Confounders in natural history of interferon‐β–treated relapsing multiple sclerosis

Gout, Olivier

doi:10.1002/ana.21186

Cited by 4 publications

(4 citation statements)

References 5 publications

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“…However, it is variable, also when expressed as 3 months sustained EDSS, 25 and secondary progression was considered a reliable measure of an irreversible course, particularly in studies over a long span of time. 26 Information on onset of secondary progression was re-considered if the patient reached an EDSS of 4 or 6. The EDSS 4 is often reached simultaneously with the transition to the SP.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies demonstrated long-term effects in studies using propensity scores, a method designed to compensate for subgroup differences in non-randomized materials. 9,13,14 Caveats proposed for propensity analyses stated that contributing factors should have predictive capacity, 15 and that the initial pre-treatment segments of the treated material should be included in the untreated group. 16 However, at variance with these results, a recent study based on a large database combining MS clinic data in British Columbia found that 5 years (median) of interferon beta therapy provide no significant effect on the time to reach EDSS 6 (walking with a cane).…”

Section: Introductionmentioning

confidence: 99%

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Time to secondary progression in patients with multiple sclerosis who were treated with first generation immunomodulating drugs

et al. 2012

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Background:It is currently unknown whether early immunomodulatory treatment in relapsing–remitting MS (RRMS) can delay the transition to secondary progression (SP).Objective:To compare the time interval from onset to SP in patients with RRMS between a contemporary cohort, treated with first generation disease modifying drugs (DMDs), and a historical control cohort.Methods:We included a cohort of contemporary RRMS patients treated with DMDs, obtained from the Swedish National MS Registry (disease onset between 1995–2004, n = 730) and a historical population-based incidence cohort (onset 1950–64, n = 186). We retrospectively analyzed the difference in time to SP, termed the “period effect” within a 12-year survival analysis, using Kaplan-Meier and Cox regression analysis.Results:We found that the “period” affected the entire severity spectrum. After adjusting for onset features, which were weaker in the contemporary material, as well as the therapy initiation time, the DMD-treated patients still exhibited a longer time to SP than the controls (hazard ratios: men, 0.32; women, 0.53).Conclusion:Our results showed there was a longer time to SP in the contemporary subjects given DMD. Our analyses suggested that this effect was not solely driven by the inclusion of benign cases, and it was at least partly due to the long-term immunomodulating therapy given.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Time to secondary progression in patients with multiple sclerosis who were treated with first generation immunomodulating drugs

et al. 2012

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“…Several postmarketing studies have suggested the effectiveness of interferon beta, as measured by relapses, disability, or MRI. [4][5][6][7][8][9][10] Although much has been learned from these studies, the validity of the findings has been brought to question [11][12][13][14] because of major methodological issues including immortal time bias, 13,15 selection bias, 10,12,16 small sample sizes, 6,8,9 and insufficient followup. 4,6,7 We set out to investigate the association between interferon beta exposure and disability progression in relapsing-remitting MS using a database of MS cases in the province of British Columbia, Canada.…”

mentioning

confidence: 99%

Association Between Use of Interferon Beta and Progression of Disability in Patients With Relapsing-Remitting Multiple Sclerosis

Shirani¹,

Zhao²,

Karim³

et al. 2012

JAMA

233

224

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ULTIPLE SCLEROSIS (MS) IS a chronic disease that often affects people in the prime of their lives. A key feature of MS is clinical progression of the disease over time manifested by the accumulation of disability. Interferon beta drugs are the most widely prescribed disease-modifying drugs (DMDs) approved by the US Food and Drug Administration for the treatment of relapsing-onset MS, the most common MS disease course. Although a substantial reduction in brain lesion development, as evidenced by magnetic resonance imaging (MRI), 1 and a one-third relative reduction in relapse frequency were demonstrated in the pivotal clinical trials of interferon beta for relapsing-remitting MS, 2 there is a lack of well-controlled longitudinal studies investigating the effect of in-terferon beta on disability progression. Typically, drug efficacy (as established through randomized clinical trials conducted under optimal conditions) is greater than drug effectiveness (as measured in "real-world" settings). 3 Patients participating in clinical trials tend to be highly selected in For editorial comment see p 290.

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“…However, the comparisons between two consecutive populations cohorts may be influenced by other biases, notably competing risks. Exogenous risk factors for MS possibly influencing the SPMS incidence such as low vitamin D levels or smoking (Manouchehrinia (Gout, 2008).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of first generation disease-modifying therapy to prevent conversion to secondary progressive multiple sclerosis

Tedeholm¹,

Piehl²,

Lycke³

et al. 2022

Multiple Sclerosis and Related Disorders

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Confounders in natural history of interferon‐β–treated relapsing multiple sclerosis

Cited by 4 publications

References 5 publications

Time to secondary progression in patients with multiple sclerosis who were treated with first generation immunomodulating drugs

Time to secondary progression in patients with multiple sclerosis who were treated with first generation immunomodulating drugs

Association Between Use of Interferon Beta and Progression of Disability in Patients With Relapsing-Remitting Multiple Sclerosis

Effectiveness of first generation disease-modifying therapy to prevent conversion to secondary progressive multiple sclerosis

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