
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