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001-es BibID:BIBFORM126270
035-os BibID:(scopus)85190160325 (wos)001201473600001
Első szerző:Dekeyser, Cathérine
Cím:Routine CSF parameters as predictors of disease course in multiple sclerosis : an MSBase cohort study / Dekeyser C., Hautekeete M., Cambron M., Van Pesch V., Patti F., Kuhle J., Khoury S., Lechner Scott J., Gerlach O., Lugaresi A., Maimone D., Surcinelli A., Grammond P., Kalincik T., Habek M., Willekens B., Macdonell R., Lalive P., Csepany T., Butzkueven H., Boz C., Tomassini V., Foschi M., Sánchez-Menoyo J. L., Altintas A., Mrabet S., Iuliano G., Sa M. J., Alroughani R., Karabudak R., Aguera-Morales E., Gray O., de Gans K., van der Walt A., McCombe P. A., Deri N., Garber J., Al-Asmi A., Skibina O., Duquette P., Cartechini E., Spitaleri D., Gouider R., Soysal A., Van Hijfte L., Slee M., Amato M. P., Buzzard K., Laureys G.
Dátum:2024
ISSN:0022-3050 1468-330X
Megjegyzések:Background: It remains unclear whether routine cerebrospinal fluid (CSF) parameters can serve as predictors of multiple sclerosis (MS) disease course. Methods: This large-scale cohort study included persons with MS with CSF data documented in the MSBase registry. CSF parameters to predict time to reach confirmed Expanded Disability Status Scale (EDSS) scores 4, 6 and 7 and annualised relapse rate in the first 2 years after diagnosis (ARR2) were assessed using (cox) regression analysis. Results: In total, 11 245 participants were included of which 93.7% (n=10 533) were persons with relapsing-remitting MS (RRMS). In RRMS, the presence of CSF oligoclonal bands (OCBs) was associated with shorter time to disability milestones EDSS 4 (adjusted HR=1.272 (95% CI, 1.089 to 1.485), p=0.002), EDSS 6 (HR=1.314 (95% CI, 1.062 to 1.626), p=0.012) and EDSS 7 (HR=1.686 (95% CI, 1.111 to 2.558), p=0.014). On the other hand, the presence of CSF pleocytosis (?5 cells/?L) increased time to moderate disability (EDSS 4) in RRMS (HR=0.774 (95% CI, 0.632 to 0.948), p=0.013). None of the CSF variables were associated with time to disability milestones in persons with primary progressive MS (PPMS). The presence of CSF pleocytosis increased ARR2 in RRMS (adjusted R2=0.036, p=0.015). Conclusions: In RRMS, the presence of CSF OCBs predicts shorter time to disability milestones, whereas CSF pleocytosis could be protective. This could however not be found in PPMS. CSF pleocytosis is associated with short-term inflammatory disease activity in RRMS. CSF analysis provides prognostic information which could aid in clinical and therapeutic decision-making.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
CLINICAL NEUROLOGY
CSF
MULTIPLE SCLEROSIS
NEUROIMMUNOLOGY
Megjelenés:Journal of Neurology, Neurosurgery, and Psychiatry . - 95 : 11 (2024), p. 1021-1031. -
További szerzők:Hautekeete, Matthias Cambron, Melissa Pesch, Vincent van Patti, Francesco Kuhle, Jens Khoury, Samia J. Lechner Scott, Jeanette Gerlach, Oliver Lugaresi, Alessandra Maimone, Davide Surcinelli, Andrea Grammond, Pierre Kalincik, Tomas Habek, Mario Willekens, Barbara Macdonell, Richard Lalive, Patrice H. Csépány Tünde (1956-) (neurológus, pszichiáter) Butzkueven, Helmut Boz, Cavit Tomassini, Valentina Foschi, Matteo Sanchez-Menoyo, Jose Altintas, Ayse Mrabet, Saloua Iuliano, Gerardo Sá, Maria José Alroughani, Raed Karabudak, Rana Aguera-Morales, Eduardo Gray, Orla de Gans, Koen Walt, Anneke van der McCombe, Pamela Deri, Norma Garber, Justin Al-Asmi, Abdullah Skibina, Olga Duquette, Pierre Cartechini, Elisabetta Spitaleri, Daniele Gouider, Riadh Soysal, Aysun Van Hijfte, Liesbeth Slee, Mark Amato, Maria Pia Buzzard, Katherine Laureys, Guy
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2.

001-es BibID:BIBFORM126432
035-os BibID:(WoS)001077004600002 (Scopus)85181761016
Első szerző:Li, Ying
Cím:Examining the environmental risk factors of progressive-onset and relapsing-onset multiple sclerosis : recruitment challenges, potential bias, and statistical strategies / Li Y., Saul A., Taylor B., Ponsonby A. L., Simpson-Yap S., Blizzard L., Broadley S., Lechner-Scott J., Ausimmune/AusLong Investigators Group, Karabudak R., Patti F., Eichau S., Onofrj M., Ozakbas S., Horakova D., Kubala Havrdova E., Grand'Maison F., Alroughani R., Gerlach O., Amato M. P., Altintas A., Girard M., Duquette P., Blanco Y., Ramo-Tello C., Laureys G., Kalincik T., Khoury S. J., Shaygannejad V., Etemadifar M., Singhal B., Mrabet S., Foschi M., Habek M., John N., Hughes S., McCombe P., Ampapa R., van der Walt A., Butzkueven H., de Gans K., McGuigan C., Oreja-Guevara C., Sa M. J., Petersen T., Al-Harbi T., Sempere A. P., Van Wijmeersch B., Grigoriadis N., Prevost J., Gray O., Castillo-Trivino T., Macdonell R., Lugaresi A., Sajedi S. A., MSBase, van der Mei I.
Dátum:2024
ISSN:0340-5354
Megjegyzések:It is unknown whether the currently known risk factors of multiple sclerosis reflect the etiology of progressive-onset multiple sclerosis (POMS) as observational studies rarely included analysis by type of onset. We designed a case-control study to examine associations between environmental factors and POMS and compared effect sizes to relapse-onset MS (ROMS), which will offer insights into the etiology of POMS and potentially contribute to prevention and intervention practice. This study utilizes data from the Primary Progressive Multiple Sclerosis (PPMS) Study and the Australian Multi-center Study of Environment and Immune Function (the AusImmune Study). This report outlines the conduct of the PPMS Study, whether the POMS sample is representative, and the planned analysis methods. The study includes 155 POMS, 204 ROMS, and 558 controls. The distributions of the POMS were largely similar to Australian POMS patients in the MSBase Study, with 54.8% female, 85.8% POMS born before 1970, mean age of onset of 41.44 ? 8.38 years old, and 67.1% living between 28.9 and 39.4? S. The POMS were representative of the Australian POMS population. There are some differences between POMS and ROMS/controls (mean age at interview: POMS 55 years vs. controls 40 years; sex: POMS 53% female vs. controls 78% female; location of residence: 14.3% of POMS at a latitude ? 28.9?S vs. 32.8% in controls), which will be taken into account in the analysis. We discuss the methodological issues considered in the study design, including prevalence-incidence bias, cohort effects, interview bias and recall bias, and present strategies to account for it. Associations between exposures of interest and POMS/ROMS will be presented in subsequent publications.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Bias
Case-control
Environmental factors
Progressive-onset multiple sclerosis
Subject recruitment.
Megjelenés:Journal Of Neurology. - 271 : 1 (2024), p. 472-485. -
További szerzők:Saul, Alice Taylor, Bruce V. Ponsonby, Anne-Louise Simpson-Yap, Steve Blizzard, Leigh Broadley, Simon Lechner-Scott, Jeannette Karabudak, Rana Patti, Francesco Eichau, Sara Onofrj, Marco Ozakbas, Serkan Horakova, Dana Kubala Havrdova, Eva Grand'Maison, Francois Alroughani, Raed Gerlach, Oliver Amato, Maria Pia Altintas, Ayse Girard, Marc Duquette, Pierre Blanco, Yolanda Ramo-Tello, Cristina Laureys, Guy Kalincik, Tomas Khoury, Samia J. Shaygannejad, Vahid Etemadifar, Masoud Singhal, Bhim Mrabet, Saloua Foschi, Matteo Habek, Mario John, Nevin Hughes, Stella McCombe, Pamela Ampapa, Radek Walt, Anneke van der Butzkueven, Helmut de Gans, Koen McGuigan, Christopher Oreja-Guevara, Celia Sá, Maria José Petersen, Thor Al-Harbi, Talal Sempere, Perez A. Wijmeersch, Bart Van Grigoriadis, Nikolaos Prevost, Julie Gray, Orla Castillo Triviño, Tamara Macdonell, Richard Lugaresi, Alessandra Sajedi, Seyed Aidin Mei, Ingrid van der Csépány Tünde (1956-) (neurológus, pszichiáter) Ausimmune/AusLong Investigators Group MSBase Study Group
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3.

001-es BibID:BIBFORM135463
035-os BibID:(Scopus)105025260703 (WoS)001643679600001
Első szerző:Lizak, Nathaniel
Cím:Managing reactivation of multiple sclerosis during treatment with natalizumab / Nathaniel Lizak, Sifat Sharmin, Dana Horáková, Eva Kubala Havrdova, Sara Eichau, Anneke van der Walt, Helmut Butzkueven, Jeannette Lechner-Scott, Katherine Buzzard, Olga Skibina, Oliver Gerlach, Alexandre Prat, Marc Girard, Pierre Duquette, Raed Alroughani, Francesco Patti, Francois Grand'Maison, Maria José Sá, Eduardo Aguera-Morales, Suzanne Hodgkinson, Pierre Grammond, Jens Kuhle, Bassem Yamout, Samia J. Khoury, Serkan Ozakbas, Tunde Csepany, Nevin John, Guy Laureys, Murat Terzi, Maria Pia Amato, Cavit Boz, Abdullah Al-Asmi, Elisabetta Cartechini, Riadh Gouider, Saloua Mrabet, Izanne Roos, Tomas Kalincik, MSBase Study Group
Dátum:2025
ISSN:1352-4585
Megjegyzések:Background: Following natalizumab failure, it is unknown whether switching to alternative high-efficacy therapies offers superior effectiveness over continuing natalizumab. Objective: To compare different treatment strategies following natalizumab failure. Methods: Patients suffering a relapse during natalizumab treatment with adequate follow-up were identified from the MSBase registry. Following natalizumab failure, natalizumab continuation was compared to switching to anti-CD20 therapies/alemtuzumab/lower-efficacy therapies and treatment discontinuation. The primary outcome was the risk of further relapses. Secondary outcomes included risk of subsequent magnetic resonance imaging (MRI) activity, confirmed disability worsening and disease-activity-free survival. Multivariable proportional hazards models compared outcomes during time-varying therapy exposures. Four sensitivity analyses were conducted with varied inclusion criteria and treatment failure definitions. Results: Of 1553 patients experiencing a relapse during natalizumab treatment, 1037 met the inclusion criteria. Following natalizumab failure, switch to anti-CD20 therapy was associated with a lower relapse risk (heart rate (HR) = 0.48, 95% confidence interval (CI) = 0.27?0.84) compared to continuing natalizumab; no differences were observed in MRI or disability outcomes. Treatment de-escalation or cessation was associated with increased relapse risk (HR = 1.46, 95% CI = 1.15?1.85; HR = 2.08, 95% CI = 1.223.55, respectively). We did not find evidence of a difference for switching to alemtuzumab. Sensitivity analyses replicated primary findings. Conclusion: This exploratory study indicates that switching to anti-CD20 therapies following natalizumab failure is associated with a >50% reduction in relapse risk. No differences were seen in secondary outcomes, despite consistent trends. Clinicians may consider anti-CD20 therapies following natalizumab failure, noting further research is needed to confirm differences in MRI and disability outcomes.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Multiple sclerosis
natalizumab
disease-modifying treatment
relapses
treatment failure
Megjelenés:Multiple Sclerosis. - 32 : 1 (2025), p. 121-133. -
További szerzők:Sharmin, Sifat Horakova, Dana Havrdova, Eva Eichau, Sara Walt, Anneke van der Butzkueven, Helmut Lechner-Scott, Jeannette Buzzard, Katherine Skibina, Olga Gerlach, Oliver Prat, Alexandre Girard, Marc Duquette, Pierre Alroughani, Raed Patti, Francesco Grand'Maison, Francois Sá, Maria José Aguera-Morales, Eduardo Hodgkinson, Suzanne Grammond, Pierre Kuhle, Jens Yamout, Bassem Khoury, Samia J. Ozakbas, Serkan Csépány Tünde (1956-) (neurológus, pszichiáter) John, Nevin Laureys, Guy Terzi, Murat Amato, Maria Pia Boz, Cavit Al-Asmi, Abdullah Cartechini, Elisabetta Gouider, Riadh Mrabet, Saloua Roos, Izanne Kalincik, Tomas MSBase Study Group
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4.

001-es BibID:BIBFORM135460
035-os BibID:(Scopus)105002792941 (WoS)001470351300001
Első szerző:Müller, Jannis
Cím:Standardized Definition of Progression Independent of Relapse Activity (PIRA) in Relapsing-Remitting Multiple Sclerosis / Jannis Müller, Sifat Sharmin, Johannes Lorscheider, Serkan Ozakbas, Rana Karabudak, Dana Horakova, Bianca Weinstock-Guttman, Vahid Shaygannejad, Masoud Etemadifar, Raed Alroughani, Francesco Patti, Sara Eichau, Alexandre Prat, Alessandra Lugaresi, Valentina Tomassini, Allan G. Kermode, Maria Pia Amato, Recai Turkoglu, Ayse Altintas, Katherine Buzzard, Aysun Soysal, Anneke van der Walt, Helmut Butzkueven, Yolanda Blanco, Oliver Gerlach, Samia J. Khoury, Michael Barnett, Nevin John, Jeannette Lechner-Scott, Matteo Foschi, Andrea Surcinelli, Vincent van Pesch, Julie Prevost, Maria Jose Sa, Davide Maimone, Marie D'hooghe, Stella Hughes, Suzanne Hodgkinson, Chris McGuigan, Elisabetta Cartechini, Bruce Taylor, Daniele Spitaleri, Mark Slee, Pamela McCombe, Bassem Yamout, Pascal Benkert, Jens Kuhle, Ludwig Kappos, Izanne Roos, Tomas Kalincik, PGCertBiostat, MSBase Study Group
Dátum:2025
Megjegyzések:Importance: Progression independent of relapse activity (PIRA) is a significant contributor to long-term disability accumulation in relapsing-remitting multiple sclerosis (MS). Prior studies have used varying PIRA definitions, hampering the comparability of study results. Objective: To compare various definitions of PIRA. Design, setting, and participants: This cohort study involved a retrospective analysis of prospectively collected data from the MSBase registry from July 2004 to July 2023. The participants were patients with MS from 186 centers across 43 countries who had clinically definite relapsing-remitting MS, a complete minimal dataset, and 3 or more documented Expanded Disability Status Scale (EDSS) assessments. Exposure: Three-hundred sixty definitions of PIRA as combinations of the following criteria: baseline disability (fixed baseline with re-baselining after PIRA, or plus re-baselining after relapses, or plus re-baselining after improvements), minimum confirmation period (6, 12, or 24 months), confirmation magnitude (EDSS score at/above worsening score or at/above threshold compared with baseline), freedom from relapse at EDSS score worsening (90 days prior, 90 days prior and 30 days after, 180 days prior and after, since previous EDSS assessment, or since baseline), and freedom from relapse at confirmation (30 days prior, 90 days prior, 30 days before and after, or between worsening and confirmation). Main outcome and measure: For each definition, we quantified PIRA incidence and persistence (ie, absence of a 3-month confirmed EDSS improvement over ?5 years). Results: Among 87 239 patients with MS, 33 303 patients fulfilled the inclusion criteria; 24 152 (72.5%) were female and 9151 (27.5%) were male. At the first visits, the mean (SD) age was 36.4 (10.9) years; 28 052 patients (84.2%) had relapsing-remitting MS, and the median (IQR) EDSS score was 2.0 (1.0-3.0). Participants had a mean (SD) 15.1 (11.9) visits over 8.9 (5.2) years. PIRA incidence ranged from 0.141 to 0.658 events per decade and persistence from 0.753 to 0.919, depending on the definition. In particular, the baseline and confirmation period influenced PIRA detection. The following definition yielded balanced incidence and persistence: a significant disability worsening compared with a baseline (reset after each PIRA event, relapse, and EDSS score improvement), in absence of relapses since the last EDSS assessment, confirmed with EDSS scores (not preceded by relapses within 30 days) that remained above the worsening threshold for at least 12 months. Conclusion and relevance: Incidence and persistence of PIRA are determined by the definition used. The proposed standardized definition aims to enhance comparability among studies.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:JAMA Neurology. - 82 : 6 (2025), p. 614-625. -
További szerzők:Sharmin, Sifat Lorscheider, Johannes Ozakbas, Serkan Karabudak, Rana Horakova, Dana Weinstock-Guttman, Bianca Shaygannejad, Vahid Etemadifar, Masoud Alroughani, Raed Patti, Francesco Eichau, Sara Prat, Alexandre Lugaresi, Alessandra Tomassini, Valentina Kermode, Allan G. Amato, Maria Pia Turkoglu, Recai Altintas, Ayse Buzzard, Katherine Soysal, Aysun Walt, Anneke van der Butzkueven, Helmut Blanco, Yolanda Gerlach, Oliver Khoury, Samia J. Barnett, Michael John, Nevin Lechner-Scott, Jeannette Foschi, Matteo Surcinelli, Andrea Pesch, Vincent van Prevost, Julie Sa, Maria Jose Maimone, Davide D'hooghe, Marie Hughes, Stella Hodgkinson, Suzanne McGuigan, Christopher Cartechini, Elisabetta Taylor, Bruce V. Spitaleri, Daniele Slee, Mark McCombe, Pamela Yamout, Bassem Benkert, Pascal Kuhle, Jens Kappos, Ludwig Roos, Izanne Kalincik, Tomas Csépány Tünde (1956-) (neurológus, pszichiáter) MSBase Study Group PGCertBiostat
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5.

001-es BibID:BIBFORM132947
035-os BibID:(scopus)105011413182 (wos)001536298500003
Első szerző:Pirmani, Ashkan
Cím:Personalized federated learning for predicting disability progression in multiple sclerosis using real-world routine clinical data / Pirmani Ashkan, De Brouwer Edward, Arany Ádám, Oldenhof Martijn, Passemiers Antoine, Faes Axel, Kalincik Tomas, Ozakbas Serkan, Gouider Riadh, Willekens Barbara, Horakova Dana, Havrdova Eva Kubala, Patti Francesco, Prat Alexandre, Lugaresi Alessandra, Tomassini Valentina, Grammond Pierre, Cartechini Elisabetta, Roos Izanne, Boz Cavit, Alroughani Raed, Amato Maria Pia, Buzzard Katherine, Lechner-Scott Jeannette, Guimaraes Joana, Solaro Claudio, Gerlach Oliver, Soysal Aysun, Kuhle Jens, Sanchez-Menoyo Jose Luis, Spitaleri Daniele, Csepany Tunde, Van Wijmeersch Bart, Ampapa Radek, Prevost Julie, Khoury Samia J., Van Pesch Vincent, John Nevin, Maimone Davide, Weinstock-Guttman Bianca, Laureys Guy, McCombe Pamela, Blanco Yolanda, Altintas Ayse, Al-Asmi Abdullah, Garber Justin, Van der Walt Anneke, Butzkueven Helmut, de Gans Koen, Rozsa Csilla, Taylor Bruce, Al-Harbi Talal, Sas Attila, Rajda Cecilia, Gray Orla, Decoo Danny, Carroll William M., Kermode Allan G., Fabis-Pedrini Marzena, Mason Deborah, Perez-Sempere Angel, Simu Mihaela, Shuey Neil, Singhal Bhim, Cauchi Marija, Hardy Todd A., Ramanathan Sudarshini, Lalive Patrice, Sirbu Carmen-Adella, Hughes Stella, Castillo Trivino Tamara, Peeters Liesbet M., Moreau Yves
Dátum:2025
ISSN:2398-6352
Megjegyzések:Early prediction of disability progression in multiple sclerosis (MS) remains challenging despite its critical importance for therapeutic decision-making. We present the first systematic evaluation of personalized federated learning (PFL) for 2-year MS disability progression prediction, leveraging multi-center real-world data from over 26,000 patients. While conventional federated learning (FL) enables privacy-aware collaborative modeling, it remains vulnerable to institutional data heterogeneity. PFL overcomes this challenge by adapting shared models to local data distributions without compromising privacy. We evaluated two personalization strategies: a novel AdaptiveDualBranchNet architecture with selective parameter sharing, and personalized fine-tuning of global models, benchmarked against centralized and client-specific approaches. Baseline FL underperformed relative to personalized methods, whereas personalization significantly improved performance, with personalized FedProx and FedAVG achieving ROC-AUC scores of 0.8398 ? 0.0019 and 0.8384 ? 0.0014, respectively. These findings establish personalization as critical for scalable, privacy-aware clinical prediction models and highlight its potential to inform earlier intervention strategies in MS and beyond.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:npj Digital Medicine. - 8 : 1 (2025), p. 1-15. -
További szerzők:De Brouwer, Edward Arany Ádám Oldenhof, Martijn Passemiers, Antoine Faes, Axel Kalincik, Tomas Ozakbas, Serkan Gouider, Riadh Willekens, Barbara Horakova, Dana Havrdova, Eva Patti, Francesco Prat, Alexandre Lugaresi, Alessandra Tomassini, Valentina Grammond, Pierre Cartechini, Elisabetta Roos, Izanne Boz, Cavit Alroughani, Raed Amato, Maria Pia Buzzard, Katherine Lechner-Scott, Jeannette Guimaraes, Joana Solaro, Claudio Gerlach, Oliver Soysal, Aysun Kuhle, Jens Sanchez-Menoyo, Jose Spitaleri, Daniele Csépány Tünde (1956-) (neurológus, pszichiáter) Wijmeersch, Bart Van Ampapa, Radek Prevost, Julie Khoury, Samia J. Pesch, Vincent van John, Nevin Maimone, Davide Weinstock-Guttman, Bianca Laureys, Guy (Universitary Hospital Ghent) McCombe, Pamela Blanco, Yolanda Altintas, Ayse Al-Asmi, Abdullah Garber, Justin Walt, Anneke van der Butzkueven, Helmut de Gans, Koen Rózsa Csilla Taylor, Bruce V. Al-Harbi, Talal Sas Attila Rajda Cecília Gray, Orla Decoo, Danny Carroll, William M. Kermode, Allan G. Fabis-Pedrini, Marzena Mason, Deborah Perez-Sempere, Angel Simu, Mihaela Shuey, Neil Singhal, Bhim Cauchi, Marija Hardy, Todd A. Ramanathan, Sudarshini Lalive, Patrice H. Sirbu, Carmen-Adella Hughes, Stella Castillo Triviño, Tamara Peeters, Liesbet Moreau, Yves
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6.

001-es BibID:BIBFORM103566
035-os BibID:(WoS)000874431500025 (Scopus)85141339945
Első szerző:Roos, Izanne
Cím:Disease Reactivation After Cessation of Disease-Modifying Therapy in Patients With Relapsing-Remitting Multiple Sclerosis / Roos Izanne, Malpas Charles, Leray Emmanuelle, Casey Romain, Horakova Dana, Havrdova Eva Kubala, Debouverie Marc, Patti Francesco, De Seze Jerome, Izquierdo Guillermo, Eichau Sara, Edan Gilles, Prat Alexandre, Girard Marc, Ozakbas Serkan, Grammond Pierre, Zephir Helene, Ciron Jonathan, Maillart Elisabeth, Moreau Thibault, Amato Maria Pia, Labauge Pierre, Alroughani Raed, Buzzard Katherine, Skibina Olga, Terzi Murat, Laplaud David Axel, Berger Eric, Grand'Maison Francois, Lebrun-Frenay Christine, Cartechini Elisabetta, Boz Cavit, Lechner-Scott Jeannette, Clavelou Pierre, Stankoff Bruno, Prevost Julie, Kappos Ludwig, Pelletier Jean, Shaygannejad Vahid, Yamout Bassem I., Khoury Samia J., Gerlach Oliver, Spitaleri Daniele L. A., Van Pesch Vincent, Gout Olivier, Turkoglu Recai, Heinzlef Olivier, Thouvenot Eric, McCombe Pamela Ann, Soysal Aysun, Bourre Bertrand, Slee Mark, Castillo-Trivino Tamara, Bakchine Serge, Ampapa Radek, Butler Ernest Gerard, Wahab Abir, Macdonell Richard A., Aguera-Morales Eduardo, Cabre Philippe, Ben Nasr Haifa, Van der Walt Anneke, Laureys Guy, Van Hijfte Liesbeth, Ramo-Tello Cristina M., Maubeuge Nicolas, Hodgkinson Suzanne, Sánchez-Menoyo José Luis, Barnett Michael H., Labeyrie Celine, Vucic Steve, Sidhom Youssef, Gouider Riadh, Csepany Tunde, Sotoca Javier, de Gans Koen, Al-Asmi Abdullah, Fragoso Yara Dadalti, Vukusic Sandra, Butzkueven Helmut, Kalincik Tomas, MSBase and OFSEP
Dátum:2022
ISSN:0028-3878 1526-632X
Megjegyzések:Objectives: To evaluate the rate of return of disease activity after cessation of multiple sclerosis (MS) disease-modifying therapy. Methods: This was a retrospective cohort study from two large observational MS registries: MSBase and OFSEP. Patients with relapsing-remitting MS who had ceased a disease-modifying therapy and were followed up for the subsequent 12-months were included in the analysis. The primary study outcome was annualised relapse rate in the 12 months after disease-modifying therapy discontinuation stratified by patients who did, and did not, commence a subsequent therapy. The secondary endpoint was the predictors of first relapse and disability accumulation after treatment discontinuation. Results: 14,213 patients, with 18,029 eligible treatment discontinuation epochs, were identified for seven therapies. Annualised rates of relapse (ARR) started to increase 2-months after natalizumab cessation (month 2-4 ARR, 95% confidence interval): 0.47, 0.43-0.51). Commencement of a subsequent therapy within 2-4 months reduced the magnitude of disease reactivation (mean ARR difference: 0.15, 0.08-0.22). After discontinuation of fingolimod, rates of relapse increased overall (month 1-2 ARR: 0.80, 0.70-0.89), and stabilised faster in patients who started a new therapy within 1-2 months (mean ARR difference: 0.14, -0.01-0.29). Magnitude of disease reactivation for other therapies was low, but reduced further by commencement of another treatment 1-10 months after treatment discontinuation. Predictors of relapse were higher relapse rate in the year before cessation, female sex, younger age and higher EDSS. Commencement of a subsequent therapy reduced both the risk of relapse (HR 0.76, 95%CI 0.72-0.81) and disability accumulation (0.73, 0.65-0.80). Conclusion: The rate of disease reactivation after treatment cessation differs among MS treatments, with the peaks of relapse activity ranging from 1 to 10 months in untreated cohorts that discontinued different therapies. These results suggest that untreated intervals should be minimised after stopping anti-trafficking therapies (natalizumab and fingolimod). Classification of evidence: This study provides class III that disease reactivation occurs within months of discontinuation of multiple sclerosis disease-modifying therapies. Risk of disease activity is reduced by commencement of a subsequent therapy.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Neurology. - 99 : 17 (2022), p. e1926-e1944. -
További szerzők:Malpas, Charles Leray, Emmanuelle Casey, Romain Horakova, Dana Havrdova, Eva Debouverie, Marc Patti, Francesco De Seze, Jérôme Izquierdo, Guillermo Eichau, Sara Edan, Gilles Prat, Alexandre Girard, Marc Ozakbas, Serkan Grammond, Pierre Zephir, Hélène Ciron, Jonathan Maillart, Elisabeth Moreau, Thibault Amato, Maria Pia Labauge, Pierre Alroughani, Raed Buzzard, Katherine Skibina, Olga Terzi, Murat Laplaud, David Berger, Eric Grand'Maison, Francois Lebrun-Frenay, Christine Cartechini, Elisabetta Boz, Cavit Lechner-Scott, Jeannette Clavelou, Pierre Stankoff, Bruno Prevost, Julie Kappos, Ludwig Pelletier, Jean Shaygannejad, Vahid Yamout, Bassem Khoury, Samia J. Gerlach, Oliver Spitaleri, Daniele L. A. Pesch, Vincent van Gout, Olivier Turkoglu, Recai Heinzlef, Olivier Thouvenot, Eric McCombe, Pamela Soysal, Aysun Bourre, Bertrand Slee, Mark Castillo Triviño, Tamara Bakchine, Serge Ampapa, Radek Butler, Ernest Wahab, Abir Macdonell, Richard Aguera-Morales, Eduardo Cabre, Philippe Ben Nasr, Haifa Walt, Anneke van der Laureys, Guy Van Hijfte, Liesbeth Ramo-Tello, Cristina Maubeuge, Nicolas Hodgkinson, Suzanne Sanchez-Menoyo, Jose Barnett, Michael Labeyrie, Céline Vucic, Steve Sidhom, Youssef Gouider, Riadh Csépány Tünde (1956-) (neurológus, pszichiáter) Sotoca, Javier de Gans, Koen Al-Asmi, Abdullah Fragoso, Yara Vukusic, Sandra Butzkueven, Helmut Kalincik, Tomas OFSEP and the MSBase investigators
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001-es BibID:BIBFORM116385
035-os BibID:(Scopus)85176495277 (WOS)001063488100001
Első szerző:Sharmin, Sifat
Cím:The risk of secondary progressive multiple sclerosis is geographically determined but modifiable / Sharmin Sifat, Roos Izanne, Simpson-Yap Steve, Charles Malpas, Marina M. Sánchez, Serkan Ozakbas, Dana Horakova, Eva K. Havrdova, Francesco Patti, Raed Alroughani, Guillermo Izquierdo, Sara Eichau, Cavit Boz, Magd Zakaria, Marco Onofrj, Alessandra Lugaresi, Bianca Weinstock-Guttman, Alexandre Prat, Marc Girard, Pierre Duquette, Murat Terzi, Maria Pia Amato, Rana Karabudak, Francois Grand'Maison, Samia J. Khoury, Pierre Grammond, Jeannette Lechner-Scott, Katherine Buzzard, Olga Skibina, Anneke van der Walt, Helmut Butzkueven, Recai Turkoglu, Ayse Altintas, Davide Maimone, Allan Kermode, Nevin Shalaby, Vincent V. Pesch, Ernest Butler, Youssef Sidhom, Riadh Gouider, Saloua Mrabet, Oliver Gerlach, Aysun Soysal, Michael Barnett, Jens Kuhle, Stella Hughes, Maria J. Sa, Suzanne Hodgkinson, Celia Oreja-Guevara, Radek Ampapa, Thor Petersen, Cristina Ramo-Tello, Daniele Spitaleri, Pamela McCombe, Bruce Taylor, Julie Prevost, Matteo Foschi, Mark Slee, Chris McGuigan, Guy Laureys, Liesbeth V. Hijfte, Koen de Gans, Claudio Solaro, Jiwon Oh, Richard Macdonell, Eduardo Aguera-Morales, Bhim Singhal, Orla Gray, Justin Garber, Bart V. Wijmeersch, Mihaela Simu, Tamara Castillo-Triviño, Jose L. Sanchez-Menoyo, Dheeraj Khurana, Abdullah Al-Asmi, Talal Al-Harbi, Norma Deri, Yara Fragoso, Patrice H. Lalive, L. G. F. Sinnige, Cameron Shaw, Neil Shuey, Tunde Csepany, Angel P. Sempere, Fraser Moore, Danny Decoo, Barbara Willekens, Claudio Gobbi, Jennifer Massey, Todd Hardy, John Parratt, Tomas Kalincik, the MSBase investigators
Dátum:2023
ISSN:0006-8950
Megjegyzések:Geographical variations in the incidence and prevalence of multiple sclerosis have been reported globally. Latitude as a surrogate for exposure to ultraviolet radiation but also other lifestyle and environmental factors are regarded as drivers of this variation. No previous studies evaluated geographical variation in the risk of secondary progressive multiple sclerosis, an advanced form of multiple sclerosis that is characterized by steady accrual of irreversible disability.We evaluated differences in the risk of secondary progressive multiple sclerosis in relation to latitude and country of residence, modified by high-to-moderate efficacy immunotherapy in a geographically diverse cohort of patients with relapsing-remitting multiple sclerosis. The study included relapsing-remitting multiple sclerosis patients from the global MSBase registry with at least one recorded assessment of disability. Secondary progressive multiple sclerosis was identified as per clinician diagnosis. Sensitivity analyses used the operationalized definition of secondary progressive multiple sclerosis and the Swedish decision tree algorithm. A proportional hazards model was used to estimate the cumulative risk of secondary progressive multiple sclerosis by country of residence (latitude), adjusted for sex, age at disease onset, time from onset to relapsing-remitting phase, disability (Multiple Sclerosis Severity Score) and relapse activity at study inclusion, national multiple sclerosis prevalence, government health expenditure, and proportion of time treated with high-to-moderate efficacy disease-modifying therapy. Geographical variation in time from relapsing-remitting phase to secondary progressive phase of multiple sclerosis was modelled through a proportional hazards model with spatially correlated frailties.We included 51 126 patients (72% female) from 27 countries. The median survival time from relapsing-remitting phase to secondary progressive multiple sclerosis among all patients was 39 (95% confidence interval: 37 to 43) years. Higher latitude [median hazard ratio = 1.21, 95% credible interval (1.16, 1.26)], higher national multiple sclerosis prevalence [1.07 (1.03, 1.11)], male sex [1.30 (1.22, 1.39)], older age at onset [1.35 (1.30, 1.39)], higher disability [2.40 (2.34, 2.47)] and frequent relapses [1.18 (1.15, 1.21)] at inclusion were associated with increased hazard of secondary progressive multiple sclerosis. Higher proportion of time on high-to-moderate efficacy therapy substantially reduced the hazard of secondary progressive multiple sclerosis [0.76 (0.73, 0.79)] and reduced the effect of latitude [interaction: 0.95 (0.92, 0.99)]. At the country-level, patients in Oman, Tunisia, Iran and Canada had higher risks of secondary progressive multiple sclerosis relative to the other studied regions.Higher latitude of residence is associated with a higher probability of developing secondary progressive multiple sclerosis. High-to-moderate efficacy immunotherapy can mitigate some of this geographically co-determined risk. By analysing longitudinal data from 27 countries, Sharmin et al. reveal a geographically varying risk of conversion to secondary progressive disease in patients with multiple sclerosis. Higher latitude of residence increases the risk while high-to-moderate efficacy immunotherapies reduce the risk substantially.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
disease-modifying therapy
geography
health expenditure
latitude
secondary progressive multiple sclerosis
Megjelenés:Brain. - 146 : 11 (2023), p. 4633-4644. -
További szerzők:Roos, Izanne Simpson-Yap, Steve Malpas, Charles Sánchez, Marina M. Ozakbas, Serkan Horakova, Dana Havrdova, Eva Patti, Francesco Alroughani, Raed Izquierdo, Guillermo Eichau, Sara Boz, Cavit Zakaria, Magd Onofrj, Marco Lugaresi, Alessandra Weinstock-Guttman, Bianca Prat, Alexandre Girard, Marc Duquette, Pierre Terzi, Murat Amato, Maria Pia Karabudak, Rana Grand'Maison, Francois Khoury, Samia J. Grammond, Pierre Lechner-Scott, Jeannette Buzzard, Katherine Skibina, Olga Walt, Anneke van der Butzkueven, Helmut Turkoglu, Recai Altintas, Ayse Maimone, Davide Kermode, Allan G. Shalaby, Nevin Pesch, Vincent van Butler, Ernest Sidhom, Youssef Gouider, Riadh Mrabet, Saloua Gerlach, Oliver Soysal, Aysun Barnett, Michael Kuhle, Jens Hughes, Stella Sá, Maria José Hodgkinson, Suzanne Oreja-Guevara, Celia Ampapa, Radek Petersen, Thor Ramo-Tello, Cristina Spitaleri, Daniele McCombe, Pamela Taylor, Bruce V. Prevost, Julie Foschi, Matteo Slee, Mark McGuigan, Christopher Laureys, Guy Hijfte, Liesbeth V. de Gans, Koen Solaro, Claudio Oh, Jiwon Macdonell, Richard Aguera-Morales, Eduardo Singhal, Bhim Gray, Orla Garber, Justin Wijmeersch, Bart Van Mihaela, Simu Castillo Triviño, Tamara Sanchez-Menoyo, Jose Khurana, Dheeraj Al-Asmi, Abdullah Al-Harbi, Talal Deri, Norma Fragoso, Yara Lalive, Patrice H. Sinnige, L. G. F. Shaw, Cameron Shuey, Neil Csépány Tünde (1956-) (neurológus, pszichiáter) Sempere, Perez A. Moore, Fraser Decoo, Danny Willekens, Barbara Gobbi, Claudio Massey, Jennifer Hardy, Todd A. Parratt, John Kalincik, Tomas the MSBase investigators
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