RT Journal Article
T1 Anti-inflammatory disease-modifying treatment and short-term disability progression in SPMS.
A1 Lorscheider, Johannes
A1 Jokubaitis, Vilija G
A1 Spelman, Tim
A1 Izquierdo, Guillermo
A1 Lugaresi, Alessandra
A1 Havrdova, Eva
A1 Horakova, Dana
A1 Trojano, Maria
A1 Duquette, Pierre
A1 Girard, Marc
A1 Prat, Alexandre
A1 Grand'Maison, François
A1 Grammond, Pierre
A1 Pucci, Eugenio
A1 Boz, Cavit
A1 Sola, Patrizia
A1 Ferraro, Diana
A1 Spitaleri, Daniele
A1 Lechner-Scott, Jeanette
A1 Terzi, Murat
A1 Van Pesch, Vincent
A1 Iuliano, Gerardo
A1 Bergamaschi, Roberto
A1 Ramo-Tello, Cristina
A1 Granella, Franco
A1 Oreja-Guevara, Celia
A1 Butzkueven, Helmut
A1 Kalincik, Tomas
A1 MSBase Study Group, 
AB 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, β = -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.
YR 2017
FD 2017-08-09
LK http://hdl.handle.net/10668/11492
UL http://hdl.handle.net/10668/11492
LA en
DS RISalud
RD Mar 14, 2025