Time to secondary progression in patients with multiple sclerosis who were treated with first generation immunomodulating drugs.
Journal article, 2013
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
DMD
bromsmedicin
progression
RRMS
SPMS
multipel skleros
Author
Helen Tedeholm
Goteborgs Universitet
Jan Lycke
Goteborgs Universitet
Bengt Skoog
Goteborgs Universitet
Vera Lisovskaja
Chalmers, Mathematical Sciences, Mathematical Statistics
University of Gothenburg
J Hillert
Karolinska University Hospital
C Dahle
Linkopings universitet
J Fagius
Akademiska Sjukhuset
S Fredrikson
Karolinska University Hospital
A-M Landtblom
Linkopings universitet
Clas Malmeström
Goteborgs Universitet
C Martin
Danderyd Hospital
F Piehl
Karolinska University Hospital
Björn Runmarker
Goteborgs Universitet
L Stawiarz
Karolinska University Hospital
M Vrethem
Linkopings universitet
Olle Nerman
Chalmers, Mathematical Sciences, Mathematical Statistics
University of Gothenburg
Oluf Andersen
Goteborgs Universitet
Multiple Sclerosis
1352-4585 (ISSN) 1477-0970 (eISSN)
Vol. 19 6 765-774Subject Categories (SSIF 2011)
Clinical Medicine
DOI
10.1177/1352458512463764
PubMed
23124789