Long-term disability trajectories in relapsing multiple sclerosis patients treated with early intensive or escalation treatment strategies
| العنوان: | Long-term disability trajectories in relapsing multiple sclerosis patients treated with early intensive or escalation treatment strategies |
|---|---|
| المؤلفون: | Eleonora Cocco, Antonella Conte, Pietro Iaffaldano, Vincenzo Brescia Morra, Marco Rovaris, Giorgia Teresa Maniscalco, Claudio Gasperini, Mauro Zaffaroni, Rocco Totaro, Marco Capobianco, Marco Salvetti, Damiano Paolicelli, F Caputo, Maria Trojano, Franco Granella, Elio Scarpini, Giuseppe Salemi, Paolo Bellantonio, Italian Ms register, Matilde Inglese, Roberto Bergamaschi, Giancarlo Comi, Davide Maimone, Francesco Patti, Giovanna De Luca, Giacomo Lus, Patrizia Sola, Valentina Torri Clerici, Giuseppe Lucisano, Carlo Pozzilli, Massimo Filippi, Maria Pia Amato |
| المساهمون: | Iaffaldano, Pietro, Lucisano, Giuseppe, Caputo, Francesca, Paolicelli, Damiano, Patti, Francesco, Zaffaroni, Mauro, Brescia Morra, Vincenzo, Pozzilli, Carlo, De Luca, Giovanna, Inglese, Matilde, Salemi, Giuseppe, Maniscalco, Giorgia Teresa, Cocco, Eleonora, Sola, Patrizia, Lus, Giacomo, Conte, Antonella, Amato, Maria Pia, Granella, Franco, Gasperini, Claudio, Bellantonio, Paolo, Totaro, Rocco, Rovaris, Marco, Salvetti, Marco, Torri Clerici, Valentina Liliana Adriana, Bergamaschi, Roberto, Maimone, Davide, Scarpini, Elio, Capobianco, Marco, Comi, Giancarlo, Filippi, Massimo, Trojano, Maria |
| المصدر: | Therapeutic Advances in Neurological Disorders, Vol 14 (2021) Therapeutic Advances in Neurological Disorders |
| بيانات النشر: | SAGE Publications, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Pediatrics, medicine.medical_specialty, big data, disability trajectories, disease registry, multiple sclerosis, 03 medical and health sciences, 0302 clinical medicine, Disease registry, Medicine, 030212 general & internal medicine, RC346-429, Original Research, Pharmacology, business.industry, Multiple sclerosis, Long term disability, medicine.disease, Neurology, Treatment strategy, Settore MED/26 - Neurologia, Neurology. Diseases of the nervous system, Neurology (clinical), business, 030217 neurology & neurosurgery |
| الوصف: | Background and aims: No consensus exists on how aggressively to treat relapsing–remitting multiple sclerosis (RRMS) nor on the timing of the treatment. The objective of this study was to evaluate disability trajectories in RRMS patients treated with an early intensive treatment (EIT) or with a moderate-efficacy treatment followed by escalation to higher-efficacy disease modifying therapy (ESC). Methods: RRMS patients with ⩾5-year follow-up and ⩾3 visits after disease modifying therapy (DMT) start were selected from the Italian MS Registry. EIT group included patients who received as first DMT fingolimod, natalizumab, mitoxantrone, alemtuzumab, ocrelizumab, cladribine. ESC group patients received the high efficacy DMT after ⩾1 year of glatiramer acetate, interferons, azathioprine, teriflunomide or dimethylfumarate treatment. Patients were 1:1 propensity score (PS) matched for characteristics at the first DMT. The disability trajectories were evaluated by applying a longitudinal model for repeated measures. The effect of early versus late start of high-efficacy DMT was assessed by the mean annual Expanded Disability Status Scale (EDSS) changes compared with baseline values (delta-EDSS) in EIT and ESC groups. Results: The study cohort included 2702 RRMS patients. The PS matching procedure produced 363 pairs, followed for a median (interquartile range) of 8.5 (6.5–11.7) years. Mean annual delta-EDSS values were all significantly ( p Conclusion: Our results indicate that EIT strategy is more effective than ESC strategy in controlling disability progression over time. |
| تدمد: | 1756-2864 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::096de3230e20ad0a2468e8355ba677cfTest https://doi.org/10.1177/17562864211019574Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....096de3230e20ad0a2468e8355ba677cf |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 17562864 |
|---|