Bibliographic Details
| Title: |
Long-term disability trajectories in relapsing multiple sclerosis patients treated with early intensive or escalation treatment strategies |
| Authors: |
Pietro Iaffaldano, Giuseppe Lucisano, Francesca Caputo, Damiano Paolicelli, Francesco Patti, Mauro Zaffaroni, Vincenzo Brescia Morra, Carlo Pozzilli, Giovanna De Luca, Matilde Inglese, Giuseppe Salemi, Giorgia Teresa Maniscalco, Eleonora Cocco, Patrizia Sola, Giacomo Lus, Antonella Conte, Maria Pia Amato, Franco Granella, Claudio Gasperini, Paolo Bellantonio, Rocco Totaro, Marco Rovaris, Marco Salvetti, Valentina Liliana Adriana Torri Clerici, Roberto Bergamaschi, Davide Maimone, Elio Scarpini, Marco Capobianco, Giancarlo Comi, Massimo Filippi, Maria Trojano |
| Source: |
Therapeutic Advances in Neurological Disorders, Vol 14 (2021) |
| Publisher Information: |
SAGE Publishing, 2021. |
| Publication Year: |
2021 |
| Collection: |
LCC:Neurology. Diseases of the nervous system |
| Subject Terms: |
Neurology. Diseases of the nervous system, RC346-429 |
| More Details: |
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 |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
1756-2864
17562864 |
| Relation: |
https://doaj.org/toc/1756-2864 |
| DOI: |
10.1177/17562864211019574 |
| Access URL: |
https://doaj.org/article/3703cb6bf10f4df8b43ccfba7b2d6c8a |
| Accession Number: |
edsdoj.3703cb6bf10f4df8b43ccfba7b2d6c8a |
| Database: |
Directory of Open Access Journals |
