Contributions
Abstract: EP1699
Type: ePoster
Abstract Category: Therapy - disease modifying - 28 Long-term treatment monitoring
Background: There is limited experience about how the new oral MS drugs influence non-motor symptoms of MS and cognition over time, especially under real-life conditions.
Objectives: To longitudinally assess
(1) the evolution of cognition, course and PROs in RRMS patients on teriflunomide as first-line therapy (de novo) or changing from other MS therapies (switchers)
(2) outcomes between de novos and switchers,
(3) differences in re-test effects between RRMS and controls.
Methods: Retrospective, multicenter, open-label registry data analysis of 35 German MS practices (NTD network) with respect to teriflunomide therapy in RRMS. Data were available at baseline (T0) and after 12 months (T12) identifying 246 RRMS patients on teriflunomide (Mc Donald; mean age: 45.8 yr, 67.5% female, mean EDSS 2.2) having completed a 12-month treatment period. Among them were 81 (32,9%) de-novos and 165 (67,1%) switchers.
Outcomes: clinical status, EDSS, IQ (MWT-B), cognition indexed by information processing, verbal and visuo-spatial memory (SDMT, CVLT,BVMT-R) from BICAMS battery, (2) interference control (Stroop), (3) fluency (RWT), and PROs represented by motor and cognitive fatigue (FSMC), depression (BDI, fast screen) and QoL (EQ-5D).
Results: At baseline (T0), RRMS patients performed below normal controls in most cognitive tests. Motor fatigue scored at a medium, cognitive fatigue at a low level, depression in the normal range. Across time (T12 vs. T0), 86,4% of patients remained relapse-free and EDSS stable (2.3 vs. 2.2), as did BICAMS parameters (SDMT, CVLT, BVMT-R) and 3 dimensions of fluency, i.e. semantic, formal-lexical and semantic category change (RWTsf, RWTflcc, RWTscc). Significant cognitive improvement was found for formal-lexical word fluency (RWTflw: 17.7 vs. 19.7, p< .000) and interference processing
(2 Stroop runs; p< 0.03, p< 0.04). Depression scored normal (2.5 vs. 2.7). Motor FSMC subscore persisted at medium level (29.4) whereas cognitive fatigue augmented significantly (25.8 vs. 27.1,
p< 0.049). Outcomes were not significantly different between de novo and switchers. Cognitive evolution was less positive, but insignificantly different, in RRMS vs. controls.
Conclusion:
(1) Teriflunomide is effective stabilizing or improving cognition and most clinical-behavioral outcomes in RRMS.
(2) Switchers take comparable benefit from therapy as de novo patients
(3) Positive cognitive dynamics around re-test effects is less expressed in RRMS patients than controls.
Disclosure: The study was funded by Genzyme
HS: Research grants from Bayer, Biogen and Teva. Honoraria (speaker fees, symposia, adboards) and travel grants from Biogen, Genzyme, Merck, Novartis and Teva.
FR, KKG: nothing to disclose
SB: research grants and honoraria from Bayer, Biogen, Genzyme, Merck, Novartis and Teva
AB: resarch grants from Novartis, Biogen, Genzyme.
Abstract: EP1699
Type: ePoster
Abstract Category: Therapy - disease modifying - 28 Long-term treatment monitoring
Background: There is limited experience about how the new oral MS drugs influence non-motor symptoms of MS and cognition over time, especially under real-life conditions.
Objectives: To longitudinally assess
(1) the evolution of cognition, course and PROs in RRMS patients on teriflunomide as first-line therapy (de novo) or changing from other MS therapies (switchers)
(2) outcomes between de novos and switchers,
(3) differences in re-test effects between RRMS and controls.
Methods: Retrospective, multicenter, open-label registry data analysis of 35 German MS practices (NTD network) with respect to teriflunomide therapy in RRMS. Data were available at baseline (T0) and after 12 months (T12) identifying 246 RRMS patients on teriflunomide (Mc Donald; mean age: 45.8 yr, 67.5% female, mean EDSS 2.2) having completed a 12-month treatment period. Among them were 81 (32,9%) de-novos and 165 (67,1%) switchers.
Outcomes: clinical status, EDSS, IQ (MWT-B), cognition indexed by information processing, verbal and visuo-spatial memory (SDMT, CVLT,BVMT-R) from BICAMS battery, (2) interference control (Stroop), (3) fluency (RWT), and PROs represented by motor and cognitive fatigue (FSMC), depression (BDI, fast screen) and QoL (EQ-5D).
Results: At baseline (T0), RRMS patients performed below normal controls in most cognitive tests. Motor fatigue scored at a medium, cognitive fatigue at a low level, depression in the normal range. Across time (T12 vs. T0), 86,4% of patients remained relapse-free and EDSS stable (2.3 vs. 2.2), as did BICAMS parameters (SDMT, CVLT, BVMT-R) and 3 dimensions of fluency, i.e. semantic, formal-lexical and semantic category change (RWTsf, RWTflcc, RWTscc). Significant cognitive improvement was found for formal-lexical word fluency (RWTflw: 17.7 vs. 19.7, p< .000) and interference processing
(2 Stroop runs; p< 0.03, p< 0.04). Depression scored normal (2.5 vs. 2.7). Motor FSMC subscore persisted at medium level (29.4) whereas cognitive fatigue augmented significantly (25.8 vs. 27.1,
p< 0.049). Outcomes were not significantly different between de novo and switchers. Cognitive evolution was less positive, but insignificantly different, in RRMS vs. controls.
Conclusion:
(1) Teriflunomide is effective stabilizing or improving cognition and most clinical-behavioral outcomes in RRMS.
(2) Switchers take comparable benefit from therapy as de novo patients
(3) Positive cognitive dynamics around re-test effects is less expressed in RRMS patients than controls.
Disclosure: The study was funded by Genzyme
HS: Research grants from Bayer, Biogen and Teva. Honoraria (speaker fees, symposia, adboards) and travel grants from Biogen, Genzyme, Merck, Novartis and Teva.
FR, KKG: nothing to disclose
SB: research grants and honoraria from Bayer, Biogen, Genzyme, Merck, Novartis and Teva
AB: resarch grants from Novartis, Biogen, Genzyme.