Assessing the role of innovative therapeutic paradigm on multiple sclerosis treatment response

MAL Romeo, V Martinelli, G Dalla Costa, B Colombo, Donatella De Feo, F Esposito, L Ferrè, C Guaschino, Simone Guerrieri, G Liberatore, F Martinelli Boneschi, A Merlini, M Messina, R Messina, A Nuara, P Preziosa, M Radaelli, MA Rocca, M Rodegher, Francesca SangalliD Strambo, L Moiola, G Comi

Research output: Contribution to journalArticle

Abstract

Objective: Within the last decade, many changes have been made to the management of patients with multiple sclerosis (MS). The aim of our study was to investigate the global impact of all these changes on the disease's course. Materials and methods: This single-centre study was carried out on patients with multiple sclerosis (pwMS) who started treatment with first-line disease-modifying therapies. We have compared three large cohorts of patients with MS diagnosis, for three consecutive periods within July 2001, August 2001-December 2005, and January 2006-September 2011. Results: A total of 1068 relapsing-remitting pwMS cases were included. Patients in the last cohort began treatment earlier (P <0.0001), started more frequent treatment with high-dose interferon beta or glatiramer acetate (P <0.0001), and had experienced a more frequent treatment escalation strategy (P = 0.004) than patients in other cohorts. The multivariate analysis adjusted for baseline characteristics showed that pwMS of the last cohort had a high probability of showing no evidence of disease activity (NEDA3) at 4 years (OR 3.22, 95% CIs 1.89-5.47; P <0.0001). These results were confirmed in a propensity score analysis. Conclusions: Our study showed an improvement over the last 15 years in the treatment response; this observation can be associated to a paradigm shift in MS treatment strategies. © 2018 John Wiley & Sons A/S.
Original languageEnglish
Pages (from-to)447-453
Number of pages7
JournalActa Neurologica Scandinavica
Volume138
Issue number5
DOIs
Publication statusPublished - 2018

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Multiple Sclerosis
Therapeutics
Propensity Score
Interferon-beta
Nuclear Family
Multivariate Analysis

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Assessing the role of innovative therapeutic paradigm on multiple sclerosis treatment response. / Romeo, MAL; Martinelli, V; Dalla Costa, G; Colombo, B; De Feo, Donatella; Esposito, F; Ferrè, L; Guaschino, C; Guerrieri, Simone; Liberatore, G; Martinelli Boneschi, F; Merlini, A; Messina, M; Messina, R; Nuara, A; Preziosa, P; Radaelli, M; Rocca, MA; Rodegher, M; Sangalli, Francesca; Strambo, D; Moiola, L; Comi, G.

In: Acta Neurologica Scandinavica, Vol. 138, No. 5, 2018, p. 447-453.

Research output: Contribution to journalArticle

Romeo, MAL, Martinelli, V, Dalla Costa, G, Colombo, B, De Feo, D, Esposito, F, Ferrè, L, Guaschino, C, Guerrieri, S, Liberatore, G, Martinelli Boneschi, F, Merlini, A, Messina, M, Messina, R, Nuara, A, Preziosa, P, Radaelli, M, Rocca, MA, Rodegher, M, Sangalli, F, Strambo, D, Moiola, L & Comi, G 2018, 'Assessing the role of innovative therapeutic paradigm on multiple sclerosis treatment response', Acta Neurologica Scandinavica, vol. 138, no. 5, pp. 447-453. https://doi.org/10.1111/ane.12999
Romeo, MAL ; Martinelli, V ; Dalla Costa, G ; Colombo, B ; De Feo, Donatella ; Esposito, F ; Ferrè, L ; Guaschino, C ; Guerrieri, Simone ; Liberatore, G ; Martinelli Boneschi, F ; Merlini, A ; Messina, M ; Messina, R ; Nuara, A ; Preziosa, P ; Radaelli, M ; Rocca, MA ; Rodegher, M ; Sangalli, Francesca ; Strambo, D ; Moiola, L ; Comi, G. / Assessing the role of innovative therapeutic paradigm on multiple sclerosis treatment response. In: Acta Neurologica Scandinavica. 2018 ; Vol. 138, No. 5. pp. 447-453.
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abstract = "Objective: Within the last decade, many changes have been made to the management of patients with multiple sclerosis (MS). The aim of our study was to investigate the global impact of all these changes on the disease's course. Materials and methods: This single-centre study was carried out on patients with multiple sclerosis (pwMS) who started treatment with first-line disease-modifying therapies. We have compared three large cohorts of patients with MS diagnosis, for three consecutive periods within July 2001, August 2001-December 2005, and January 2006-September 2011. Results: A total of 1068 relapsing-remitting pwMS cases were included. Patients in the last cohort began treatment earlier (P <0.0001), started more frequent treatment with high-dose interferon beta or glatiramer acetate (P <0.0001), and had experienced a more frequent treatment escalation strategy (P = 0.004) than patients in other cohorts. The multivariate analysis adjusted for baseline characteristics showed that pwMS of the last cohort had a high probability of showing no evidence of disease activity (NEDA3) at 4 years (OR 3.22, 95{\%} CIs 1.89-5.47; P <0.0001). These results were confirmed in a propensity score analysis. Conclusions: Our study showed an improvement over the last 15 years in the treatment response; this observation can be associated to a paradigm shift in MS treatment strategies. {\circledC} 2018 John Wiley & Sons A/S.",
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AU - Romeo, MAL

AU - Martinelli, V

AU - Dalla Costa, G

AU - Colombo, B

AU - De Feo, Donatella

AU - Esposito, F

AU - Ferrè, L

AU - Guaschino, C

AU - Guerrieri, Simone

AU - Liberatore, G

AU - Martinelli Boneschi, F

AU - Merlini, A

AU - Messina, M

AU - Messina, R

AU - Nuara, A

AU - Preziosa, P

AU - Radaelli, M

AU - Rocca, MA

AU - Rodegher, M

AU - Sangalli, Francesca

AU - Strambo, D

AU - Moiola, L

AU - Comi, G

PY - 2018

Y1 - 2018

N2 - Objective: Within the last decade, many changes have been made to the management of patients with multiple sclerosis (MS). The aim of our study was to investigate the global impact of all these changes on the disease's course. Materials and methods: This single-centre study was carried out on patients with multiple sclerosis (pwMS) who started treatment with first-line disease-modifying therapies. We have compared three large cohorts of patients with MS diagnosis, for three consecutive periods within July 2001, August 2001-December 2005, and January 2006-September 2011. Results: A total of 1068 relapsing-remitting pwMS cases were included. Patients in the last cohort began treatment earlier (P <0.0001), started more frequent treatment with high-dose interferon beta or glatiramer acetate (P <0.0001), and had experienced a more frequent treatment escalation strategy (P = 0.004) than patients in other cohorts. The multivariate analysis adjusted for baseline characteristics showed that pwMS of the last cohort had a high probability of showing no evidence of disease activity (NEDA3) at 4 years (OR 3.22, 95% CIs 1.89-5.47; P <0.0001). These results were confirmed in a propensity score analysis. Conclusions: Our study showed an improvement over the last 15 years in the treatment response; this observation can be associated to a paradigm shift in MS treatment strategies. © 2018 John Wiley & Sons A/S.

AB - Objective: Within the last decade, many changes have been made to the management of patients with multiple sclerosis (MS). The aim of our study was to investigate the global impact of all these changes on the disease's course. Materials and methods: This single-centre study was carried out on patients with multiple sclerosis (pwMS) who started treatment with first-line disease-modifying therapies. We have compared three large cohorts of patients with MS diagnosis, for three consecutive periods within July 2001, August 2001-December 2005, and January 2006-September 2011. Results: A total of 1068 relapsing-remitting pwMS cases were included. Patients in the last cohort began treatment earlier (P <0.0001), started more frequent treatment with high-dose interferon beta or glatiramer acetate (P <0.0001), and had experienced a more frequent treatment escalation strategy (P = 0.004) than patients in other cohorts. The multivariate analysis adjusted for baseline characteristics showed that pwMS of the last cohort had a high probability of showing no evidence of disease activity (NEDA3) at 4 years (OR 3.22, 95% CIs 1.89-5.47; P <0.0001). These results were confirmed in a propensity score analysis. Conclusions: Our study showed an improvement over the last 15 years in the treatment response; this observation can be associated to a paradigm shift in MS treatment strategies. © 2018 John Wiley & Sons A/S.

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