Early treatment delays long-term disability accrual in RRMS: Results from the BMSD network
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Multiple Sclerosis Journal |
| Vol/bind | 27 |
| Udgave nummer | 10 |
| Sider (fra-til) | 1543-1555 |
| Antal sider | 13 |
| ISSN | 1352-4585 |
| DOI | |
| Status | Udgivet - 2021 |
Bibliografisk note
Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This project was supported by Biogen International (Zug, Switzerland) on the basis of a Sponsored Research Agreement in place with the Big MS Data Network.
Funding Information:
The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: P.I. has served on scientific advisory boards for Biogen Idec, Bayer, Teva, Roche, Merck Serono, Novartis, and Genzyme and has received funding for travel and/or Speaker honoraria from Sanofi-Aventis, Genzyme, Biogen Idec, Teva, Merck Serono, and Novartis. G.L. has nothing to disclose. H.B. received compensation for serving on scientific advisory boards and as a consultant for Biogen and Novartis; speaker honoraria from Biogen Australia, Merck Serono Australia, and Novartis Australia; travel support from Biogen Australia and Merck Serono Australia; research support from the CASS Foundation (Australia), Merck Serono Australia, and the Royal Melbourne Hospital. J.H. has received honoraria for serving on advisory boards for Biogen, Sanofi-Genzyme, and Novartis and speaker’s fees from Biogen, Novartis, Merck Serono, Bayer-Schering, Teva, and Sanofi-Genzyme. He has served as P.I. for projects or received unrestricted research support from Biogen Idec, Merck Serono, TEVA, Sanofi-Genzyme, and Bayer-Schering; his MS research is funded by the Swedish Research Council and the Swedish Brain Foundation. R.H. is an employee of Biogen and holds stock. N.K.-H. has received honoraria for lecturing and participation in advisory councils, travel expenses for attending congresses and meetings, and financial support for monitoring the Danish Multiple Sclerosis Treatment Register from Bayer-Schering, Merck Serono, Biogen Idec, Teva, Sanofi-Aventis, and Novartis. M.M. has served on scientific advisory board for Biogen Idec and Teva and has received honoraria for lecturing from Biogen Idec, Merck Serono, Sanofi-Aventis, and Teva. She has received support for congress participation from Biogen Idec, Merck Serono, Novartis, and Genzyme. F.P. is an employee of Biogen. T.S. received compensation for serving on scientific advisory boards, honoraria for consultancy, and funding for travel from Biogen; speaker honoraria from Novartis. P.S.S. has served on scientific advisory boards for Merck Serono, Teva, Novartis, Sanofi-Aventis, and Biogen Idec and has received research support from Biogen Idec, Novartis, and Sanofi-Aventis and received speaker honoraria from Merck Serono, Novartis, Teva, Sanofi-Aventis, Biogen Idec, and Genzyme. S.V. received consulting and lecturing fees, travel grants, and research support from Biogen, Celgene, Genentech, Genzyme, Medday pharmaceuticals, Merck Serono, Novartis, Roche, Sanofi-Aventis, and Teva Pharma. M.T. has served on scientific Advisory Boards for Biogen, Novartis, Roche, and Genzyme; has received speaker honoraria and travel support from Biogen Idec, Sanofi-Aventis, Merck Serono, Teva, Genzyme, and Novartis; and has received research grants for her Institution from Biogen Idec, Merck Serono, and Novartis.
Publisher Copyright:
© The Author(s), 2021.
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