TY - JOUR
T1 - Country, Sex, EDSS Change and Therapy Choice Independently Predict Treatment Discontinuation in Multiple Sclerosis and Clinically Isolated Syndrome
AU - Meyniel, Claire
AU - Spelman, Timothy
AU - Jokubaitis, Vilija G.
AU - Trojano, Maria
AU - Izquierdo, Guillermo
AU - Grand'Maison, Francois
AU - Oreja-Guevara, Celia
AU - Boz, Cavit
AU - Lugaresi, Alessandra
AU - Girard, Marc
AU - Grammond, Pierre
AU - Iuliano, Gerardo
AU - Fiol, Marcela
AU - Antonio Cabrera-Gomez, Jose
AU - Fernandez-Bolanos, Ricardo
AU - Giuliani, Giorgio
AU - Lechner-Scott, Jeannette
AU - Cristiano, Edgardo
AU - Herbert, Joseph
AU - Petkovska-Boskova, Tatjana
AU - Bergamaschi, Roberto
AU - Van Pesch, Vincent
AU - Moore, Fraser
AU - Vella, Norbert
AU - Slee, Mark
AU - Santiago, Vetere
AU - Barnett, Michael
AU - Havrdova, Eva
AU - Young, Carolyn
AU - Sirbu, Carmen-Adella
AU - Tanner, Mary
AU - Rutherford, Michelle
AU - MSBasis Study Grp
AU - Hupperts, R.
AU - Butzkueven, Helmut
PY - 2012/6/29
Y1 - 2012/6/29
N2 - We conducted a prospective study, MSBASIS, to assess factors leading to first treatment discontinuation in patients with a clinically isolated syndrome (CIS) and early relapsing-remitting multiple sclerosis (RRMS).The MSBASIS Study, conducted by MSBase Study Group members, enrols patients seen from CIS onset, reporting baseline demographics, cerebral magnetic resonance imaging (MRI) features and Expanded Disability Status Scale (EDSS) scores. Follow-up visits report relapses, EDSS scores, and the start and end dates of MS-specific therapies. We performed a multivariable survival analysis to determine factors within this dataset that predict first treatment discontinuation.A total of 2314 CIS patients from 44 centres were followed for a median of 2.7 years, during which time 1247 commenced immunomodulatory drug (IMD) treatment. Ninety percent initiated IMD after a diagnosis of MS was confirmed, and 10% while still in CIS status. Over 40% of these patients stopped their first IMD during the observation period. Females were more likely to cease medication than males (HR 1.36, p?=?0.003). Patients treated in Australia were twice as likely to cease their first IMD than patients treated in Spain (HR 1.98, p?=?0.001). Increasing EDSS was associated with higher rate of IMD cessation (HR 1.21 per EDSS unit, p
AB - We conducted a prospective study, MSBASIS, to assess factors leading to first treatment discontinuation in patients with a clinically isolated syndrome (CIS) and early relapsing-remitting multiple sclerosis (RRMS).The MSBASIS Study, conducted by MSBase Study Group members, enrols patients seen from CIS onset, reporting baseline demographics, cerebral magnetic resonance imaging (MRI) features and Expanded Disability Status Scale (EDSS) scores. Follow-up visits report relapses, EDSS scores, and the start and end dates of MS-specific therapies. We performed a multivariable survival analysis to determine factors within this dataset that predict first treatment discontinuation.A total of 2314 CIS patients from 44 centres were followed for a median of 2.7 years, during which time 1247 commenced immunomodulatory drug (IMD) treatment. Ninety percent initiated IMD after a diagnosis of MS was confirmed, and 10% while still in CIS status. Over 40% of these patients stopped their first IMD during the observation period. Females were more likely to cease medication than males (HR 1.36, p?=?0.003). Patients treated in Australia were twice as likely to cease their first IMD than patients treated in Spain (HR 1.98, p?=?0.001). Increasing EDSS was associated with higher rate of IMD cessation (HR 1.21 per EDSS unit, p
U2 - 10.1371/journal.pone.0038661
DO - 10.1371/journal.pone.0038661
M3 - Article
C2 - 22768046
SN - 1932-6203
VL - 7
JO - PLOS ONE
JF - PLOS ONE
IS - 6
M1 - e38661
ER -