Comparative efficacy of first-line natalizumab vs IFN-β or glatiramer acetate in relapsing MS.

Autor:	Spelman T; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Kalincik T; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Jokubaitis V; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Zhang A; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Pellegrini F; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Wiendl H; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Belachew S; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Hyde R; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Verheul F; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Lugaresi A; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Havrdová E; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Horáková D; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Grammond P; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Duquette P; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Prat A; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Iuliano G; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Terzi M; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Izquierdo G; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Hupperts RM; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Boz C; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Pucci E; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Giuliani G; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Sola P; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Spitaleri DL; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Lechner-Scott J; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Bergamaschi R; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Grand'Maison F; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Granella F; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Kappos L; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Trojano M; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia., Butzkueven H; Department of Medicine and Melbourne Brain Centre at the Royal Melbourne Hospital (TS, TK, VJ, HB), University of Melbourne, Australia; Biogen Idec Inc. (AZ, FP, SB, RH), Cambridge, MA; Department of Neurology (HW), University of Münster, Germany; Groene Hart Ziekenhuis (FV), Gouda, the Netherlands; MS Center, Department of Neuroscience, Imaging and Clinical Sciences (AL), University 'G. d'Annunzio,' Chieti, Italy; MS Center, Department of Neurology, First Medical Faculty (EH, DH), Charles University, Prague, Czech Republic; Center de Réadaptation Déficience Physique Chaudière-Appalache (PG), Levis; Hôpital Notre Dame (PD, AP), Montreal, Canada; Ospedali Riuniti di Salerno (G. Iuliano), Salerno, Italy; 19 Mayis University (M. Terzi), Medical Faculty, Turkey; Hospital Universitario Virgen Macarena (G. Izquierdo), Sevilla, Spain; Orbis Medical Centre (RMMH), Sittard-Geleen, the Netherlands; KTU Medical Faculty Farabi Hospital (CB), Trabzon, Turkey; Neurology Unit (EP, GG), ASUR Marche-AV3, Macerata; Nuovo Ospedale Civile S. Agostino (PS), Modena; AORN San Giuseppe Moscati (DLAS), Avellino, Italy; John Hunter Hospital (JL-S), Newcastle, Australia; Neurological Institute IRCCS Mondino (RB), Pavia, Italy; Neuro Rive-Sud (F. Grand'Maison), Hôpital Charles LeMoyne, Quebec, Canada; University of Parma (F. Granella), Italy; Department of Neurology (LK), University Hospital Basel, Switzerland; Department of Basic Medical Sciences, Neuroscience and Sense Organs (M. Trojano), University of Bari, Italy; and Department of Neurology (HB), Eastern Health, Monash University, Australia.
Jazyk:	angličtina
Zdroj:	Neurology. Clinical practice [Neurol Clin Pract] 2016 Apr; Vol. 6 (2), pp. 102-115.
DOI:	10.1212/CPJ.0000000000000227
Abstrakt:	Background: We compared efficacy and treatment persistence in treatment-naive patients with relapsing-remitting multiple sclerosis (RRMS) initiating natalizumab compared with interferon-β (IFN-β)/glatiramer acetate (GA) therapies, using propensity score-matched cohorts from observational multiple sclerosis registries. Methods: The study population initiated IFN-β/GA in the MSBase Registry or natalizumab in the Tysabri Observational Program, had ≥3 months of on-treatment follow-up, and had active RRMS, defined as ≥1 gadolinium-enhancing lesion on cerebral MRI at baseline or ≥1 relapse within the 12 months prior to baseline. Baseline demographics and disease characteristics were balanced between propensity-matched groups. Annualized relapse rate (ARR), time to first relapse, treatment persistence, and disability outcomes were compared between matched treatment arms in the total population (n = 366/group) and subgroups with higher baseline disease activity. Results: First-line natalizumab was associated with a 68% relative reduction in ARR from a mean (SD) of 0.63 (0.92) on IFN-β/GA to 0.20 (0.63) ( p [signed-rank] < 0.0001), a 64% reduction in the rate of first relapse (hazard ratio [HR] 0.36, 95% confidence interval [CI] 0.28-0.47; p < 0.001), and a 27% reduction in the rate of discontinuation (HR 0.73, 95% CI 0.58-0.93; p = 0.01), compared with first-line IFN-β/GA therapy. Confirmed disability progression and area under the Expanded Disability Status Scale-time curve analyses were not significant. Similar relapse and treatment persistence results were observed in each of the higher disease activity subgroups. Conclusions: This study provides Class IV evidence that first-line natalizumab for RRMS improves relapse and treatment persistence outcomes compared to first-line IFN-β/GA. This needs to be balanced against the risk of progressive multifocal leukoencephalopathy in natalizumab-treated patients. Classification of Evidence: This study provides Class IV evidence that first-line natalizumab for RRMS improves relapse rates and treatment persistence outcomes compared to first-line IFN-β/GA.
Databáze:	MEDLINE
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