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Early treatment delays long-term disability accrual in RRMS
Mult Scler
. 2021 Apr 26;13524585211010128.
doi: 10.1177/13524585211010128. Online ahead of print.
Early treatment delays long-term disability accrual in RRMS: Results from the BMSD network
Pietro Iaffaldano 1, Giuseppe Lucisano 2, Helmut Butzkueven 3, Jan Hillert 4, Robert Hyde 5, Nils Koch-Henriksen 6, Melinda Magyari 6, Fabio Pellegrini 5, Tim Spelman 7, Per Soelberg Sørensen 6, Sandra Vukusic 8, Maria Trojano 1
Affiliations expand
Background: The optimal timing of treatment starts for achieving the best control on the long-term disability accumulation in multiple sclerosis (MS) is still to be defined.
Objective: The aim of this study was to estimate the optimal time to start disease-modifying therapies (DMTs) to prevent the long-term disability accumulation in MS, using a pooled dataset from the Big Multiple Sclerosis Data (BMSD) network.
Methods: Multivariable Cox regression models adjusted for the time to first treatment start from disease onset (in quintiles) were used. To mitigate the impact of potential biases, a set of pairwise propensity score (PS)-matched analyses were performed. The first quintile, including patients treated within 1.2 years from onset, was used as reference.
Results: A cohort of 11,871 patients (median follow-up after treatment start: 13.2 years) was analyzed. A 3- and 12-month confirmed disability worsening event and irreversible Expanded Disability Status Scale (EDSS) 4.0 and 6.0 scores were reached by 7062 (59.5%), 4138 (34.9%), 3209 (31.1%), and 1909 (16.5%) patients, respectively. The risk of reaching all the disability outcomes was significantly lower (p < 0.0004) for the first quintile patients' group.
Conclusion: Real-world data from the BMSD demonstrate that DMTs should be commenced within 1.2 years from the disease onset to reduce the risk of disability accumulation over the long term.
. 2021 Apr 26;13524585211010128.
doi: 10.1177/13524585211010128. Online ahead of print.
Early treatment delays long-term disability accrual in RRMS: Results from the BMSD network
Pietro Iaffaldano 1, Giuseppe Lucisano 2, Helmut Butzkueven 3, Jan Hillert 4, Robert Hyde 5, Nils Koch-Henriksen 6, Melinda Magyari 6, Fabio Pellegrini 5, Tim Spelman 7, Per Soelberg Sørensen 6, Sandra Vukusic 8, Maria Trojano 1
Affiliations expand
- PMID: 33900144
- DOI: 10.1177/13524585211010128
Background: The optimal timing of treatment starts for achieving the best control on the long-term disability accumulation in multiple sclerosis (MS) is still to be defined.
Objective: The aim of this study was to estimate the optimal time to start disease-modifying therapies (DMTs) to prevent the long-term disability accumulation in MS, using a pooled dataset from the Big Multiple Sclerosis Data (BMSD) network.
Methods: Multivariable Cox regression models adjusted for the time to first treatment start from disease onset (in quintiles) were used. To mitigate the impact of potential biases, a set of pairwise propensity score (PS)-matched analyses were performed. The first quintile, including patients treated within 1.2 years from onset, was used as reference.
Results: A cohort of 11,871 patients (median follow-up after treatment start: 13.2 years) was analyzed. A 3- and 12-month confirmed disability worsening event and irreversible Expanded Disability Status Scale (EDSS) 4.0 and 6.0 scores were reached by 7062 (59.5%), 4138 (34.9%), 3209 (31.1%), and 1909 (16.5%) patients, respectively. The risk of reaching all the disability outcomes was significantly lower (p < 0.0004) for the first quintile patients' group.
Conclusion: Real-world data from the BMSD demonstrate that DMTs should be commenced within 1.2 years from the disease onset to reduce the risk of disability accumulation over the long term.