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): data from the Italian MS Register: Journal of Neurology

D Paolicelli; G Lucisano; A Manni; C Avolio; S Bonavita; V Brescia Morra; M Capobianco; E Cocco; A Conte; G De Luca; F De Robertis; C Gasperini; M Gatto; P Gazzola; G Lus; A Iaffaldano; P Iaffaldano; D Maimone; G Mallucci; GT Maniscalco; GA Marfia; F Patti; I Pesci; C Pozzilli; M Rovaris; G Salemi; M Salvetti; D Spitaleri; R Totaro; M Zaffaroni; G Comi; MP Amato; M Trojano; on behalf of the Italian MS Register

doi:10.1007/s00415-019-09531-6

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): data from the Italian MS Register: Journal of Neurology

D Paolicelli, G Lucisano, A Manni, C Avolio, S Bonavita, V Brescia Morra, M Capobianco, E Cocco, A Conte, G De Luca, F De Robertis, C Gasperini, M Gatto, P Gazzola, G Lus, A Iaffaldano, P Iaffaldano, D Maimone, G Mallucci, GT ManiscalcoGA Marfia, F Patti, I Pesci, C Pozzilli, M Rovaris, G Salemi, M Salvetti, D Spitaleri, R Totaro, M Zaffaroni, G Comi, MP Amato, M Trojano, on behalf of the Italian MS Register

IRCCS Ospedale San Raffaele

Research output: Contribution to journal › Article

Abstract

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. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature.

Original language	English
Pages (from-to)	3098-3107
Number of pages	10
Journal	Journal of Neurology
Volume	266
DOIs	https://doi.org/10.1007/s00415-019-09531-6
Publication status	Published - 2019

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Paolicelli, D., Lucisano, G., Manni, A., Avolio, C., Bonavita, S., Brescia Morra, V., Capobianco, M., Cocco, E., Conte, A., De Luca, G., De Robertis, F., Gasperini, C., Gatto, M., Gazzola, P., Lus, G., Iaffaldano, A., Iaffaldano, P., Maimone, D., Mallucci, G., ... Register, O. B. O. T. I. MS. (2019). 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): data from the Italian MS Register: Journal of Neurology. Journal of Neurology, 266, 3098-3107. https://doi.org/10.1007/s00415-019-09531-6

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): data from the Italian MS Register : Journal of Neurology. / Paolicelli, D; Lucisano, G; Manni, A; Avolio, C; Bonavita, S; Brescia Morra, V; Capobianco, M; Cocco, E; Conte, A; De Luca, G; De Robertis, F; Gasperini, C; Gatto, M; Gazzola, P; Lus, G; Iaffaldano, A; Iaffaldano, P; Maimone, D; Mallucci, G; Maniscalco, GT; Marfia, GA; Patti, F; Pesci, I; Pozzilli, C; Rovaris, M; Salemi, G; Salvetti, M; Spitaleri, D; Totaro, R; Zaffaroni, M; Comi, G; Amato, MP; Trojano, M; Register, on behalf of the Italian MS.

In: Journal of Neurology, Vol. 266, 2019, p. 3098-3107.

Research output: Contribution to journal › Article

Paolicelli, D, Lucisano, G, Manni, A, Avolio, C, Bonavita, S, Brescia Morra, V, Capobianco, M, Cocco, E, Conte, A, De Luca, G, De Robertis, F, Gasperini, C, Gatto, M, Gazzola, P, Lus, G, Iaffaldano, A, Iaffaldano, P, Maimone, D, Mallucci, G, Maniscalco, GT, Marfia, GA, Patti, F, Pesci, I, Pozzilli, C, Rovaris, M, Salemi, G, Salvetti, M, Spitaleri, D, Totaro, R, Zaffaroni, M, Comi, G, Amato, MP, Trojano, M & Register, OBOTIMS 2019, '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): data from the Italian MS Register: Journal of Neurology', Journal of Neurology, vol. 266, pp. 3098-3107. https://doi.org/10.1007/s00415-019-09531-6

Paolicelli D, Lucisano G, Manni A, Avolio C, Bonavita S, Brescia Morra V et al. 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): data from the Italian MS Register: Journal of Neurology. Journal of Neurology. 2019;266:3098-3107. https://doi.org/10.1007/s00415-019-09531-6

Paolicelli, D ; Lucisano, G ; Manni, A ; Avolio, C ; Bonavita, S ; Brescia Morra, V ; Capobianco, M ; Cocco, E ; Conte, A ; De Luca, G ; De Robertis, F ; Gasperini, C ; Gatto, M ; Gazzola, P ; Lus, G ; Iaffaldano, A ; Iaffaldano, P ; Maimone, D ; Mallucci, G ; Maniscalco, GT ; Marfia, GA ; Patti, F ; Pesci, I ; Pozzilli, C ; Rovaris, M ; Salemi, G ; Salvetti, M ; Spitaleri, D ; Totaro, R ; Zaffaroni, M ; Comi, G ; Amato, MP ; Trojano, M ; Register, on behalf of the Italian MS. / 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): data from the Italian MS Register : Journal of Neurology. In: Journal of Neurology. 2019 ; Vol. 266. pp. 3098-3107.

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title = "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): data from the Italian MS Register: Journal of Neurology",

abstract = "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 {\textquoteleft}real-world{\textquoteright} 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-na{\"i}ve 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. {\textcopyright} 2019, Springer-Verlag GmbH Germany, part of Springer Nature.",

author = "D Paolicelli and G Lucisano and A Manni and C Avolio and S Bonavita and {Brescia Morra}, V and M Capobianco and E Cocco and A Conte and {De Luca}, G and {De Robertis}, F and C Gasperini and M Gatto and P Gazzola and G Lus and A Iaffaldano and P Iaffaldano and D Maimone and G Mallucci and GT Maniscalco and GA Marfia and F Patti and I Pesci and C Pozzilli and M Rovaris and G Salemi and M Salvetti and D Spitaleri and R Totaro and M Zaffaroni and G Comi and MP Amato and M Trojano and Register, {on behalf of the Italian MS}",

year = "2019",

doi = "10.1007/s00415-019-09531-6",

language = "English",

volume = "266",

pages = "3098--3107",

journal = "Journal of Neurology",

issn = "0340-5354",

publisher = "Dr. Dietrich Steinkopff Verlag GmbH and Co. KG",

}

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): data from the Italian MS Register

T2 - Journal of Neurology

AU - Paolicelli, D

AU - Lucisano, G

AU - Manni, A

AU - Avolio, C

AU - Bonavita, S

AU - Brescia Morra, V

AU - Capobianco, M

AU - Cocco, E

AU - Conte, A

AU - De Luca, G

AU - De Robertis, F

AU - Gasperini, C

AU - Gatto, M

AU - Gazzola, P

AU - Lus, G

AU - Iaffaldano, A

AU - Iaffaldano, P

AU - Maimone, D

AU - Mallucci, G

AU - Maniscalco, GT

AU - Marfia, GA

AU - Patti, F

AU - Pesci, I

AU - Pozzilli, C

AU - Rovaris, M

AU - Salemi, G

AU - Salvetti, M

AU - Spitaleri, D

AU - Totaro, R

AU - Zaffaroni, M

AU - Comi, G

AU - Amato, MP

AU - Trojano, M

AU - Register, on behalf of the Italian MS

PY - 2019

Y1 - 2019

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. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature.

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. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature.

U2 - 10.1007/s00415-019-09531-6

DO - 10.1007/s00415-019-09531-6

M3 - Article

VL - 266

SP - 3098

EP - 3107

JO - Journal of Neurology

JF - Journal of Neurology

SN - 0340-5354

ER -