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  • Country, Sex, EDSS Change and Therapy Choice Independently Predict Treatment Discontinuation in Multiple Sclerosis and Clinically Isolated Syndrome

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    Author(s)
    Meyniel, Claire
    Spelman, Timothy
    Jokubaitis, Vilija G
    Trojano, Maria
    Izquierdo, Guillermo
    Grand'Maison, Francois
    Oreja-Guevara, Celia
    Boz, Cavit
    Lugaresi, Alessandra
    Girard, Marc
    Grammond, Pierre
    Iuliano, Gerardo
    Fiol, Marcela
    Antonio Cabrera-Gomez, Jose
    Fernandez-Bolanos, Ricardo
    Giuliani, Giorgio
    Lechner-Scott, Jeannette
    Cristiano, Edgardo
    Herbert, Joseph
    Petkovska-Boskova, Tatjana
    Bergamaschi, Roberto
    van Pesch, Vincent
    Moore, Fraser
    Vella, Norbert
    Slee, Mark
    Santiago, Vetere
    Barnett, Michael
    Havrdova, Eva
    Young, Carolyn
    Sirbu, Carmen-Adella
    Tanner, Mary
    Rutherford, Michelle
    Butzkueven, Helmut
    Griffith University Author(s)
    Butzkueven, Helmut
    Year published
    2012
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    Abstract
    Objectives We conducted a prospective study, MSBASIS, to assess factors leading to first treatment discontinuation in patients with a clinically isolated syndrome (CIS) and early relapsing-remitting multiple sclerosis (RRMS). Methods The MSBASIS Study, conducted by MSBase Study Group members, enrols patients seen from CIS onset, reporting baseline demographics, cerebral magnetic resonance imaging (MRI) features and Expanded Disability Status Scale (EDSS) scores. Follow-up visits report relapses, EDSS scores, and the start and end dates of MS-specific therapies. We performed a multivariable survival analysis to determine ...
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    Objectives We conducted a prospective study, MSBASIS, to assess factors leading to first treatment discontinuation in patients with a clinically isolated syndrome (CIS) and early relapsing-remitting multiple sclerosis (RRMS). Methods The MSBASIS Study, conducted by MSBase Study Group members, enrols patients seen from CIS onset, reporting baseline demographics, cerebral magnetic resonance imaging (MRI) features and Expanded Disability Status Scale (EDSS) scores. Follow-up visits report relapses, EDSS scores, and the start and end dates of MS-specific therapies. We performed a multivariable survival analysis to determine factors within this dataset that predict first treatment discontinuation. Results A total of 2314 CIS patients from 44 centres were followed for a median of 2.7 years, during which time 1247 commenced immunomodulatory drug (IMD) treatment. Ninety percent initiated IMD after a diagnosis of MS was confirmed, and 10% while still in CIS status. Over 40% of these patients stopped their first IMD during the observation period. Females were more likely to cease medication than males (HR 1.36, p = 0.003). Patients treated in Australia were twice as likely to cease their first IMD than patients treated in Spain (HR 1.98, p = 0.001). Increasing EDSS was associated with higher rate of IMD cessation (HR 1.21 per EDSS unit, p<0.001), and intramuscular interferon-߭1a (HR 1.38, p = 0.028) and subcutaneous interferon-߭1a (HR 1.45, p = 0.012) had higher rates of discontinuation than glatiramer acetate, although this varied widely in different countries. Onset cerebral MRI features, age, time to treatment initiation or relapse on treatment were not associated with IMD cessation. Conclusion In this multivariable survival analysis, female sex, country of residence, EDSS change and IMD choice independently predicted time to first IMD cessation.
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    Journal Title
    PloS One
    Volume
    7
    Issue
    6
    DOI
    https://doi.org/10.1371/journal.pone.0038661
    Copyright Statement
    © 2012 Meyniel et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
    Subject
    Medical and Health Sciences not elsewhere classified
    Publication URI
    http://hdl.handle.net/10072/53218
    Collection
    • Journal articles

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