Prognostic factors for disease activity in newly diagnosed teriflunomide-treated patients with multiple sclerosis: a nationwide Danish study.

Autor:	Mahler MR; The Danish Multiple Sclerosis Registry, Danish Multiple Sclerosis Research Center, Copenhagen University Hospital, Glostrup, Denmark mie.mahler@dadlnet.dk., Magyari M; The Danish Multiple Sclerosis Registry, Danish Multiple Sclerosis Research Center, Copenhagen University Hospital, Glostrup, Denmark.; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Pontieri L; The Danish Multiple Sclerosis Registry, Danish Multiple Sclerosis Research Center, Copenhagen University Hospital, Glostrup, Denmark., Elberling F; The Danish Multiple Sclerosis Registry, Danish Multiple Sclerosis Research Center, Copenhagen University Hospital, Glostrup, Denmark., Holm RP; The Danish Multiple Sclerosis Registry, Danish Multiple Sclerosis Research Center, Copenhagen University Hospital, Glostrup, Denmark., Weglewski A; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.; Department of Neurology, Herlev Hospital, Herlev, Denmark., Poulsen MB; Department of Neurology, Nordsjaellands Hospital, Hilleroed, Denmark., Storr LK; Department of Neurology, Zealand University Hospital, Roskilde, Denmark., Bekyarov PA; Department of Neurology, Slagelse Hospital, Slagelse, Denmark., Illes Z; Department of Neurology, Odense University Hospital, Odense, Denmark., Kant M; Department of Neurology, Hospital of Southern Jutland Soenderborg Branch, Soenderborg, Denmark., Sejbaek T; Department of Neurology, Esbjerg Central Hospital, Esbjerg, Denmark.; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark., Stilund ML; Department of Neurology, Physiotherapy and Occupational Therapy, Goedstrup Hospital, Herning, Denmark., Rasmussen PV; Department of Neurology, Aarhus University Hospital, Aarhus, Denmark., Brask M; Department of Neurology, Viborg Regional Hospital, Viborg, Denmark., Urbonaviciute I; Department of Neurology, Aalborg University Hospital, Aalborg, Denmark., Sellebjerg F; The Danish Multiple Sclerosis Registry, Danish Multiple Sclerosis Research Center, Copenhagen University Hospital, Glostrup, Denmark.; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Jazyk:	angličtina
Zdroj:	Journal of neurology, neurosurgery, and psychiatry [J Neurol Neurosurg Psychiatry] 2024 Sep 17; Vol. 95 (10), pp. 979-987. Date of Electronic Publication: 2024 Sep 17.
DOI:	10.1136/jnnp-2023-333265
Abstrakt:	Background: Clinicians frequently rely on relapse counts, T2 MRI lesion load (T2L) and Expanded Disability Status Scale (EDSS) scores to guide treatment decisions for individuals diagnosed with multiple sclerosis (MS). This study evaluates how these factors, along with age and sex, influence prognosis during treatment with teriflunomide (TFL). Methods: We conducted a nationwide cohort study using data from the Danish Multiple Sclerosis Registry.Eligible participants had relapsing-remitting MS or clinically isolated syndrome and initiated TFL as their first treatment between 2013 and 2019. The effect of age, pretreatment relapses, T2L and EDSS scores on the risk of disease activity on TFL were stratified by sex. Results: In total, 784 individuals were included (57.4% females). A high number of pretreatment relapses (≥2) was associated with an increased risk of disease activity in females only (OR and (95% CI): 1.76 (1.11 to 2.81)). Age group 50+ was associated with a lower risk of disease activity in both sexes (OR females=0.28 (0.14 to 0.56); OR males=0.22 (0.09 to 0.55)), while age 35-49 showed a different impact in males and females (OR females=0.79 (0.50 to 1.23); OR males=0.42 (0.24 to 0.72)). EDSS scores and T2L did not show any consistent associations. Conclusion: A high number of pretreatment relapses was only associated with an increased risk of disease activity in females, while age had a differential impact on the risk of disease activity according to sex. Clinicians may consider age, sex and relapses when deciding on TFL treatment. Competing Interests: Competing interests: MRM has received support from Merck for participation in a scientific meeting. MM has served on scientific advisory boards, served as a consultant, received support for congress participation, or received speaker honoraria from Roche, Sanofi, Biogen, Merck, Novartis, Bristol Myers Squibb, Medscape, Alexion, and Moderna. Her research group has contracts with Biogen, Merck, Novartis, Roche, Sanofi, and Bristol Myers Squibb. FE has received speaker honoraria from Roche and Sanofi. RPH has received speaker honoraria from Sanofi and Novartis, has served on an advisory board for Novartis, and has received a travel grant from The Danish Multiple Sclerosis Society. AW has served on advisory boards for Merck, Sanofi, Roche, and Biogen. He has also received honoraria for lecturing and manuscript writing from Sanofi, Merck, and Roche and has received financial support for congress participation from Biogen, Sanofi, Novartis, Merck and Roche. MBP reports support for congress participation from Novartis and Merck. ZI has received speaker honoraria, been a member of an advisory board, and received support for congress participation from Sanofi. TS has received travel grants from Sanofi and Merck, research grants from Biogen, Merck and Roche, served on advisory boards for Biogen, Merck, Novartis and Sanofi, and received honoraria for lecturing from Biogen, Merck, Novartis and Sanofi. MLS has received support for congress participation from Biogen, Merck, and Roche and has participated on advisory boards for Sanofi and Roche. PVR has served on scientific advisory boards, received support for congress participation or received speaker honoraria from Biogen, Merck, Novartis, Roche and Sanofi. FS has served on scientific advisory boards, served as a consultant, received support for congress participation or received speaker honoraria from Biogen, Bristol Myers Squibb, H. Lundbeck A/S, Merck, Novartis, Roche and Sanofi. His laboratory has received research support from Biogen, Merck, Novartis, Roche and Sanofi. In addition, FS is section editor of the journal Multiple Sclerosis and Related Disorders, chairman of the research board for the Danish Multiple Sclerosis Society, and member of the scientific steering committee for the International Progressive MS Alliance. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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