Lorscheider, JohannesJokubaitis, Vilija GSpelman, TimIzquierdo, GuillermoLugaresi, AlessandraHavrdova, EvaHorakova, DanaTrojano, MariaDuquette, PierreGirard, MarcPrat, AlexandreGrand'Maison, FrançoisGrammond, PierrePucci, EugenioBoz, CavitSola, PatriziaFerraro, DianaSpitaleri, DanieleLechner-Scott, JeanetteTerzi, MuratVan Pesch, VincentIuliano, GerardoBergamaschi, RobertoRamo-Tello, CristinaGranella, FrancoOreja-Guevara, CeliaButzkueven, HelmutKalincik, TomasMSBase Study Group2023-01-252023-01-252017-08-09http://hdl.handle.net/10668/11492To 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.enAdultAnti-Inflammatory AgentsArea Under CurveDisability EvaluationDisease ProgressionFemaleFollow-Up StudiesHumansLongitudinal StudiesMagnetic Resonance ImagingMaleMiddle AgedMultiple Sclerosis, Chronic ProgressivePropensity ScoreProportional Hazards ModelsRecurrenceTreatment Outcomeresearch article28794248open access10.1212/WNL.00000000000043301526-632XPMC5589791https://europepmc.org/articles/pmc5589791?pdf=renderhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5589791/pdf