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dc.contributor.authorLorscheider, Johannes
dc.contributor.authorJokubaitis, Vilija G.
dc.contributor.authorSpelman, Tim
dc.contributor.authorIzquierdo, Guillermo
dc.contributor.authorLugaresi, Alessandra
dc.contributor.authorHavrdova, Eva
dc.contributor.authorGranella, Franco
dc.date.accessioned2020-06-21T13:18:18Z
dc.date.available2020-06-21T13:18:18Z
dc.date.issued2017
dc.identifier.issn0028-3878
dc.identifier.issn1526-632X
dc.identifier.urihttps://doi.org/10.1212/WNL.0000000000004330
dc.identifier.urihttps://hdl.handle.net/20.500.12712/12241
dc.descriptionKermode, Allan/0000-0002-4476-4016; Ferraro, Diana/0000-0003-4818-3806; Lugaresi, Alessandra/0000-0003-2902-5589; Jokubaitis, Vilija G./0000-0002-3942-4340; McCombe, Pamela/0000-0003-2704-8517; Ramo-Tello, Cristina M/0000-0001-8643-5053; Oreja-Guevara, Celia/0000-0002-9221-5716; Havrdova, Eva Kubala/0000-0002-9543-4359; Vucic, Steve/0000-0002-8323-873X; Kalincik, Tomas/0000-0003-3778-1376; Slee, Mark/0000-0003-4323-2453; Prat, Alexandre/0000-0001-6188-0580; Sanchez Menoyo, Jose Luis/0000-0003-2634-8294; van Pesch, Vincent/0000-0003-2885-9004; Trojano, Maria/0000-0002-6329-8946; Butzkueven, Helmut/0000-0003-3940-8727; Lorscheider, Johannes/0000-0003-1100-2506; pucci, eugenio/0000-0001-7606-7330; Petersen, Thor/0000-0001-5633-2600en_US
dc.descriptionWOS: 000409172500017en_US
dc.descriptionPubMed: 28794248en_US
dc.description.abstractObjective: To investigate the effect of disease-modifying treatment on short-term disability outcomes in secondary progressive multiple sclerosis (SPMS). Methods: Using MSBase, an international cohort study, we previously validated a highly accurate definition of SPMS. Here, we identified patients in MSBase who were either untreated or treated with a disease-modifying drug when meeting this definition. Propensity score matching was used to select subpopulations with comparable baseline characteristics. Disability outcomes were compared in paired, pairwise-censored analyses adjusted for treatment persistence, visit density, and relapse rates. Results: Of the 2,381 included patients, 1,378 patients were matchable (treated n=689, untreated n=689). Median pairwise-censored follow-up was 2.1 years (quartiles 1.2-3.8 years). No difference in the risk of 6-month sustained disability progression was observed between the groups (hazard ratio [HR] 0.9, 95% confidence interval [CI] 0.7-1.1, p=0.27). We also did not find differences in any of the secondary endpoints: risk of reaching Expanded Disability Status Scale (EDSS) score $ 7 (HR 0.6, 95% CI 0.4-1.1, p=0.10), sustained disability reduction (HR 1.0, 95% CI 0.8-1.3, p=0.79), or change in disability burden (area under the EDSS-time curve, beta=20.05, p=0.09). Secondary and sensitivity analyses confirmed the results. Conclusions: Our pooled analysis of the currently available disease-modifying agents used after conversion to SPMS suggests that, on average, these therapies have no substantial effect on relapse-unrelated disability outcomes measured by the EDSS up to 4 years. Classification of evidence: This study provides Class IV evidence that for patients with SPMS, disease-modifying treatment has no beneficial effect on short-term disability progression.en_US
dc.description.sponsorshipBiogenBiogen; National Health and Medical Research CouncilNational Health and Medical Research Council of Australia; University of MelbourneUniversity of Melbourne; MerckMerck & Company; NovartisNovartis; BayerBayer AG; GenzymeGenzyme Corporation; Teva; Sanofi-AventisSanofi-Aventisen_US
dc.description.sponsorshipThis study was financially supported by Biogen (Fellowship in MS Registries Research), the National Health and Medical Research Council (practitioner fellowship 1,080,518; project grants 1,083,539 and 1,129,189; and Centre for Research Excellence 1,001,216), and the University of Melbourne (Faculty of Medicine, Dentistry and Health Sciences research fellowship). The MSBase Foundation is a not-for-profit organization that receives support from Merck, Biogen, Novartis, Bayer, Genzyme, Teva, and Sanofi-Aventis. The study was conducted separately and apart from the guidance of the sponsors.en_US
dc.language.isoengen_US
dc.publisherLippincott Williams & Wilkinsen_US
dc.relation.isversionof10.1212/WNL.0000000000004330en_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.titleAnti-inflammatory disease-modifying treatment and short-term disability progression in SPMSen_US
dc.typearticleen_US
dc.contributor.departmentOMÜen_US
dc.identifier.volume89en_US
dc.identifier.issue10en_US
dc.identifier.startpage1050en_US
dc.identifier.endpage1059en_US
dc.relation.journalNeurologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US


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