Contributions
Abstract: EP1405
Type: ePoster
Abstract Category: Clinical aspects of MS - 8 Clinical assessment tools
Objective: A critical analysis on whether optimization of approach and follow up in relapsing remitting MS (RRMS) patients impact long term outcomes in real world scenario.
Background: Multiple sclerosis (MS) treatment evolved on last two decades, mostly after introduction of so called disease modifying drugs (DMDs). Parallel to advent of new drugs our expertise applying diagnostic protocols and custom therapy improved. Nevertheless, paradigms for optimal care in MS still depend upon prompt and correct diagnosis together with an early as possible onset of treatment.
Design and methods: Consecutive naive RRMS patients (McDonald 2001), all using a first line DMD, were stratified according to year of inclusion on treatment program, from 2002 to 2004 (n=101), 2005 to 2007 (n=93) and 2008 to 2010 (n=128). There were 17
treatment discontinuations: 9 in first, 6 in second and 2 in third cohort. Intentionto-treat data were plotted after 4 years in each group.
Results: Cohorts matched for age, gender, age at first relapse, prior annualized relapse rate (ARR) and time from first to second relapse. On baseline, time delay to beginning of DMD (p< .0001) and number of T2W hyperintense MRI lesions (p< .01), were significant especially when comparing cohorts 1 and 3. Annual number of visits (p< .001) and frequency of imaging studies (p< .001) were also noteworthy. On follow up, ARR (p< .0001), EDSS worsening more than 1 point confirmed at 6 month (p< .0001), NEDA 3(no relapses, no Gd+ and/or new T2W lesions, no EDSS progression) (p< .0002) and annualized corpus callosum index (CCI) loss (p< .001) was also relevant. All differences had more impact when comparing first and third cohorts.
Conclusions: Prompt and early institution of treatment had a positive impact on inflammation (ARR and NEDA3) as well as a possible benefit on degenerative domain (EDSS and CCI). Our findings suggest that optimization of standards of care can positively impact on long term disease course.
Disclosure:
Fernando Faria Andrade Figueira: nothing to disclose
Gustavo Medeiros Andrade Figueira: nothing to disclose
Paula Vallegas Soares Bilouro: nothing to disclose
Mariana Xavier: nothing to disclose
Raquel Custódio da Silveira: nothing to disclose
Debora Angst Bartzen: nothing to disclose
Abstract: EP1405
Type: ePoster
Abstract Category: Clinical aspects of MS - 8 Clinical assessment tools
Objective: A critical analysis on whether optimization of approach and follow up in relapsing remitting MS (RRMS) patients impact long term outcomes in real world scenario.
Background: Multiple sclerosis (MS) treatment evolved on last two decades, mostly after introduction of so called disease modifying drugs (DMDs). Parallel to advent of new drugs our expertise applying diagnostic protocols and custom therapy improved. Nevertheless, paradigms for optimal care in MS still depend upon prompt and correct diagnosis together with an early as possible onset of treatment.
Design and methods: Consecutive naive RRMS patients (McDonald 2001), all using a first line DMD, were stratified according to year of inclusion on treatment program, from 2002 to 2004 (n=101), 2005 to 2007 (n=93) and 2008 to 2010 (n=128). There were 17
treatment discontinuations: 9 in first, 6 in second and 2 in third cohort. Intentionto-treat data were plotted after 4 years in each group.
Results: Cohorts matched for age, gender, age at first relapse, prior annualized relapse rate (ARR) and time from first to second relapse. On baseline, time delay to beginning of DMD (p< .0001) and number of T2W hyperintense MRI lesions (p< .01), were significant especially when comparing cohorts 1 and 3. Annual number of visits (p< .001) and frequency of imaging studies (p< .001) were also noteworthy. On follow up, ARR (p< .0001), EDSS worsening more than 1 point confirmed at 6 month (p< .0001), NEDA 3(no relapses, no Gd+ and/or new T2W lesions, no EDSS progression) (p< .0002) and annualized corpus callosum index (CCI) loss (p< .001) was also relevant. All differences had more impact when comparing first and third cohorts.
Conclusions: Prompt and early institution of treatment had a positive impact on inflammation (ARR and NEDA3) as well as a possible benefit on degenerative domain (EDSS and CCI). Our findings suggest that optimization of standards of care can positively impact on long term disease course.
Disclosure:
Fernando Faria Andrade Figueira: nothing to disclose
Gustavo Medeiros Andrade Figueira: nothing to disclose
Paula Vallegas Soares Bilouro: nothing to disclose
Mariana Xavier: nothing to disclose
Raquel Custódio da Silveira: nothing to disclose
Debora Angst Bartzen: nothing to disclose