The Danish Multiple Sclerosis Registry

Magyari, Melinda; Joensen, Hanna; Laursen, Bjarne; Koch‐Henriksen, Nils

doi:10.1002/brb3.1921

Cited by 61 publications

(53 citation statements)

References 44 publications

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“…This study included all patients at the MS Clinis at Rigshospitalet in Copenhagen and Glostrup ever receiving anti-CD20 antibody therapy and recorded in the Danish Multiple Sclerosis Registry (DMSR) (Magyari et al, 2021). The DMSR collects national data on all patients with demyelinating diseases, and all treating clinics record data online on all patients with MS, NMO and MOGAD.…”

Section: Methodsmentioning

confidence: 99%

Anti-CD20 antibody therapy and risk of infection in patients with demyelinating diseases

Oksbjerg

Nielsen

Blinkenberg

et al. 2021

Multiple Sclerosis and Related Disorders

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Background: Anti-CD20 antibody therapy may be associated with an increased risk of infections. We therefore investigated risk factors for infection in patients with demyelinating diseases treated with anti-CD20 antibody therapy. Methods: In this retrospective uncontrolled study, patients ever treated with anti-CD20 antibodies at an academic clinic were identified through the Danish Multiple Sclerosis Registry (DMSR). Data were collected from medical charts and the DMSR. We assessed occurrence of severe infections (requiring hospitalization), varicella zoster virus (VZV), major comorbidities and routine laboratory values for lymphocytes, IgG and IgM. Results: A total of 447 patients ever treated with anti-CD20 antibody therapy were identified; of these 416 with 649 patient years of follow-up were still under therapy. In this group, seven patients had VZV infections, and 16 patients had been hospitalized with infections during up to three years of follow-up on anti-CD20 therapy. Comorbidity was recorded in 80 patients. The risk of severe infection was associated with comorbidities, higher age, longer duration of treatment, and higher Expanded Disability Status Scale (EDSS) scores. In multivariable analyses treatment duration, EDSS scores and presence of comorbidity were independently associated with risk of severe infections. Serum concentrations of IgG and IgM decreased with increasing duration of therapy but were not associated with risk of severe infections. Patients with VZV infection had lower lymphocyte counts and lower serum concentrations of IgM. In multivariable analyses only lymphocyte counts were independently associated with risk of VZV infection. Conclusions: In this retrospective study of patients treated with anti-CD20 antibodies, the risk of infections requiring hospitalization was independently associated with comorbidities, duration of treatment, and higher EDSS scores. Risk of VZV infection was independently associated with lymphopenia. Future studies investigating strategies for mitigating risk of infection in patients treated with anti-CD20 antibodies are warranted, especially for older patients, patients with higher levels of disability and for patients with a longer duration of treatment.

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Section: Methodsmentioning

confidence: 99%

Anti-CD20 antibody therapy and risk of infection in patients with demyelinating diseases

Oksbjerg

Nielsen

Blinkenberg

et al. 2021

Multiple Sclerosis and Related Disorders

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“…The DMSR, which was established in 1956, compiles prospectively collected data on a range of pre- and on-treatment clinical parameters [ 28 ]. In Denmark, diagnostic and clinical management of patients with MS is exclusively carried out by 13 MS clinics in public hospitals, these being the only units that are authorized to prescribe and dispense DMTs.…”

Section: Methodsmentioning

confidence: 99%

Real-world outcomes for a complete nationwide cohort of more than 3200 teriflunomide-treated multiple sclerosis patients in The Danish Multiple Sclerosis Registry

et al. 2021

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Objective Teriflunomide is a once-daily, oral disease-modifying therapy (DMT) for relapsing forms of multiple sclerosis (MS). We studied clinical outcomes in a real-world setting involving a population-based large cohort of unselected patients enrolled in The Danish Multiple Sclerosis Registry (DMSR) who started teriflunomide treatment between 2013–2019. Methods This was a complete nationwide population-based cohort study with prospectively enrolled unselected cases. Demographic and disease-specific patient parameters related to treatment history, efficacy outcomes, and discontinuation and switching rates among other clinical variables were assessed at baseline and during follow-up visits. Results A total of 3239 patients (65.4% female) started treatment with teriflunomide during the study period, 56% of whom were treatment-naïve. Compared to previously treated patients, treatment-naïve patients were older on average at disease onset, had a shorter disease duration, a lower Expanded Disability Status Scale score at teriflunomide treatment start and more frequently experienced a relapse in the 12 months prior to teriflunomide initiation. In the 3001 patients initiating teriflunomide treatment at least 12 months before the cut-off date, 72.7% were still on treatment one year after treatment start. Discontinuations in the first year were due mainly to adverse events (15.6%). Over the full follow-up period, 47.5% of patients discontinued teriflunomide treatment. Sixty-three percent of the patients treated with teriflunomide for 5 years were relapse-free, while significantly more treatment-naïve versus previously treated patients experienced a relapse during the follow-up (p<0.0001). Furthermore, 85% of the patients with available data were free of disability worsening at the end of follow-up. Conclusions Solid efficacy and treatment persistence data consistent with other real-world studies were obtained over the treatment period. Treatment outcomes in this real-world scenario of the population-based cohort support previous findings that teriflunomide is an effective and generally well-tolerated DMT for relapsing MS patients with mild to moderate disease activity.

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“…We used prospectively collected data from the nationwide population-based DMSR (Magyari et al, 2020). The DMSR regularly collects data on all Danish patients with MS during clinical visits at 13 departments of Neurology/MS clinics in public hospitals, which are exclusively authorized to prescribe and dispense DMT.…”

Section: Study Populationmentioning

confidence: 99%

Application of definitions for conversion to secondary progressive MS in a Danish nationwide population

Kopp

Bramow

Illés

et al. 2021

Multiple Sclerosis and Related Disorders

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Background: The number of patients with relapsing remitting multiple sclerosis (RRMS) who convert to secondary progressive (SP) MS is uncertain, and with emerging treatment options for SPMS, it is important to identify RRMS patients in transition to the SP phase. The objective of the present study was to characterize clinical parameters and use of disease modifying therapies in patients diagnosed with SPMS and RRMS patients already entered the SP phase by use of the Danish Multiple Sclerosis Registry (DMSR). Methods: We used a cross-sectional design, including all living patients with MS as of June 30, 2020 from DMSR. First, we applied the MSBase definition of SPMS on all RRMS patients. Second, we applied the slightly modified inclusion criteria from the EXPAND clinical trial on patients with clinically confirmed SPMS and patients with RRMS fulfilling the MSBase definition of SPMS to identify SPMS patients recently progressed who may benefit from treatment with disease modifying therapy. We compared clinical characteristics and disease-modifying therapy use in the different patient groups. Results: Among patients with clinically confirmed SPMS, application of a slightly modified EXPAND trial inclusion criteria for SPMS (m-EXPAND) captured patients who had converted to SPMS more recently and who had relapsed and initiated high-efficacy treatment more frequently. Moreover, our RRMS patients fulfilling the "SPMS"-criteria according to MSBase and recently progression according to m-EXPAND had similar characteristics and remarkably resembled the SPMS population in the EXPAND trial. Conclusion:Our results indicate that data-driven diagnostic definitions might help identify RRMS patients at risk for SPMS and we highlight the challenges and reluctance in diagnosing SPMS in clinical practice.

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The Danish Multiple Sclerosis Registry

Cited by 61 publications

References 44 publications

Anti-CD20 antibody therapy and risk of infection in patients with demyelinating diseases

Anti-CD20 antibody therapy and risk of infection in patients with demyelinating diseases

Real-world outcomes for a complete nationwide cohort of more than 3200 teriflunomide-treated multiple sclerosis patients in The Danish Multiple Sclerosis Registry

Application of definitions for conversion to secondary progressive MS in a Danish nationwide population

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