- Title
- Effectiveness of Disease-Modifying Treatment on Spinal Cord Lesion Formation in Relapse-Onset Multiple Sclerosis: An MSBase Registry Study
- Creator
- Kreiter, Daniel; Kalincik, Tomas; Lechner-Scott, Jeannette; Ozakbas, Serkan; Gerlach, Ozakbas; Turkoglu, R.; Soysal, A.; Boz, C.; Al-Asmi, A.; Alkhaboori, J.; Amato, M. P.; Onofrj, M.; Hupperts, Raymond; Lugaresi, A.; Besora, S; Sanchez-Menoyo, JL; Lapointe, E; Grand’Maison, F; Grammond, P; Butzkueven, H; Van der Walt, A; Taylor, BV; McCombe, PA; Patti, Francesco; Garber, JY; Skibina, OG; Buzzard, KA; John, NA; Shaw, C; Barnett, MH; Spitaleri, Daniele; Foschi, Matteo; Surcinelli, Andrea; Maimone, Davide; Yamout, Bassem; Khoury, Samia J.
- Relation
- CNS Drugs Vol. 38, p. 921-930
- Publisher Link
- http://dx.doi.org/10.1007/s40263-024-01115-x
- Publisher
- Adis International
- Resource Type
- journal article
- Date
- 2024
- Description
- Background: Spinal cord lesions in multiple sclerosis (MS) have considerable impact on disability. High-efficacy disease-modifying treatments (hDMTs) are associated with greater reduction of relapses and new brain lesions compared to low-efficacy treatments (lDMTs). Knowledge on the impact of DMTs on cord lesion formation is limited as these outcome measures were not included in MS treatment trials. This study aims to investigate whether hDMTs reduce the formation of cord lesions more effectively than lDMTs. Methods: Patients with relapse-onset MS, a cord magnetic resonance imaging (MRI) within 6 months before/after initiation of their first DMT and ≥1 cord MRI at follow-up (interval > 6 months) were extracted from the MSBase registry (ACTRN12605000455662). Patients treated with hDMTs ≥90% or lDMTs ≥90% of follow-up duration were considered the hDMT and lDMT groups, respectively. Matching was performed using propensity scores. Cox proportional hazards models were used to estimate the hazards of new cord lesions, brain lesions and relapses. Results: Ninety-four and 783 satisfied hDMT and lDMT group criteria, respectively. Seventy-seven hDMT patients were matched to 184 lDMT patients. In the hDMT group there was no evidence of reduction of new cord lesions (hazard ratio [HR] 0.99 [95% CI 0.51, 1.92], p = 0.97), while there were fewer new brain lesions (HR 0.22 [95% CI 0.10, 0.49], p < 0.001) and fewer relapses (HR 0.45 [95% CI 0.28, 0.72], p = 0.004). Conclusion: A potential discrepancy exists in the effect of hDMTs over lDMTs in preventing spinal cord lesions versus brain lesions and relapses. While hDMTs provided a significant reduction for the latter when compared to lDMTs, there was no significant reduction in new spinal cord lesions.
- Subject
- spinal cord; multiple sclerosis (MS); high-efficacy disease- modifying treatments (hDMTs); low- efficacy treatments (lDMTs)
- Identifier
- http://hdl.handle.net/1959.13/1512619
- Identifier
- uon:56642
- Identifier
- ISSN:1172-7047
- Rights
- This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.
- Language
- eng
- Full Text
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