BACKGROUND: Few studies have analysed long-term effects of immunomodulatory disease modifying drugs (DMDs). OBJECTIVE: Assessment of the efficacy of DMDs on long-term evolution of multiple sclerosis, using a Bayesian approach to overcome methodological problems related to open-label studies. METHODS: MS patients from three different Italian multiple sclerosis centres were divided into subgroups according to the presence of treatment in their disease history before the endpoint, which was represented by secondary progression. Patients were stratified on the basis of the risk score BREMS (Bayesian risk estimate for multiple sclerosis), which is able to predict the unfavourable long-term evolution of MS at an early stage. RESULTS: We analysed data from 1178 patients with a relapsing form of multiple sclerosis at onset and at least 10 years of disease duration, treated (59%) or untreated with DMDs. The risk of secondary progression was significantly lower in patients treated with DMDs, regardless of the initial prognosis predicted by BREMS. CONCLUSIONS: DMDs significantly reduce the risk of multiple sclerosis progression both in patients with initial high-risk and patients with initial low-risk. These findings reinforce the role of DMDs in modifying the natural course of the disease, suggesting that they have a positive effect not only on the inflammatory but also on the neurodegenerative process. The study also confirms the capability of the BREMS score to predict MS evolution.
BACKGROUND: Few studies have analysed long-term effects of immunomodulatory disease modifying drugs (DMDs). OBJECTIVE: Assessment of the efficacy of DMDs on long-term evolution of multiple sclerosis, using a Bayesian approach to overcome methodological problems related to open-label studies. METHODS: MS patients from three different Italian multiple sclerosis centres were divided into subgroups according to the presence of treatment in their disease history before the endpoint, which was represented by secondary progression. Patients were stratified on the basis of the risk score BREMS (Bayesian risk estimate for multiple sclerosis), which is able to predict the unfavourable long-term evolution of MS at an early stage. RESULTS: We analysed data from 1178 patients with a relapsing form of multiple sclerosis at onset and at least 10 years of disease duration, treated (59%) or untreated with DMDs. The risk of secondary progression was significantly lower in patients treated with DMDs, regardless of the initial prognosis predicted by BREMS. CONCLUSIONS:DMDs significantly reduce the risk of multiple sclerosis progression both in patients with initial high-risk and patients with initial low-risk. These findings reinforce the role of DMDs in modifying the natural course of the disease, suggesting that they have a positive effect not only on the inflammatory but also on the neurodegenerative process. The study also confirms the capability of the BREMS score to predict MS evolution.
Authors: Maria Trojano; Mar Tintore; Xavier Montalban; Jan Hillert; Tomas Kalincik; Pietro Iaffaldano; Tim Spelman; Maria Pia Sormani; Helmut Butzkueven Journal: Nat Rev Neurol Date: 2017-01-13 Impact factor: 42.937
Authors: Murray G Brown; Mark Asbridge; Vern Hicks; Sarah Kirby; Thomas J Murray; Pantelis Andreou; Dong Lin Journal: PLoS One Date: 2014-10-17 Impact factor: 3.240
Authors: T Zhang; A Shirani; Y Zhao; M E Karim; P Gustafson; J Petkau; C Evans; E Kingwell; M van der Kop; F Zhu; J Oger; H Tremlett Journal: Eur J Neurol Date: 2015-04-06 Impact factor: 6.089
Authors: J William L Brown; Alasdair Coles; Dana Horakova; Eva Havrdova; Guillermo Izquierdo; Alexandre Prat; Marc Girard; Pierre Duquette; Maria Trojano; Alessandra Lugaresi; Roberto Bergamaschi; Pierre Grammond; Raed Alroughani; Raymond Hupperts; Pamela McCombe; Vincent Van Pesch; Patrizia Sola; Diana Ferraro; Francois Grand'Maison; Murat Terzi; Jeannette Lechner-Scott; Schlomo Flechter; Mark Slee; Vahid Shaygannejad; Eugenio Pucci; Franco Granella; Vilija Jokubaitis; Mark Willis; Claire Rice; Neil Scolding; Alastair Wilkins; Owen R Pearson; Tjalf Ziemssen; Michael Hutchinson; Katharine Harding; Joanne Jones; Christopher McGuigan; Helmut Butzkueven; Tomas Kalincik; Neil Robertson Journal: JAMA Date: 2019-01-15 Impact factor: 56.272
Authors: Peter Joseph Jongen; Marco Heerings; Wim A Lemmens; Rogier Donders; Anneke van der Zande; Esther van Noort; Anton Kool Journal: BMC Neurol Date: 2015-08-04 Impact factor: 2.474