%0 Journal Article
%A Lorscheider, J
%A Kuhle, J
%A Izquierdo, G
%A Lugaresi, A
%A Havrdova, E
%A Horakova, D
%A Hupperts, R
%A Duquette, P
%A Girard, M
%A Prat, A
%A Grand'Maison, F
%A Grammond, P
%A Sola, P
%A Ferraro, D
%A Trojano, M
%A Ramo-Tello, C
%A Lechner-Scott, J
%A Pucci, E
%A Solaro, C
%A Slee, M
%A Van Pesch, V
%A Sanchez Menoyo, J L
%A van der Walt, A
%A Butzkueven, H
%A Kappos, L
%A Kalincik, T
%A MSBase Study Group
%T Anti-inflammatory disease-modifying treatment and disability progression in primary progressive multiple sclerosis: a cohort study.
%D 2018
%U http://hdl.handle.net/10668/13050
%X Treatment options in primary progressive multiple sclerosis (PPMS) are scarce and, with the exception of ocrelizumab, anti-inflammatory agents have failed to show efficacy in ameliorating disability progression. The aim of this study was to investigate a potential effect of anti-inflammatory disease-modifying treatment on disability outcomes in PPMS. Using MSBase, a large, international, observational database, we identified patients with PPMS who were either never treated or treated with a disease-modifying agent. Propensity score matching was used to select subpopulations with similar baseline characteristics. Expanded Disability Status Scale (EDSS) outcomes were compared with an intention-to-treat and an as-treated approach in paired, pairwise-censored analyses. Of the 1284 included patients, 533 were matched (treated, n = 195; untreated n = 338). Median on-study pairwise-censored follow-up was 3.4 years (quartiles 1.2-5.5). No difference in the hazard of experiencing 3-month confirmed EDSS progression events was observed between the groups [hazard ratio (HR), 1.0; 95% confidence interval (CI), 0.6-1.7, P = 0.87]. We did not find significant differences in the hazards of confirmed EDSS improvement (HR, 1.0; 95% CI, 0.6-1.6, P = 0.91) or reaching a confirmed EDSS step ≥7 (HR, 1.1; 95% CI, 0.7-1.6, P = 0.69). Our pooled analysis of disease-modifying agents suggests that these therapies have no substantial effect on short- to medium-term disability outcomes in PPMS.
%K clinical outcomes
%K immunomodulation
%K multiple sclerosis
%K observational study
%K primary progressive
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