Determinants of therapeutic lag in multiple sclerosis
Language English Country Great Britain, England Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
- Keywords
- Neurology, multiple sclerosis, observational study, therapeutic lag,
- MeSH
- Humans MeSH
- Persons with Disabilities * MeSH
- Disability Evaluation MeSH
- Disease Progression MeSH
- Recurrence MeSH
- Registries MeSH
- Multiple Sclerosis, Relapsing-Remitting * MeSH
- Multiple Sclerosis * drug therapy MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
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 multinational multiple sclerosis (MS) registry, and OFSEP, the French MS registry, were used. Patients diagnosed with MS, minimum 1 year of exposure to MS treatment and 3 years of pre-treatment follow-up, were included in the analysis. Studied outcomes were incidence of relapses and disability accumulation. Therapeutic lag was calculated using an objective, validated method in subgroups stratified by patient and disease characteristics. Therapeutic lag under specific circumstances was then estimated in subgroups defined by combinations of clinical and demographic determinants. RESULTS: High baseline disability scores, annualised relapse rate (ARR) ⩾ 1 and male sex were associated with longer therapeutic lag on disability progression in sufficiently populated groups: females with expanded disability status scale (EDSS) < 6 and ARR < 1 had mean lag of 26.6 weeks (95% CI = 18.2-34.9), males with EDSS < 6 and ARR < 1 31.0 weeks (95% CI = 25.3-36.8), females with EDSS < 6 and ARR ⩾ 1 44.8 weeks (95% CI = 24.5-65.1), and females with EDSS ⩾ 6 and ARR < 1 54.3 weeks (95% CI = 47.2-61.5). CONCLUSIONS: Pre-treatment EDSS and ARR are the most important determinants of therapeutic lag.
Amiens University Hospital Department of Neurology place Victor Pauchet Amiens France
Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases Istanbul Turkey
Centre hospitalier universitaire Limoges Department of Neurology Hôpital Dupuytren Limoges France
Centro Hospitalar Universitário de São João and Universidade Fernando Pessoa Porto Portugal
CHU de Besançon Department of Neurology Besançon France
CHU de Dijon Department of Neurology EA4184 Dijon France
CHU de Montpellier MS Unit Montpellier France University of Montpellier Montpellier France
CHU de Nantes Service de Neurologie and CIC015 INSERM Nantes France CRTI Inserm U1064 Nantes France
CHU La Milétrie Hôpital Jean Bernard Department of Neurology Poitiers France
CHU Lille CRCSEP Lille Univ Lille U1172 Lille France
CHUM MS Center and Universite de Montreal Montreal QC Canada
CISSS Chaudière Appalache Lévis QC Canada
Cliniques universitaires Saint Luc UCLouvain Bruxelles Belgium
CSSS Saint Jérôme Saint Jerome QC Canada
Department of Basic Medical Sciences Neuroscience and Sense Organs University of Bari Bari Italy
Department of Clinical Neurosciences University of Cambridge Cambridge UK
Department of Neurology Centre hospitalier de Pontoise Hôpital René Dubos Pontoise France
Department of Neurology Centre Hospitalier Sud Francilien Corbeil Essonnes France
Department of Neurology Centre hospitalier universitaire Grenoble Alpes La Tronche Grenoble France
Department of Neurology Faculty of Medicine University of Debrecen Debrecen Hungary
Department of Neurology LR 18 SP03 CIC Neurosciences Razi Hospital La Manouba Tunisia
Department of Neurology Zuyderland Medical Center Sittard Geleen The Netherlands
Department of Neuroscience Azienda Ospedaliera Universitaria Modena Italy
Department of Neuroscience Imaging and Clinical Sciences University G d'Annunzio Chieti Italy
Division of Neurology Department of Medicine Amiri Hospital Sharq Kuwait
Dokuz Eylul University Konak Izmir Turkey
Fondation Adolphe de Rothschild de l'œil et du cerveau Department of Neurology Paris France
GF Ingrassia Department University of Catania Catania Italy Policlinico G Rodolico Catania Italy
Haydarpasa Numune Training and Research Hospital Istanbul Turkey
Hopital Andre Mignot Department of Neurology 177 Rue de Versailles Le Chesnay France
Hôpital Pierre Paul Riquet Department of Neurology CHU de Toulouse CRC SEP Toulouse France
Hospital Universitario Reina Sofia Cordoba Cordoba Spain
Hospital Universitario Virgen Macarena Sevilla Spain
Instituto de Investigación Sanitaria Biodonostia Hospital Universitario Donostia San Sebastian Spain
IRCCS Mondino Foundation Pavia Italy
KTU Medical Faculty Farabi Hospital Trabzon Turkey
Medical Faculty 19 Mayis University Samsun Turkey
Neuro Rive Sud Quebec QC Canada
Neurological Unit AORN San G Moscati Avellino Italy
Ospedali Riuniti di Salerno Salerno Italy
Rehabilitation and MS Centre Overpelt and Hasselt University Hasselt Belgium
UOC Neurologia Azienda Sanitaria Unica Regionale Marche AV3 Macerata Italy
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