RT Journal Article
T1 Association of Initial Disease-Modifying Therapy With Later Conversion to Secondary Progressive Multiple Sclerosis.
A1 Brown, J William L
A1 Coles, Alasdair
A1 Horakova, Dana
A1 Havrdova, Eva
A1 Izquierdo, Guillermo
A1 Prat, Alexandre
A1 Girard, Marc
A1 Duquette, Pierre
A1 Trojano, Maria
A1 Lugaresi, Alessandra
A1 Bergamaschi, Roberto
A1 Grammond, Pierre
A1 Alroughani, Raed
A1 Hupperts, Raymond
A1 McCombe, Pamela
A1 Van Pesch, Vincent
A1 Sola, Patrizia
A1 Ferraro, Diana
A1 Grand'Maison, Francois
A1 Terzi, Murat
A1 Lechner-Scott, Jeannette
A1 Flechter, Schlomo
A1 Slee, Mark
A1 Shaygannejad, Vahid
A1 Pucci, Eugenio
A1 Granella, Franco
A1 Jokubaitis, Vilija
A1 Willis, Mark
A1 Rice, Claire
A1 Scolding, Neil
A1 Wilkins, Alastair
A1 Pearson, Owen R
A1 Ziemssen, Tjalf
A1 Hutchinson, Michael
A1 Harding, Katharine
A1 Jones, Joanne
A1 McGuigan, Christopher
A1 Butzkueven, Helmut
A1 Kalincik, Tomas
A1 Robertson, Neil
A1 MSBase Study Group, 
AB Within 2 decades of onset, 80% of untreated patients with relapsing-remitting multiple sclerosis (MS) convert to a phase of irreversible disability accrual termed secondary progressive MS. The association between disease-modifying treatments (DMTs), and this conversion has rarely been studied and never using a validated definition. To determine the association between the use, the type of, and the timing of DMTs with the risk of conversion to secondary progressive MS diagnosed with a validated definition. Cohort study with prospective data from 68 neurology centers in 21 countries examining patients with relapsing-remitting MS commencing DMTs (or clinical monitoring) between 1988-2012 with minimum 4 years' follow-up. The use, type, and timing of the following DMTs: interferon beta, glatiramer acetate, fingolimod, natalizumab, or alemtuzumab. After propensity-score matching, 1555 patients were included (last follow-up, February 14, 2017). Conversion to objectively defined secondary progressive MS. Of the 1555 patients, 1123 were female (mean baseline age, 35 years [SD, 10]). Patients initially treated with glatiramer acetate or interferon beta had a lower hazard of conversion to secondary progressive MS than matched untreated patients (HR, 0.71; 95% CI, 0.61-0.81; P  Among patients with relapsing-remitting MS, initial treatment with fingolimod, alemtuzumab, or natalizumab was associated with a lower risk of conversion to secondary progressive MS vs initial treatment with glatiramer acetate or interferon beta. These findings, considered along with these therapies' risks, may help inform decisions about DMT selection.
YR 2019
FD 2019
LK http://hdl.handle.net/10668/13424
UL http://hdl.handle.net/10668/13424
LA en
DS RISalud
RD Apr 5, 2025