Early treatment delays long-term disability accrual in RRMS: Results from the BMSD network
| Autor: | Sandra Vukusic, Tim Spelman, Pietro Iaffaldano, Per Soelberg Sørensen, Fabio Pellegrini, Jan Hillert, Nils Koch-Henriksen, Maria Trojano, Melinda Magyari, Giuseppe Lucisano, Helmut Butzkueven, Robert Hyde |
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| Rok vydání: | 2021 |
| Předmět: |
Pediatrics
medicine.medical_specialty Multiple Sclerosis Accrual Time-to-Treatment Cohort Studies 03 medical and health sciences 0302 clinical medicine Medicine Humans Disabled Persons 030212 general & internal medicine business.industry Multiple sclerosis Disease progression Guideline Long term disability medicine.disease Clinical neurology Natural history Neurology Disease Progression Neurology (clinical) business 030217 neurology & neurosurgery Cohort study |
| Zdroj: | Multiple sclerosis (Houndmills, Basingstoke, England). 27(10) |
| ISSN: | 1477-0970 |
| Popis: | Background: The optimal timing of treatment starts for achieving the best control on the long-term disability accumulation in multiple sclerosis (MS) is still to be defined. Objective: The aim of this study was to estimate the optimal time to start disease-modifying therapies (DMTs) to prevent the long-term disability accumulation in MS, using a pooled dataset from the Big Multiple Sclerosis Data (BMSD) network. Methods: Multivariable Cox regression models adjusted for the time to first treatment start from disease onset (in quintiles) were used. To mitigate the impact of potential biases, a set of pairwise propensity score (PS)-matched analyses were performed. The first quintile, including patients treated within 1.2 years from onset, was used as reference. Results: A cohort of 11,871 patients (median follow-up after treatment start: 13.2 years) was analyzed. A 3- and 12-month confirmed disability worsening event and irreversible Expanded Disability Status Scale (EDSS) 4.0 and 6.0 scores were reached by 7062 (59.5%), 4138 (34.9%), 3209 (31.1%), and 1909 (16.5%) patients, respectively. The risk of reaching all the disability outcomes was significantly lower ( p < 0.0004) for the first quintile patients’ group. Conclusion: Real-world data from the BMSD demonstrate that DMTs should be commenced within 1.2 years from the disease onset to reduce the risk of disability accumulation over the long term. |
| Databáze: | OpenAIRE |
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