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Assessing the role of innovative therapeutic paradigm on multiple sclerosis treatment response
Author(s) -
Romeo Marzia A. L.,
Martinelli Vittorio,
Dalla Costa Gloria,
Colombo Bruno,
De Feo Donatella,
Esposito Federica,
Ferrè Laura,
Guaschino Clara,
Guerrieri Simone,
Liberatore Giuseppe,
Martinelli Boneschi Filippo,
Merlini Arianna,
Messina Mariajosè,
Messina Roberta,
Nuara Arturo,
Preziosa Paolo,
Radaelli Marta,
Rocca Maria A.,
Rodegher Mariaemma,
Sangalli Francesca,
Strambo Davide,
Moiola Lucia,
Comi Giancarlo
Publication year - 2018
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12999
Subject(s) - glatiramer acetate , medicine , multiple sclerosis , cohort , propensity score matching , multivariate analysis , natalizumab , cohort study , disease , physical therapy , immunology
Objective Within the last decade, many changes have been made to the management of patients with multiple sclerosis ( MS ). The aim of our study was to investigate the global impact of all these changes on the disease's course. Materials and methods This single‐centre study was carried out on patients with multiple sclerosis (pw MS ) who started treatment with first‐line disease‐modifying therapies. We have compared three large cohorts of patients with MS diagnosis, for three consecutive periods within July 2001, August 2001‐December 2005, and January 2006‐September 2011. Results A total of 1068 relapsing‐remitting pw MS cases were included. Patients in the last cohort began treatment earlier ( P < 0.0001), started more frequent treatment with high‐dose interferon beta or glatiramer acetate ( P < 0.0001), and had experienced a more frequent treatment escalation strategy ( P = 0.004) than patients in other cohorts. The multivariate analysis adjusted for baseline characteristics showed that pw MS of the last cohort had a high probability of showing no evidence of disease activity ( NEDA 3) at 4 years ( OR 3.22, 95% CI s 1.89‐5.47; P < 0.0001). These results were confirmed in a propensity score analysis. Conclusions Our study showed an improvement over the last 15 years in the treatment response; this observation can be associated to a paradigm shift in MS treatment strategies.