- Title
- Anti-inflammatory disease-modifying treatment and disability progression in primary progressive multiple sclerosis: a cohort study
- Creator
- Lorscheider, J.; Kuhle, J.; Grand'Maison, F.; Grammond, P.; Sola, P.; Ferraro, D.; Trojano, M.; Ramo-Tello, C.; Lechner-Scott, J.; Pucci, E.; Solaro, C.; Slee, M.; Izquierdo, G.; Van Pesch, V.; Sanchez Menoyo, J. L.; van der Walt, A.; Butzkueven, H.; Kappos, L.; Kalincik, T.; Lugaresi, A.; Havrdova, E.; Horakova, D.; Hupperts, R.; Duquette, P.; Girard, M.; Prat, A.
- Relation
- European Journal of Neurology Vol. 26, Issue 2, p. 363-370
- Publisher Link
- http://dx.doi.org/10.1111/ene.13824
- Publisher
- Wiley-Blackwell Publishing
- Resource Type
- journal article
- Date
- 2019
- Description
- Background and purpose: Treatment options in primary progressive multiple sclerosis (PPMS) are scarce and, with the exception of ocrelizumab, anti-inflammatory agents have failed to show efficacy in ameliorating disability progression. The aim of this study was to investigate a potential effect of anti-inflammatory disease-modifying treatment on disability outcomes in PPMS. Methods: Using MSBase, a large, international, observational database, we identified patients with PPMS who were either never treated or treated with a disease-modifying agent. Propensity score matching was used to select subpopulations with similar baseline characteristics. Expanded Disability Status Scale (EDSS) outcomes were compared with an intention-to-treat and an as-treated approach in paired, pairwise-censored analyses. Results: Of the 1284 included patients, 533 were matched (treated, n = 195; untreated n = 338). Median on-study pairwise-censored follow-up was 3.4 years (quartiles 1.2–5.5). No difference in the hazard of experiencing 3-month confirmed EDSS progression events was observed between the groups [hazard ratio (HR), 1.0; 95% confidence interval (CI), 0.6–1.7, P = 0.87]. We did not find significant differences in the hazards of confirmed EDSS improvement (HR, 1.0; 95% CI, 0.6–1.6, P = 0.91) or reaching a confirmed EDSS step ≥7 (HR, 1.1; 95% CI, 0.7–1.6, P = 0.69). Conclusion: Our pooled analysis of disease-modifying agents suggests that these therapies have no substantial effect on short- to medium-term disability outcomes in PPMS.
- Subject
- clinical outcomes; immunomodulation; multiple sclerosis; observational study; primary progressive
- Identifier
- http://hdl.handle.net/1959.13/1446356
- Identifier
- uon:42843
- Identifier
- ISSN:1351-5101
- Language
- eng
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