Time to relapse and disability progression in a long-term cohort of people with clinically isolated syndrome and relapse-onset multiple sclerosis treated with disease-modifying drugs: a prospective nationwide survey in Switzerland
(Abstract release date: 09/23/15)
ECTRIMS Learn. Lienert C. 10/08/15; 115532; 563
Carmen Lienert
Contributions
Contributions
Abstract
Abstract: P287
Type: Poster
Abstract Category: Epidemiology
Background: The efficacy of disease modifying drugs (DMDs) to prevent relapses in relapsing-remitting multiple sclerosis (RRMS) has been shown in numerous Phase-III trials. However, the long-term effect on disability progression is still a matter of debate.
Aim: To determine time to relapse and disability progression in a large long-term MS cohort treated with DMDs.
Methods: Analysis of data from the Swiss Federation for Common Tasks of Health Insurances (SVK) that includes standardised annual information on diagnosis, disease onset, relapses and neurological status assessed using the Expanded Disability Status Scale (EDSS) of about 80% of all MS patients treated with DMDs in Switzerland. The case record forms provided by the treating neurologists were reviewed for completeness and internal plausibility and queries about missing or inconsistent data were issued by the SVK under the supervision of an independent physician. EDSS progression was defined as>= 1 step if EDSS was < = 5.0 and >= 0.5 if EDSS was >=5.5 confirmed at two consecutive annual evaluations. Patients who switched or discontinued treatment before confirmation of the EDSS change were censored. Hazard ratios were propensity-score adjusted for clinically relevant baseline characteristics including age, gender, disease duration, disease subtype, EDSS at treatment start and time of DMD introduction.
Results: From 1995 to 2010, 8044 patients were included in this study: 472 clinically isolated syndrome, 6832 RRMS, 740 secondary-progressive MS (SPMS); mean age 39.6±11.3, disease duration 7.15±8.01 years, annualised relapse rate 0.91±0.66 [based on the two antecedent years], median EDSS at treatment start 2.5 (range 0-8), mean time of follow-up 4.4±3.94 years. In the year prior to treatment start, 16.6% of the patients were relapse-free. This proportion increased after one year of treatment to 60.6% similar across the treatment groups. After 10 years on DMD treatment, 15.1% of the patients had still relapses. Median time to confirmed EDSS progression was 7.92 years (interquartile range [IQR] 7.68-8.74) in RRMS and 4.96 years (IQR 4.33-5.97) in SPMS calculated from treatment start. In a propensity-score adjusted analysis, both the median time to relapse and confirmed EDSS progression was similar across the treatment groups.
Conclusions: In this comprehensive and large long-term MS cohort, time to relapse and confirmed EDSS progression was similar across interferon-beta products and glatiramer acetate.
Disclosure:
Carmen Lienert received travel support for scientific meetings from TEVA, Biogen and Merck-Serono
Andy Schötzau has nothing to disclose
Serafin Beer has nothing to disclose
Peter Hänni has nothing to disclose
Marcus D'Souza received travel support from Bayer AG, Teva and Genzyme and research support from the University of Basel
Jens Kuhle has received research support by an ECTRIMS Research Fellowship Programme, University of Basel, Swiss MS Society, Swiss National Science Foundation, Protagen AG, Roche, Genzyme and Novartis.
Ludwig Kappos has received in the last 3 years and used exclusively for research support: steering committee, advisory board and consultancy fees from Actelion, Addex, Bayer Health Care, Biogen, Biotica, Genzyme, Lilly, Merck, Mitsubishi, Novartis, Ono Pharma, Pfizer, Receptos, Sanofi-Aventis, Santhera, Siemens, Teva, UCB, Xenoport; speaker fees from Bayer Health Care, Biogen, Merck, Novartis, Sanofi-Aventis, Teva; support of educational activities from Bayer Health Care, Biogen, CSL Behring, Genzyme, Merck, Novartis, Sanofi, Teva; royalties from Neurostatus Systems GmbH; grants from Bayer Health Care, Biogen, Merck, Novartis, Roche, Swiss MS Society, the Swiss National Research Foundation, the European Union, and Roche Research Foundations.
Özgür Yaldizli has nothing to disclose in the last two years
Type: Poster
Abstract Category: Epidemiology
Background: The efficacy of disease modifying drugs (DMDs) to prevent relapses in relapsing-remitting multiple sclerosis (RRMS) has been shown in numerous Phase-III trials. However, the long-term effect on disability progression is still a matter of debate.
Aim: To determine time to relapse and disability progression in a large long-term MS cohort treated with DMDs.
Methods: Analysis of data from the Swiss Federation for Common Tasks of Health Insurances (SVK) that includes standardised annual information on diagnosis, disease onset, relapses and neurological status assessed using the Expanded Disability Status Scale (EDSS) of about 80% of all MS patients treated with DMDs in Switzerland. The case record forms provided by the treating neurologists were reviewed for completeness and internal plausibility and queries about missing or inconsistent data were issued by the SVK under the supervision of an independent physician. EDSS progression was defined as>= 1 step if EDSS was < = 5.0 and >= 0.5 if EDSS was >=5.5 confirmed at two consecutive annual evaluations. Patients who switched or discontinued treatment before confirmation of the EDSS change were censored. Hazard ratios were propensity-score adjusted for clinically relevant baseline characteristics including age, gender, disease duration, disease subtype, EDSS at treatment start and time of DMD introduction.
Results: From 1995 to 2010, 8044 patients were included in this study: 472 clinically isolated syndrome, 6832 RRMS, 740 secondary-progressive MS (SPMS); mean age 39.6±11.3, disease duration 7.15±8.01 years, annualised relapse rate 0.91±0.66 [based on the two antecedent years], median EDSS at treatment start 2.5 (range 0-8), mean time of follow-up 4.4±3.94 years. In the year prior to treatment start, 16.6% of the patients were relapse-free. This proportion increased after one year of treatment to 60.6% similar across the treatment groups. After 10 years on DMD treatment, 15.1% of the patients had still relapses. Median time to confirmed EDSS progression was 7.92 years (interquartile range [IQR] 7.68-8.74) in RRMS and 4.96 years (IQR 4.33-5.97) in SPMS calculated from treatment start. In a propensity-score adjusted analysis, both the median time to relapse and confirmed EDSS progression was similar across the treatment groups.
Conclusions: In this comprehensive and large long-term MS cohort, time to relapse and confirmed EDSS progression was similar across interferon-beta products and glatiramer acetate.
Disclosure:
Carmen Lienert received travel support for scientific meetings from TEVA, Biogen and Merck-Serono
Andy Schötzau has nothing to disclose
Serafin Beer has nothing to disclose
Peter Hänni has nothing to disclose
Marcus D'Souza received travel support from Bayer AG, Teva and Genzyme and research support from the University of Basel
Jens Kuhle has received research support by an ECTRIMS Research Fellowship Programme, University of Basel, Swiss MS Society, Swiss National Science Foundation, Protagen AG, Roche, Genzyme and Novartis.
Ludwig Kappos has received in the last 3 years and used exclusively for research support: steering committee, advisory board and consultancy fees from Actelion, Addex, Bayer Health Care, Biogen, Biotica, Genzyme, Lilly, Merck, Mitsubishi, Novartis, Ono Pharma, Pfizer, Receptos, Sanofi-Aventis, Santhera, Siemens, Teva, UCB, Xenoport; speaker fees from Bayer Health Care, Biogen, Merck, Novartis, Sanofi-Aventis, Teva; support of educational activities from Bayer Health Care, Biogen, CSL Behring, Genzyme, Merck, Novartis, Sanofi, Teva; royalties from Neurostatus Systems GmbH; grants from Bayer Health Care, Biogen, Merck, Novartis, Roche, Swiss MS Society, the Swiss National Research Foundation, the European Union, and Roche Research Foundations.
Özgür Yaldizli has nothing to disclose in the last two years
Abstract: P287
Type: Poster
Abstract Category: Epidemiology
Background: The efficacy of disease modifying drugs (DMDs) to prevent relapses in relapsing-remitting multiple sclerosis (RRMS) has been shown in numerous Phase-III trials. However, the long-term effect on disability progression is still a matter of debate.
Aim: To determine time to relapse and disability progression in a large long-term MS cohort treated with DMDs.
Methods: Analysis of data from the Swiss Federation for Common Tasks of Health Insurances (SVK) that includes standardised annual information on diagnosis, disease onset, relapses and neurological status assessed using the Expanded Disability Status Scale (EDSS) of about 80% of all MS patients treated with DMDs in Switzerland. The case record forms provided by the treating neurologists were reviewed for completeness and internal plausibility and queries about missing or inconsistent data were issued by the SVK under the supervision of an independent physician. EDSS progression was defined as>= 1 step if EDSS was < = 5.0 and >= 0.5 if EDSS was >=5.5 confirmed at two consecutive annual evaluations. Patients who switched or discontinued treatment before confirmation of the EDSS change were censored. Hazard ratios were propensity-score adjusted for clinically relevant baseline characteristics including age, gender, disease duration, disease subtype, EDSS at treatment start and time of DMD introduction.
Results: From 1995 to 2010, 8044 patients were included in this study: 472 clinically isolated syndrome, 6832 RRMS, 740 secondary-progressive MS (SPMS); mean age 39.6±11.3, disease duration 7.15±8.01 years, annualised relapse rate 0.91±0.66 [based on the two antecedent years], median EDSS at treatment start 2.5 (range 0-8), mean time of follow-up 4.4±3.94 years. In the year prior to treatment start, 16.6% of the patients were relapse-free. This proportion increased after one year of treatment to 60.6% similar across the treatment groups. After 10 years on DMD treatment, 15.1% of the patients had still relapses. Median time to confirmed EDSS progression was 7.92 years (interquartile range [IQR] 7.68-8.74) in RRMS and 4.96 years (IQR 4.33-5.97) in SPMS calculated from treatment start. In a propensity-score adjusted analysis, both the median time to relapse and confirmed EDSS progression was similar across the treatment groups.
Conclusions: In this comprehensive and large long-term MS cohort, time to relapse and confirmed EDSS progression was similar across interferon-beta products and glatiramer acetate.
Disclosure:
Carmen Lienert received travel support for scientific meetings from TEVA, Biogen and Merck-Serono
Andy Schötzau has nothing to disclose
Serafin Beer has nothing to disclose
Peter Hänni has nothing to disclose
Marcus D'Souza received travel support from Bayer AG, Teva and Genzyme and research support from the University of Basel
Jens Kuhle has received research support by an ECTRIMS Research Fellowship Programme, University of Basel, Swiss MS Society, Swiss National Science Foundation, Protagen AG, Roche, Genzyme and Novartis.
Ludwig Kappos has received in the last 3 years and used exclusively for research support: steering committee, advisory board and consultancy fees from Actelion, Addex, Bayer Health Care, Biogen, Biotica, Genzyme, Lilly, Merck, Mitsubishi, Novartis, Ono Pharma, Pfizer, Receptos, Sanofi-Aventis, Santhera, Siemens, Teva, UCB, Xenoport; speaker fees from Bayer Health Care, Biogen, Merck, Novartis, Sanofi-Aventis, Teva; support of educational activities from Bayer Health Care, Biogen, CSL Behring, Genzyme, Merck, Novartis, Sanofi, Teva; royalties from Neurostatus Systems GmbH; grants from Bayer Health Care, Biogen, Merck, Novartis, Roche, Swiss MS Society, the Swiss National Research Foundation, the European Union, and Roche Research Foundations.
Özgür Yaldizli has nothing to disclose in the last two years
Type: Poster
Abstract Category: Epidemiology
Background: The efficacy of disease modifying drugs (DMDs) to prevent relapses in relapsing-remitting multiple sclerosis (RRMS) has been shown in numerous Phase-III trials. However, the long-term effect on disability progression is still a matter of debate.
Aim: To determine time to relapse and disability progression in a large long-term MS cohort treated with DMDs.
Methods: Analysis of data from the Swiss Federation for Common Tasks of Health Insurances (SVK) that includes standardised annual information on diagnosis, disease onset, relapses and neurological status assessed using the Expanded Disability Status Scale (EDSS) of about 80% of all MS patients treated with DMDs in Switzerland. The case record forms provided by the treating neurologists were reviewed for completeness and internal plausibility and queries about missing or inconsistent data were issued by the SVK under the supervision of an independent physician. EDSS progression was defined as>= 1 step if EDSS was < = 5.0 and >= 0.5 if EDSS was >=5.5 confirmed at two consecutive annual evaluations. Patients who switched or discontinued treatment before confirmation of the EDSS change were censored. Hazard ratios were propensity-score adjusted for clinically relevant baseline characteristics including age, gender, disease duration, disease subtype, EDSS at treatment start and time of DMD introduction.
Results: From 1995 to 2010, 8044 patients were included in this study: 472 clinically isolated syndrome, 6832 RRMS, 740 secondary-progressive MS (SPMS); mean age 39.6±11.3, disease duration 7.15±8.01 years, annualised relapse rate 0.91±0.66 [based on the two antecedent years], median EDSS at treatment start 2.5 (range 0-8), mean time of follow-up 4.4±3.94 years. In the year prior to treatment start, 16.6% of the patients were relapse-free. This proportion increased after one year of treatment to 60.6% similar across the treatment groups. After 10 years on DMD treatment, 15.1% of the patients had still relapses. Median time to confirmed EDSS progression was 7.92 years (interquartile range [IQR] 7.68-8.74) in RRMS and 4.96 years (IQR 4.33-5.97) in SPMS calculated from treatment start. In a propensity-score adjusted analysis, both the median time to relapse and confirmed EDSS progression was similar across the treatment groups.
Conclusions: In this comprehensive and large long-term MS cohort, time to relapse and confirmed EDSS progression was similar across interferon-beta products and glatiramer acetate.
Disclosure:
Carmen Lienert received travel support for scientific meetings from TEVA, Biogen and Merck-Serono
Andy Schötzau has nothing to disclose
Serafin Beer has nothing to disclose
Peter Hänni has nothing to disclose
Marcus D'Souza received travel support from Bayer AG, Teva and Genzyme and research support from the University of Basel
Jens Kuhle has received research support by an ECTRIMS Research Fellowship Programme, University of Basel, Swiss MS Society, Swiss National Science Foundation, Protagen AG, Roche, Genzyme and Novartis.
Ludwig Kappos has received in the last 3 years and used exclusively for research support: steering committee, advisory board and consultancy fees from Actelion, Addex, Bayer Health Care, Biogen, Biotica, Genzyme, Lilly, Merck, Mitsubishi, Novartis, Ono Pharma, Pfizer, Receptos, Sanofi-Aventis, Santhera, Siemens, Teva, UCB, Xenoport; speaker fees from Bayer Health Care, Biogen, Merck, Novartis, Sanofi-Aventis, Teva; support of educational activities from Bayer Health Care, Biogen, CSL Behring, Genzyme, Merck, Novartis, Sanofi, Teva; royalties from Neurostatus Systems GmbH; grants from Bayer Health Care, Biogen, Merck, Novartis, Roche, Swiss MS Society, the Swiss National Research Foundation, the European Union, and Roche Research Foundations.
Özgür Yaldizli has nothing to disclose in the last two years
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