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001-es BibID:	BIBFORM126269
035-os BibID:	(scopus)85164541334 (wos)000999038400003
Első szerző:	Kalincik, Tomas
Cím:	Comparative Effectiveness of Autologous Hematopoietic Stem Cell Transplant vs Fingolimod, Natalizumab, and Ocrelizumab in Highly Active Relapsing-Remitting Multiple Sclerosis / Tomas Kalincik, Sifat Sharmin, Izanne Roos, Mark S. Freedman, Harold Atkins, Joachim Burman, Jennifer Massey, Ian Sutton, Barbara Withers, Richard Macdonell, Andrew Grigg, øivind Torkildsen, Lars Bo, Anne Kristine Lehmann, Eva Kubala Havrdova, Eva Krasulova, Marek Trneny, Tomas Kozak, Anneke van der Walt, Helmut Butzkueven, Pamela McCombe, Olga Skibina, Jeannette Lechner-Scott, Barbara Willekens, Elisabetta Cartechini, Serkan Ozakbas, Raed Alroughani, Jens Kuhle, Francesco Patti, Pierre Duquette, Alessandra Lugaresi, Samia J. Khoury, Mark Slee, Recai Turkoglu, Suzanne Hodgkinson, Nevin John, Davide Maimone, Maria Jose Sa, Vincent van Pesch, Oliver Gerlach, Guy Laureys, Liesbeth Van Hijfte, Rana Karabudak, Daniele Spitaleri, Tunde Csepany, Riadh Gouider, Tamara Castillo-Trivino, Bruce Taylor, Basil Sharrack, John A. Snowden, MSBase Study Group Collaborators
Dátum:	2023
ISSN:	2168-6149 2168-6157
Megjegyzések:	IMPORTANCE Autologous hematopoietic stem cell transplant (AHSCT) is available for treatment of highly active multiple sclerosis (MS). OBJECTIVE To compare the effectiveness of AHSCT vs fingolimod, natalizumab, and ocrelizumab in relapsing-remitting MS by emulating pairwise trials. DESIGN, SETTING, AND PARTICIPANTS This comparative treatment effectiveness study included 6 specialist MS centers with AHSCT programs and international MSBase registry between 2006 and 2021. The study included patients with relapsing-remitting MS treated with AHSCT, fingolimod, natalizumab, or ocrelizumab with 2 or more years study follow-up including 2 or more disability assessments. Patients were matched on a propensity score derived from clinical and demographic characteristics. EXPOSURE AHSCT vs fingolimod, natalizumab, or ocrelizumab. MAIN OUTCOMES Pairwise-censored groups were compared on annualized relapse rates (ARR) and freedom from relapses and 6-month confirmed Expanded Disability Status Scale (EDSS) score worsening and improvement. RESULTS Of 4915 individuals, 167 were treated with AHSCT; 2558, fingolimod; 1490, natalizumab; and 700, ocrelizumab. The prematch AHSCT cohort was younger and with greater disability than the fingolimod, natalizumab, and ocrelizumab cohorts; thematched groups were closely aligned. The proportion ofwomen ranged from65% to70%,and themean (SD)age ranged from 35.3 (9.4) to 37.1 (10.6) years. The mean (SD) disease duration ranged from 7.9 (5.6) to 8.7 (5.4) years, EDSS score ranged from 3.5 (1.6) to 3.9 (1.9), and frequency of relapses ranged from0.77 (0.94) to0.86 (0.89) in the preceding year. Compared with the fingolimod group (769 [30.0%]), AHSCT (144 [86.2%]) was associated with fewer relapses (ARR: mean [SD], 0.09 [0.30] vs 0.20 [0.44]), similar risk of disability worsening (hazard ratio [HR], 1.70; 95% CI, 0.91-3.17), and higher chance of disability improvement (HR, 2.70; 95% CI, 1.71-4.26) over 5 years. Compared with natalizumab (730 [49.0%]), AHSCT (146 [87.4%]) was associated withmarginally lower ARR (mean [SD],0.08 [0.31]vs0.10 [0.34]), similar risk of disabilityworsening (HR, 1.06; 95% CI,0.54-2.09), and higher chance of disability improvement (HR, 2.68; 95% CI, 1.72-4.18) over 5 years. AHSCT (110 [65.9%]) and ocrelizumab (343 [49.0%])were associatedwith similarARR (mean [SD],0.09 [0.34]vs0.06 [0.32]), disability worsening (HR, 1.77; 95% CI, 0.61-5.08), and disability improvement (HR, 1.37; 95% CI, 0.66-2.82) over 3 years. AHSCT-related mortality occurred in 1 of 159 patients (0.6%). CONCLUSION In this study, the association of AHSCT with preventing relapses and facilitating recovery from disability was considerably superior to fingolimod and marginally superior to natalizumab. This study did not find evidence for difference in the effectiveness of AHSCT and ocrelizumab over a shorter available follow-up time.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk AHSCT Fingolimod Natalizumab Ocrelizumab multiple sclerosis
Megjelenés:	JAMA Neurology. - 80 : 7 (2023), p. 702-713. -
További szerzők:	Sharmin, Sifat Roos, Izanne Freedman, Mark S. Atkins, Harold Burman, Joachim Massey, Jennifer Sutton, Ian Withers, Barbara Macdonell, Richard Grigg, Andrew Torkildsen, øivind Bo, Lars Lehmann, Anne Kristine Kubala Havrdova, Eva Krasulova, Eva Trneny, Marek Kozak, Tomas Walt, Anneke van der Butzkueven, Helmut McCombe, Pamela Skibina, Olga Lechner-Scott, Jeannette Willekens, Barbara Cartechini, Elisabetta Ozakbas, Serkan Alroughani, Raed Kuhle, Jens Patti, Francesco Duquette, Pierre Lugaresi, Alessandra Khoury, Samia J. Slee, Mark Turkoglu, Recai Hodgkinson, Suzanne John, Nevin Maimone, Davide José Sá, Maria Pesch, Vincent van Gerlach, Oliver Laureys, Guy Van Hijfte, Liesbeth Karabudak, Rana Spitaleri, Daniele Csépány Tünde (1956-) (neurológus, pszichiáter) Gouider, Riadh Castillo Triviño, Tamara Taylor, Bruce V. Sharrack, Basil Snowden, John A. MSBase Study Group
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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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