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dc.contributor.authorMeyniel, Claire
dc.contributor.authorSpelman, Timothy
dc.contributor.authorJokubaitis, Vilija G
dc.contributor.authorTrojano, Maria
dc.contributor.authorIzquierdo, Guillermo
dc.contributor.authorGrand'Maison, Francois
dc.contributor.authorOreja-Guevara, Celia
dc.contributor.authorBoz, Cavit
dc.contributor.authorLugaresi, Alessandra
dc.contributor.authorGirard, Marc
dc.contributor.authorGrammond, Pierre
dc.contributor.authorIuliano, Gerardo
dc.contributor.authorFiol, Marcela
dc.contributor.authorAntonio Cabrera-Gomez, Jose
dc.contributor.authorFernandez-Bolanos, Ricardo
dc.contributor.authorGiuliani, Giorgio
dc.contributor.authorLechner-Scott, Jeannette
dc.contributor.authorCristiano, Edgardo
dc.contributor.authorHerbert, Joseph
dc.contributor.authorPetkovska-Boskova, Tatjana
dc.contributor.authorBergamaschi, Roberto
dc.contributor.authorvan Pesch, Vincent
dc.contributor.authorMoore, Fraser
dc.contributor.authorVella, Norbert
dc.contributor.authorSlee, Mark
dc.contributor.authorSantiago, Vetere
dc.contributor.authorBarnett, Michael
dc.contributor.authorHavrdova, Eva
dc.contributor.authorYoung, Carolyn
dc.contributor.authorSirbu, Carmen-Adella
dc.contributor.authorTanner, Mary
dc.contributor.authorRutherford, Michelle
dc.contributor.authorButzkueven, Helmut
dc.date.accessioned2018-01-12T00:45:08Z
dc.date.available2018-01-12T00:45:08Z
dc.date.issued2012
dc.date.modified2013-12-12T03:47:20Z
dc.identifier.issn1932-6203
dc.identifier.doi10.1371/journal.pone.0038661
dc.identifier.urihttp://hdl.handle.net/10072/53218
dc.description.abstractObjectives 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.
dc.description.peerreviewedYes
dc.description.publicationstatusYes
dc.languageEnglish
dc.language.isoeng
dc.publisherPublic Library of Science
dc.publisher.placeUnited States
dc.relation.ispartofstudentpublicationN
dc.relation.ispartofpagefrome38661-1
dc.relation.ispartofpagetoe38661-8
dc.relation.ispartofissue6
dc.relation.ispartofjournalPloS One
dc.relation.ispartofvolume7
dc.rights.retentionY
dc.subject.fieldofresearchMedical and Health Sciences not elsewhere classified
dc.subject.fieldofresearchcode119999
dc.titleCountry, Sex, EDSS Change and Therapy Choice Independently Predict Treatment Discontinuation in Multiple Sclerosis and Clinically Isolated Syndrome
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
dcterms.licensehttps://creativecommons.org/licenses/by/4.0/
dc.description.versionVersion of Record (VoR)
gro.rights.copyright© 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.
gro.date.issued2012
gro.hasfulltextFull Text
gro.griffith.authorButzkueven, Helmut


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