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https://www.um.edu.mt/library/oar/handle/123456789/45899
Title: | Country, sex, EDSS change and therapy choice independently predict treatment discontinuation in multiple sclerosis and clinically isolated syndrome |
Authors: | Meyniel, Claire Spelman, Timothy Jokubaitis, Vilija G. Trojano, Maria Izquierdo, Guillermo Grand’Maison, Francois Oreja-Guevara, Celia Boz, Cavit Lugaresi, Alessandra Girard, Marc Grammond, Pierre Iuliano, Gerardo Fiol, Marcela Cabrera-Gomez, Jose Antonio Fernandez-Bolanos, Ricardo Giuliani, Giorgio Lechner-Scott, Jeannette Cristiano, Edgardo Herbert, Joseph Petkovska-Boskova, Tatjana Bergamaschi, Roberto Pesch, Vincent van Moore, Fraser Vella, Norbert Slee, Mark Santiago, Vetere Barnett, Michael Havrdova, Eva Young, Carolyn Sirbu, Carmen-Adella Tanner, Mary Rutherford, Michelle Butzkueven, Helmut |
Authors: | MSBasis Study Group |
Keywords: | Multiple sclerosis -- Research Multiple sclerosis, Relapsing-remitting Nervous system -- Diseases -- Research Demyelination |
Issue Date: | 2012 |
Publisher: | PLOS |
Citation: | Meyniel, C., Spelman, T., Jokubaitis, V. G., Trojano, M., Izquierdo, G., Grand’Maison, F.,....Butzkueven, H. (2012). Country, sex, EDSS change and therapy choice independently predict treatment discontinuation in multiple sclerosis and clinically isolated syndrome. PloS one, 7(6), e38661. |
Abstract: | Objectives: We conducted a prospective study, MSBASIS, to assess factors leading to first treatment discontinuation in patients with a clinically isolated syndrome (CIS) and early relapsing-remitting multiple sclerosis (RRMS). Methods: The MSBASIS Study, conducted by MSBase Study Group members, enrols patients seen from CIS onset, reporting baseline demographics, cerebral magnetic resonance imaging (MRI) features and Expanded Disability Status Scale (EDSS) scores. Follow-up visits report relapses, EDSS scores, and the start and end dates of MS-specific therapies. We performed a multivariable survival analysis to determine factors within this dataset that predict first treatment discontinuation. Results: A total of 2314 CIS patients from 44 centres were followed for a median of 2.7 years, during which time 1247 commenced immunomodulatory drug (IMD) treatment. Ninety percent initiated IMD after a diagnosis of MS was confirmed, and 10% while still in CIS status. Over 40% of these patients stopped their first IMD during the observation period. Females were more likely to cease medication than males (HR 1.36, p = 0.003). Patients treated in Australia were twice as likely to cease their first IMD than patients treated in Spain (HR 1.98, p = 0.001). Increasing EDSS was associated with higher rate of IMD cessation (HR 1.21 per EDSS unit, p<0.001), and intramuscular interferon-β-1a (HR 1.38, p = 0.028) and subcutaneous interferon-β-1a (HR 1.45, p = 0.012) had higher rates of discontinuation than glatiramer acetate, although this varied widely in different countries. Onset cerebral MRI features, age, time to treatment initiation or relapse on treatment were not associated with IMD cessation. Conclusion: In this multivariable survival analysis, female sex, country of residence, EDSS change and IMD choice independently predicted time to first IMD cessation. |
URI: | https://www.um.edu.mt/library/oar/handle/123456789/45899 |
Appears in Collections: | Scholarly Works - FacM&SMed |
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File | Description | Size | Format | |
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Country_sex_EDSS_change_and_therapy_choice_independently_predict_treatment_discontinuation_in _multiple_sclerosis_2012.PDF | 183.3 kB | Adobe PDF | View/Open |
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