Anti-inflammatory disease-modifying treatment and short-term disability progression in SPMS

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11110%2F17%3A10362904" target="_blank" >RIV/00216208:11110/17:10362904 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00064165:_____/17:10362904

Výsledek na webu

<a href="http://dx.doi.org/000409172500017" target="_blank" >http://dx.doi.org/000409172500017</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1212/WNL.0000000000004330" target="_blank" >10.1212/WNL.0000000000004330</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Anti-inflammatory disease-modifying treatment and short-term disability progression in SPMS

Popis výsledku v původním jazyce

Objective: To investigate the effect of disease-modifying treatment on short-term disability outcomes in secondary progressive multiple sclerosis (SPMS). Methods: Using MSBase, an international cohort study, we previously validated a highly accurate definition of SPMS. Here, we identified patients in MSBase who were either untreated or treated with a disease-modifying drug when meeting this definition. Propensity score matching was used to select subpopulations with comparable baseline characteristics. Disability outcomes were compared in paired, pairwise-censored analyses adjusted for treatment persistence, visit density, and relapse rates. Results: Of the 2,381 included patients, 1,378 patients were matchable (treated n=689, untreated n=689). Median pairwise-censored follow-up was 2.1 years (quartiles 1.2-3.8 years). No difference in the risk of 6-month sustained disability progression was observed between the groups (hazard ratio [HR] 0.9, 95% confidence interval [CI] 0.7-1.1, p=0.27). We also did not find differences in any of the secondary endpoints: risk of reaching Expanded Disability Status Scale (EDSS) score $ 7 (HR 0.6, 95% CI 0.4-1.1, p=0.10), sustained disability reduction (HR 1.0, 95% CI 0.8-1.3, p=0.79), or change in disability burden (area under the EDSS-time curve, beta=20.05, p=0.09). Secondary and sensitivity analyses confirmed the results. Conclusions: Our pooled analysis of the currently available disease-modifying agents used after conversion to SPMS suggests that, on average, these therapies have no substantial effect on relapse-unrelated disability outcomes measured by the EDSS up to 4 years. . Classification of evidence: This study provides Class IV evidence that for patients with SPMS, disease-modifying treatment has no beneficial effect on short-term disability progression

Název v anglickém jazyce

Anti-inflammatory disease-modifying treatment and short-term disability progression in SPMS

Popis výsledku anglicky

Objective: To investigate the effect of disease-modifying treatment on short-term disability outcomes in secondary progressive multiple sclerosis (SPMS). Methods: Using MSBase, an international cohort study, we previously validated a highly accurate definition of SPMS. Here, we identified patients in MSBase who were either untreated or treated with a disease-modifying drug when meeting this definition. Propensity score matching was used to select subpopulations with comparable baseline characteristics. Disability outcomes were compared in paired, pairwise-censored analyses adjusted for treatment persistence, visit density, and relapse rates. Results: Of the 2,381 included patients, 1,378 patients were matchable (treated n=689, untreated n=689). Median pairwise-censored follow-up was 2.1 years (quartiles 1.2-3.8 years). No difference in the risk of 6-month sustained disability progression was observed between the groups (hazard ratio [HR] 0.9, 95% confidence interval [CI] 0.7-1.1, p=0.27). We also did not find differences in any of the secondary endpoints: risk of reaching Expanded Disability Status Scale (EDSS) score $ 7 (HR 0.6, 95% CI 0.4-1.1, p=0.10), sustained disability reduction (HR 1.0, 95% CI 0.8-1.3, p=0.79), or change in disability burden (area under the EDSS-time curve, beta=20.05, p=0.09). Secondary and sensitivity analyses confirmed the results. Conclusions: Our pooled analysis of the currently available disease-modifying agents used after conversion to SPMS suggests that, on average, these therapies have no substantial effect on relapse-unrelated disability outcomes measured by the EDSS up to 4 years. . Classification of evidence: This study provides Class IV evidence that for patients with SPMS, disease-modifying treatment has no beneficial effect on short-term disability progression

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30103 - Neurosciences (including psychophysiology)

Projekt

<a href="/cs/project/NT13237" target="_blank" >NT13237: Klinické a paraklinické markery roztroušené sklerózy – korelace se současným stavem pacienta a predikce průběhu nemoci.</a><br>

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2017

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Neurology

ISSN

0028-3878

e-ISSN

—

Svazek periodika

89

Číslo periodika v rámci svazku

10

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

10

Strana od-do

1050-1059

Kód UT WoS článku

000409172500017

EID výsledku v databázi Scopus

2-s2.0-85028863302