Early treatment delays long-term disability accrual in RRMS: Results from the BMSD network
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Early treatment delays long-term disability accrual in RRMS : Results from the BMSD network. / Iaffaldano, Pietro; Lucisano, Giuseppe; Butzkueven, Helmut; Hillert, Jan; Hyde, Robert; Koch-Henriksen, Nils; Magyari, Melinda; Pellegrini, Fabio; Spelman, Tim; Sørensen, Per Soelberg; Vukusic, Sandra; Trojano, Maria.
In: Multiple Sclerosis Journal, Vol. 27, No. 10, 2021, p. 1543-1555.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Early treatment delays long-term disability accrual in RRMS
T2 - Results from the BMSD network
AU - Iaffaldano, Pietro
AU - Lucisano, Giuseppe
AU - Butzkueven, Helmut
AU - Hillert, Jan
AU - Hyde, Robert
AU - Koch-Henriksen, Nils
AU - Magyari, Melinda
AU - Pellegrini, Fabio
AU - Spelman, Tim
AU - Sørensen, Per Soelberg
AU - Vukusic, Sandra
AU - Trojano, Maria
N1 - Publisher Copyright: © The Author(s), 2021.
PY - 2021
Y1 - 2021
N2 - Background: The optimal timing of treatment starts for achieving the best control on the long-term disability accumulation in multiple sclerosis (MS) is still to be defined. Objective: The aim of this study was to estimate the optimal time to start disease-modifying therapies (DMTs) to prevent the long-term disability accumulation in MS, using a pooled dataset from the Big Multiple Sclerosis Data (BMSD) network. Methods: Multivariable Cox regression models adjusted for the time to first treatment start from disease onset (in quintiles) were used. To mitigate the impact of potential biases, a set of pairwise propensity score (PS)-matched analyses were performed. The first quintile, including patients treated within 1.2 years from onset, was used as reference. Results: A cohort of 11,871 patients (median follow-up after treatment start: 13.2 years) was analyzed. A 3- and 12-month confirmed disability worsening event and irreversible Expanded Disability Status Scale (EDSS) 4.0 and 6.0 scores were reached by 7062 (59.5%), 4138 (34.9%), 3209 (31.1%), and 1909 (16.5%) patients, respectively. The risk of reaching all the disability outcomes was significantly lower (p < 0.0004) for the first quintile patients’ group. Conclusion: Real-world data from the BMSD demonstrate that DMTs should be commenced within 1.2 years from the disease onset to reduce the risk of disability accumulation over the long term.
AB - Background: The optimal timing of treatment starts for achieving the best control on the long-term disability accumulation in multiple sclerosis (MS) is still to be defined. Objective: The aim of this study was to estimate the optimal time to start disease-modifying therapies (DMTs) to prevent the long-term disability accumulation in MS, using a pooled dataset from the Big Multiple Sclerosis Data (BMSD) network. Methods: Multivariable Cox regression models adjusted for the time to first treatment start from disease onset (in quintiles) were used. To mitigate the impact of potential biases, a set of pairwise propensity score (PS)-matched analyses were performed. The first quintile, including patients treated within 1.2 years from onset, was used as reference. Results: A cohort of 11,871 patients (median follow-up after treatment start: 13.2 years) was analyzed. A 3- and 12-month confirmed disability worsening event and irreversible Expanded Disability Status Scale (EDSS) 4.0 and 6.0 scores were reached by 7062 (59.5%), 4138 (34.9%), 3209 (31.1%), and 1909 (16.5%) patients, respectively. The risk of reaching all the disability outcomes was significantly lower (p < 0.0004) for the first quintile patients’ group. Conclusion: Real-world data from the BMSD demonstrate that DMTs should be commenced within 1.2 years from the disease onset to reduce the risk of disability accumulation over the long term.
KW - big data
KW - early treatment
KW - EDSS
KW - Multiple sclerosis
U2 - 10.1177/13524585211010128
DO - 10.1177/13524585211010128
M3 - Journal article
C2 - 33900144
AN - SCOPUS:85105040323
VL - 27
SP - 1543
EP - 1555
JO - Multiple Sclerosis Journal
JF - Multiple Sclerosis Journal
SN - 1352-4585
IS - 10
ER -
ID: 303772038