Are we studying MS relapses in the right way?

Scott, Thomas F.

doi:10.1016/j.msard.2012.08.003

Cited by 2 publications

(2 citation statements)

References 16 publications

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“…19 This analysis highlights the relevance of relapse recovery as a useful additional measure of treatment effect. Relapses with incomplete versus complete recovery may be a more appropriate endpoint than relapse rate for MS clinical trials, in recognition that quality may be more relevant than quantity of relapses in predicting clinical outcomes, 2 as overall relapse frequency after the first few years of MS may be a poor predictor of long-term outcome. 20 A previous analysis of patient-reported outcomes in ADVANCE showed that CDP due to incomplete relapse recovery was an important factor in driving the negative impact of MS on health-related quality of life, having a greater impact than CDP independent of relapse, or relapses that did not lead to CDP, 21 further highlighting the value of improving relapse recovery.…”

Section: Discussionmentioning

confidence: 99%

“…The long-term impact of relapses with incomplete recovery on disease worsening has been studied almost exclusively in the context of a first or second exacerbation of relapsingremitting multiple sclerosis (RRMS). 1,2 The contribution of later relapses to long-term patterns of confirmed worsening of disability in RRMS has rarely been explored, but recent evidence suggests recovery from later relapses may play an important role in predicting long-term outcomes. 3 Even short-term changes in Expanded Disability Status Scale (EDSS) score due to relapse have been studied in only a limited fashion, 4,5 and rarely has relapse recovery been examined in the context of treatment trials.…”

Section: Introductionmentioning

confidence: 99%

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Improvement in relapse recovery with peginterferon beta-1a in patients with multiple sclerosis

Scott

Kieseier

Newsome

et al. 2016

Multiple Sclerosis Journal - Experimental, Translational and Cl

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BackgroundSubcutaneous peginterferon beta-1a every 2 weeks significantly affects clinical outcomes in patients with relapsing–remitting multiple sclerosis (RRMS).ObjectivesTo explore relationships between relapses and worsening of disability in patients with RRMS, and assess the treatment effect of peginterferon beta-1a on relapse recovery.MethodsPost-hoc analysis of the 2-year, randomized, double-blind, parallel-group, Phase 3 ADVANCE study. The severity of relapses, proportion of patients with relapses associated with residual disability (onset of 24-week confirmed disability progression (CDP) within 90 days following a relapse), and persistence of changes in Functional Systems Scores, were compared between treatment groups.ResultsSubcutaneous peginterferon beta-1a every 2 weeks significantly reduced the proportion of patients experiencing relapse associated with CDP over 2 years (6.6%, compared with 15.1% of patients who received placebo in Year 1; p = 0.02). Reduction in relapses associated with residual disability was greater than the treatment effect on overall relapse rate, and occurred despite similar relapse severity across treatment groups.ConclusionsThe beneficial effect of peginterferon beta-1a on risk of CDP may be attributable to the combination of an overall reduction in the risk of relapses and improvement in recovery from relapses, thus limiting further disability progression.Trial registrationClinicalTrials.gov identifier: NCT00906399

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