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Variability of the response to immunotherapy among subgroups of patients with multiple sclerosis.

Authors :
Diouf I
Malpas CB
Sharmin S
Roos I
Horakova D
Havrdova EK
Patti F
Shaygannejad V
Ozakbas S
Izquierdo G
Eichau S
Onofrj M
Lugaresi A
Alroughani R
Prat A
Girard M
Duquette P
Terzi M
Boz C
Grand'Maison F
Hamdy S
Sola P
Ferraro D
Grammond P
Turkoglu R
Buzzard K
Skibina O
Yamout B
Altintas A
Gerlach O
van Pesch V
Blanco Y
Maimone D
Lechner-Scott J
Bergamaschi R
Karabudak R
Iuliano G
McGuigan C
Cartechini E
Barnett M
Hughes S
Sa MJ
Solaro C
Kappos L
Ramo-Tello C
Cristiano E
Hodgkinson S
Spitaleri D
Soysal A
Petersen T
Slee M
Butler E
Granella F
de Gans K
McCombe P
Ampapa R
Van Wijmeersch B
van der Walt A
Butzkueven H
Prevost J
Sinnige LGF
Sanchez-Menoyo JL
Vucic S
Laureys G
Van Hijfte L
Khurana D
Macdonell R
Gouider R
Castillo-Triviño T
Gray O
Aguera-Morales E
Al-Asmi A
Shaw C
Deri N
Al-Harbi T
Fragoso Y
Csepany T
Perez Sempere A
Trevino-Frenk I
Schepel J
Moore F
Kalincik T
Source :
European journal of neurology [Eur J Neurol] 2023 Apr; Vol. 30 (4), pp. 1014-1024. Date of Electronic Publication: 2023 Feb 16.
Publication Year :
2023

Abstract

Background and Purpose: This study assessed the effect of patient characteristics on the response to disease-modifying therapy (DMT) in multiple sclerosis (MS).<br />Methods: We extracted data from 61,810 patients from 135 centers across 35 countries from the MSBase registry. The selection criteria were: clinically isolated syndrome or definite MS, follow-up ≥ 1 year, and Expanded Disability Status Scale (EDSS) score ≥ 3, with ≥1 score recorded per year. Marginal structural models with interaction terms were used to compare the hazards of 12-month confirmed worsening and improvement of disability, and the incidence of relapses between treated and untreated patients stratified by their characteristics.<br />Results: Among 24,344 patients with relapsing MS, those on DMTs experienced 48% reduction in relapse incidence (hazard ratio [HR] = 0.52, 95% confidence interval [CI] = 0.45-0.60), 46% lower risk of disability worsening (HR = 0.54, 95% CI = 0.41-0.71), and 32% greater chance of disability improvement (HR = 1.32, 95% CI = 1.09-1.59). The effect of DMTs on EDSS worsening and improvement and the risk of relapses was attenuated with more severe disability. The magnitude of the effect of DMT on suppressing relapses declined with higher prior relapse rate and prior cerebral magnetic resonance imaging activity. We did not find any evidence for the effect of age on the effectiveness of DMT. After inclusion of 1985 participants with progressive MS, the effect of DMT on disability mostly depended on MS phenotype, whereas its effect on relapses was driven mainly by prior relapse activity.<br />Conclusions: DMT is generally most effective among patients with lower disability and in relapsing MS phenotypes. There is no evidence of attenuation of the effect of DMT with age.<br /> (© 2023 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)

Details

Language :
English
ISSN :
1468-1331
Volume :
30
Issue :
4
Database :
MEDLINE
Journal :
European journal of neurology
Publication Type :
Academic Journal
Accession number :
36692895
Full Text :
https://doi.org/10.1111/ene.15706