Treatment escalation leads to fewer relapses compared with switching to another moderately effective therapy

AbstractBackgroundPatients with multiple sclerosis who experience disease breakthrough often switch disease-modifying therapy (DMT).ObjectiveTo compare treatment effectiveness of switch to highly effective DMT (heDMT) with switch to moderately effective DMT (meDMT) for patients who switch due to disease breakthrough defined as at least one relapse within 12  months of their treatment switch.MethodsWe retrieved data from The Danish Multiple Sclerosis Registry on all relapsing-remitting MS patients with expanded disability status scale (EDSS) less than 6 who experienced disease breakthrough. We used propensity score matching to compare annualized relapse rates (ARRs), time to first confirmed relapse, time to first confirmed  EDSS worsening and time to first confirmed EDSS improvement.ResultsEach matched group comprised 404 patients. Median follow-up time was 3.2  years [interquartile range (IQR) 1.7–5.8]. ARRs were 0.22 (0.19–0.27) with heDMT and 0.32 (IQR 0.28–0.37) with meDMT; relapse rate ratio was 0.70 (95% CI 0.56–0.86;p = 0.001). Escalation to heDMT reduced the hazard of reaching a first relapse (HR 0.65; 95% CI 0.53–0.80;p 
Source: Journal of Neurology - Category: Neurology Source Type: research

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This study aims to identify reliable and objective gait-based biomarkers to monitor progressive multiple sclerosis (MS) in clinical s...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Ergonomics, Human Factors, Anthropometrics, Physiology Source Type: news
CONCLUSION: These findings suggest that ProCog-SEP could improve verbal learning abilities and working memory in people with multiple sclerosis. These improvements were observed with 13 group sessions over 6 months. PMID: 32475261 [PubMed - in process]
Source: Clinical Rehabilitation - Category: Rehabilitation Authors: Tags: Clin Rehabil Source Type: research
ConclusionModifiable lifestyle factors including healthy diet, increased physical activity and supplement use were associated with higher HRQOL among people with MS. The SF-6D instrument revealed significant discriminatory power in this international cohort of people with MS.
Source: Quality of Life Research - Category: Health Management Source Type: research
             Basel, 28 May 2020 - Roche (SIX: RO, ROG; OTCQX: RHHBY) today announced European Medicines Agency (EMA) approval of a new, shorter two-hour OCREVUS ® (ocrelizumab) infusion time, dosed twice yearly, for relapsing or primary progressive multiple sclerosis (MS). The approval is based on a positive opinion from the EMA’s Committee for Medicinal Products for Human Use (CHMP).“The approval of a shorter, two-hour infusion time for OCREVUS in Europe, dosed twice yearly, will further improve the treatment experience for patients while als...
Source: Roche Media News - Category: Pharmaceuticals Source Type: news
This article summarises current knowledge on the use of new prognostic factors such as neurofilament light chain, chitinase 3-like 1 and 2, heat shock proteins, and tubulins in MS. FUTURE DIRECTIONS: Despite numerous studies on the use of biomarkers in the diagnosis of MS, more extensive research is needed to determine the clinical usefulness of these molecules and to develop diagnostic tests applicable in everyday practice. This in turn may result in earlier MS detection, faster implementation of treatment, and better therapeutic effects. PMID: 32462652 [PubMed - as supplied by publisher]
Source: Neurologia i Neurochirurgia Polska - Category: Neurology Authors: Tags: Neurol Neurochir Pol Source Type: research
This study aims to identify reliable and objective gait-based biomarkers to monitor progressive multiple sclerosis (MS) in clinical settings. During routine clinical visits, 57 people with secondary progressive MS and 24 healthy controls walked for 6  minutes wearing three inertial motion sensors. Fifteen gait measures were computed from the sensor data and tested for between-session reliability, for differences between controls and people with moderate and severe MS disability, and for correlation with Expanded Disability Status Scale (EDSS) s cores. The majority of gait measures showed good to excellent between-sess...
Source: Journal of Neurology - Category: Neurology Source Type: research
Destruction of oligodendrocytes and myelin sheaths in cortical gray matter profoundly alters neural activity and is associated with cognitive disability in multiple sclerosis (MS). Myelin can be restored by regenerating oligodendrocytes from resident progenitors; however, it is not known whether regeneration restores the complex myelination patterns in cortical circuits. Here we performed time lapsein vivo two photon imaging in somatosensory cortex of adult mice to define the kinetics and specificity of myelin regeneration after acute oligodendrocyte ablation. These longitudinal studies revealed that the pattern of myelina...
Source: eLife - Category: Biomedical Science Tags: Neuroscience Source Type: research
AbstractPurpose of ReviewThe purpose of this review is to discuss the interaction between aging, progressive disease course, disability worsening, and treatment strategies in multiple sclerosis (MS).Recent FindingsThe transition from the relapsing-remitting phase to the progressive phase in MS often happens in the fifth decade. In MS, structural central nervous system reserve decreases with aging and MS-associated mechanisms. While clinical and subclinical disease activity decreases with aging, the post-relapse recovery potential decreases with aging as well. Moreover, the efficacy of disease-modifying treatments declines ...
Source: Current Neurology and Neuroscience Reports - Category: Neuroscience Source Type: research
ConclusionsThe effects of daclizumab beta on clinical and radiologic outcomes were sustained for up to ~  8 years of treatment. No new safety concerns were identified in SELECTED.Trial registrationClinicaltrials.gov NCT01051349; first registered on January 15, 2010.
Source: Journal of Neurology - Category: Neurology Source Type: research
AbstractObjectiveTo evaluate systematically the efficacy of exergames for balance dysfunction in neurological conditions and to identify factors of exergaming protocols that may influence their effects.MethodsWe searched electronic databases for randomized clinical trials investigating the effect of commercial exergames versus alternative interventions on balance dysfunction as assessed by standard clinical scales in adults with acquired neurological disabilities. Standardized mean differences (Hedge ’sg) were calculated with random-effects models. Subgroup analyses and meta-regression were run to explore potential m...
Source: Journal of Neurology - Category: Neurology Source Type: research
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