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

ABSTRACT: To investigate the effect of disease-modifying treatment on short-term disability outcomes in secondary progressive multiple sclerosis (SPMS).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.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, ? = -0.05, p = 0.09). Secondary and sensitivity analyses confirmed the results.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.This study provides Class IV evidence that for patients with SPMS, disease-modifying treatment has no beneficial effect on short-term disability progression.

SUBMITTER: Lorscheider J

PROVIDER: S-EPMC5589791 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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

Lorscheider Johannes J Jokubaitis Vilija G VG Spelman Tim T Izquierdo Guillermo G Lugaresi Alessandra A Havrdova Eva E Horakova Dana D Trojano Maria M Duquette Pierre P Girard Marc M Prat Alexandre A Grand'Maison François F Grammond Pierre P Pucci Eugenio E Boz Cavit C Sola Patrizia P Ferraro Diana D Spitaleri Daniele D Lechner-Scott Jeanette J Terzi Murat M Van Pesch Vincent V Iuliano Gerardo G Bergamaschi Roberto R Ramo-Tello Cristina C Granella Franco F Oreja-Guevara Celia C Butzkueven Helmut H Kalincik Tomas T

Neurology 20170809 10

<h4>Objective</h4>To investigate the effect of disease-modifying treatment on short-term disability outcomes in secondary progressive multiple sclerosis (SPMS).<h4>Methods</h4>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 basel ...[more]

PMID: 28794248

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Dataset Information

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

Publications

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

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