BACKGROUND: The Knowledge Program (KP) is an initiative to collect self-reported patient data and objective clinician assessments electronically at each outpatient clinical encounter. Available outcomes include the EuroQoL-5D (EQ5D), Patient Health Questionnaire-9 (PHQ9), Multiple Sclerosis Performance Scales (MSPS), and the timed 25-foot walk (T25FW). OBJECTIVE: This study was designed to use the KP to investigate the long-term benefits of early treatment (ET) in multiple sclerosis (MS). METHODS: The KP was queried for patients with relapsing-remitting MS or secondary progressive MS who were ≥ 5 years from symptom onset. ET was defined as treatment with an approved agent for ≥ 3 of the first five years after symptom onset. Propensity scores for ET were calculated based on early clinical characteristics. Patients were divided into propensity score quintiles and linear regression models were constructed to determine the treatment effect sizes and confidence intervals. RESULTS: From the 1082 patients that met entry criteria, 453 patients (41.9%) received ET. Those patients receiving ET showed significantly better scores on the EQ5D index, PHQ9, and MSPS, but only in the upper three propensity quintiles. For the T25FW, ET did not result in significantly better times in any quintile. CONCLUSIONS: These results suggest that ET of MS is beneficial but the effect appears modest.
BACKGROUND: The Knowledge Program (KP) is an initiative to collect self-reported patient data and objective clinician assessments electronically at each outpatient clinical encounter. Available outcomes include the EuroQoL-5D (EQ5D), Patient Health Questionnaire-9 (PHQ9), Multiple Sclerosis Performance Scales (MSPS), and the timed 25-foot walk (T25FW). OBJECTIVE: This study was designed to use the KP to investigate the long-term benefits of early treatment (ET) in multiple sclerosis (MS). METHODS: The KP was queried for patients with relapsing-remitting MS or secondary progressive MS who were ≥ 5 years from symptom onset. ET was defined as treatment with an approved agent for ≥ 3 of the first five years after symptom onset. Propensity scores for ET were calculated based on early clinical characteristics. Patients were divided into propensity score quintiles and linear regression models were constructed to determine the treatment effect sizes and confidence intervals. RESULTS: From the 1082 patients that met entry criteria, 453 patients (41.9%) received ET. Those patients receiving ET showed significantly better scores on the EQ5D index, PHQ9, and MSPS, but only in the upper three propensity quintiles. For the T25FW, ET did not result in significantly better times in any quintile. CONCLUSIONS: These results suggest that ET of MS is beneficial but the effect appears modest.
Authors: Dagmar Amtmann; Jiseon Kim; Hyewon Chung; Alyssa M Bamer; Robert L Askew; Salene Wu; Karon F Cook; Kurt L Johnson Journal: Rehabil Psychol Date: 2014-03-24
Authors: H Tedeholm; J Lycke; B Skoog; V Lisovskaja; J Hillert; C Dahle; J Fagius; S Fredrikson; A-M Landtblom; C Malmeström; C Martin; F Piehl; B Runmarker; L Stawiarz; M Vrethem; O Nerman; O Andersen Journal: Mult Scler Date: 2012-11-01 Impact factor: 6.312
Authors: Tomas Kalincik; Timothy Spelman; Maria Trojano; Pierre Duquette; Guillermo Izquierdo; Pierre Grammond; Alessandra Lugaresi; Raymond Hupperts; Edgardo Cristiano; Vincent Van Pesch; Francois Grand'maison; Daniele La Spitaleri; Maria Edite Rio; Sholmo Flechter; Celia Oreja-Guevara; Giorgio Giuliani; Aldo Savino; Maria Pia Amato; Thor Petersen; Ricardo Fernandez-Bolanos; Roberto Bergamaschi; Gerardo Iuliano; Cavit Boz; Jeannette Lechner-Scott; Norma Deri; Orla Gray; Freek Verheul; Marcela Fiol; Michael Barnett; Erik van Munster; Vetere Santiago; Fraser Moore; Mark Slee; Maria Laura Saladino; Raed Alroughani; Cameron Shaw; Krisztian Kasa; Tatjana Petkovska-Boskova; Leontien den Braber-Moerland; Joab Chapman; Eli Skromne; Joseph Herbert; Dieter Poehlau; Merrilee Needham; Elizabeth Alejandra Bacile Bacile; Walter Oleschko Arruda; Mark Paine; Bhim Singhal; Steve Vucic; Jose Antonio Cabrera-Gomez; Helmut Butzkueven Journal: PLoS One Date: 2013-05-21 Impact factor: 3.240