Abstract
| Original language | English |
|---|---|
| Journal | Journal of Neurology |
| DOIs | |
| Publication status | Published - Sep 18 2019 |
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Retrospectively acquired cohort study to evaluate the long-term impact of two different treatment strategies on disability outcomes in patients with relapsing multiple sclerosis (RE.LO.DI.MS). / Register, Italian MS; Paolicelli, Damiano; Lucisano, Giuseppe; Manni, Alessia; Avolio, Carlo; Bonavita, Simona; Brescia Morra, Vincenzo; Capobianco, Marco; Cocco, Eleonora; Conte, Antonella; De Luca, Giovanna; De Robertis, Francesca; Gasperini, Claudio; Gatto, Maurizia; Gazzola, Paola; Lus, Giacomo; Iaffaldano, Antonio; Iaffaldano, Pietro; Maimone, Davide; Mallucci, Giulia; Maniscalco, Giorgia T; Marfia, Girolama A; Patti, Francesco; Pesci, Ilaria; Pozzilli, Carlo; Rovaris, Marco; Salemi, Giuseppe; Salvetti, Marco; Spitaleri, Daniele; Totaro, Rocco; Zaffaroni, Mauro; Comi, Giancarlo; Amato, Maria Pia; Trojano, Maria.
In: Journal of Neurology, 18.09.2019.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Retrospectively acquired cohort study to evaluate the long-term impact of two different treatment strategies on disability outcomes in patients with relapsing multiple sclerosis (RE.LO.DI.MS)
AU - Register, Italian MS
AU - Paolicelli, Damiano
AU - Lucisano, Giuseppe
AU - Manni, Alessia
AU - Avolio, Carlo
AU - Bonavita, Simona
AU - Brescia Morra, Vincenzo
AU - Capobianco, Marco
AU - Cocco, Eleonora
AU - Conte, Antonella
AU - De Luca, Giovanna
AU - De Robertis, Francesca
AU - Gasperini, Claudio
AU - Gatto, Maurizia
AU - Gazzola, Paola
AU - Lus, Giacomo
AU - Iaffaldano, Antonio
AU - Iaffaldano, Pietro
AU - Maimone, Davide
AU - Mallucci, Giulia
AU - Maniscalco, Giorgia T
AU - Marfia, Girolama A
AU - Patti, Francesco
AU - Pesci, Ilaria
AU - Pozzilli, Carlo
AU - Rovaris, Marco
AU - Salemi, Giuseppe
AU - Salvetti, Marco
AU - Spitaleri, Daniele
AU - Totaro, Rocco
AU - Zaffaroni, Mauro
AU - Comi, Giancarlo
AU - Amato, Maria Pia
AU - Trojano, Maria
PY - 2019/9/18
Y1 - 2019/9/18
N2 - BACKGROUND: The increase in disease-modifying drugs (DMDs) allows individualization of treatment in relapsing multiple sclerosis (RMS); however, the long-term impact of different treatment sequences is not well established. This is particularly relevant for MS patients who may need to postpone more aggressive DMD strategies.OBJECTIVE: To evaluate different therapeutic strategies and their long-term outcomes, measured as relapses and confirmed disability progression (CDP), in MS 'real-world' settings.METHODS: Multicentre, observational, retrospectively acquired cohort study evaluating the long-term impact of different treatment strategies on disability outcomes in patients with RMS in the Italian MS Register.RESULTS: We evaluated 1152 RMS-naïve patients after propensity-score adjustment. Patients included were receiving: interferon beta-1a (IFN-β1a) 44 µg switching to fingolimod (FTY; IFN-switchers; n = 97); FTY only (FTY-stayers; n = 157); IFN-β1a only (IFN-stayers; n = 849). CDP and relapses did not differ between FTY-stayers and IFN-switchers [HR (95% CI) 0.99 (0.48-2.04), p = 0.98 and 0.81 (0.42-1.58), p = 0.55, respectively]. However, IFN-stayers showed increased risk of relapses compared with FTY-stayers [HR (95% CI) 1.46 (1.00-2.12), p = 0.05].CONCLUSION: The ideal treatment option for MS is becoming increasingly complex, with the need to balance benefit and risks. Our results suggest that starting with FTY affects the long-term disease outcome similarly to escalating from IFN-β1a to FTY.
AB - BACKGROUND: The increase in disease-modifying drugs (DMDs) allows individualization of treatment in relapsing multiple sclerosis (RMS); however, the long-term impact of different treatment sequences is not well established. This is particularly relevant for MS patients who may need to postpone more aggressive DMD strategies.OBJECTIVE: To evaluate different therapeutic strategies and their long-term outcomes, measured as relapses and confirmed disability progression (CDP), in MS 'real-world' settings.METHODS: Multicentre, observational, retrospectively acquired cohort study evaluating the long-term impact of different treatment strategies on disability outcomes in patients with RMS in the Italian MS Register.RESULTS: We evaluated 1152 RMS-naïve patients after propensity-score adjustment. Patients included were receiving: interferon beta-1a (IFN-β1a) 44 µg switching to fingolimod (FTY; IFN-switchers; n = 97); FTY only (FTY-stayers; n = 157); IFN-β1a only (IFN-stayers; n = 849). CDP and relapses did not differ between FTY-stayers and IFN-switchers [HR (95% CI) 0.99 (0.48-2.04), p = 0.98 and 0.81 (0.42-1.58), p = 0.55, respectively]. However, IFN-stayers showed increased risk of relapses compared with FTY-stayers [HR (95% CI) 1.46 (1.00-2.12), p = 0.05].CONCLUSION: The ideal treatment option for MS is becoming increasingly complex, with the need to balance benefit and risks. Our results suggest that starting with FTY affects the long-term disease outcome similarly to escalating from IFN-β1a to FTY.
U2 - 10.1007/s00415-019-09531-6
DO - 10.1007/s00415-019-09531-6
M3 - Article
JO - Journal of Neurology
JF - Journal of Neurology
SN - 0340-5354
ER -