Publication type: Conference poster
Type of review: Peer review (abstract)
Title: Is there an impact of early initiation of disease-modifying therapies in patients with relapsing-remitting multiple sclerosis in the German registry?
Authors: Braune, Stefan
Drewek, Anna
Bergmann, Arnfin
Schuler, Maximilian
Ait-Tihyaty, Maria
H Le, Hoa
Keenan, Alex
Gandhi, Kavita
van Denderen, Jacqueline
et. al: No
Conference details: 38th Congress of the European Committee for Treatment and Research in Multiple Sclerosis, Amsterdam, The Netherlands, 26-28 Oktober 2022
Issue Date: Oct-2022
Language: English
Subject (DDC): 615: Pharmacology and therapeutics
616.8: Neurology, diseases of nervous system
Abstract: Aim: To compare the characteristics and outcomes of patients who initiate disease modifying treatments (DMTs) early compared to later over a 5-year period. Methods: Data came from NeuroTransData (NTD) MS registry run by a network of Germany-wide neurologists. Study included patients initiating DMTs between Jan 1, 2009, and Oct 1, 2021. Patient cohorts were defined based on the time of initiation of their first DMT relative to the date of RRMS diagnosis: Cohort 1 (<=12 months n=5048), Cohort 2 (> 12 months to <= 24 months, n=559), Cohort 3 (> 24 months to < 5 years, n=788), and Cohort 4 treatment (more than 5 years, n=1604). Results: There were no meaningful differences in age, time since symptoms manifestation, or EDSS across the cohorts at time of first DMT initiation (index). Relapse activity appeared to be a leading reason for DMT initiation with at least one relapse experienced 1-year pre-index by 43.6% patients in cohort 1 compared to 31.3%, 27.2% and 18.1% of patients in cohorts 2,3,4, respectively. Glatiramer acetate/interferons were most used in cohort 1 (74.4%) and least in cohort 4 (54.5%). The use of other DMTs, including monoclonal antibodies, increased with delayed time to DMT initiation. For cohorts 1 and 2, average (SD) annual relapse rate (ARR) was 0.4 (0.6) and 0.3 (0.6) at year 1 but declined to 0.08 (0.3) and 0.1 (0.3) by year 5, respectively. In vontrast, average ARR mean (SD) was in a narrow range for cohorts 3 [0.1 (0.4)- 0.2 (0.5)] and 4 [0.05 (0.2)-0.1 (0.3)] through the study period. EDSS for patients delaying DMTs numerically worsened than those who initiated early over 5 years [e.g., mean (SD) worsening from 1.3 (1.1) at year 1 to 1.9 (1.6) at year 5 in cohort 3 compared to stable EDSS of 1.5 over 5 years in cohort 1]. EDSS results must be interpreted with caution due to high level of missingness. Conclusions: Neurologists appear to make a reasonable prognosis regarding potential changes in patients’ EDSS status over a 5-year period and whether to initiate treatment or wait and see clinical changes. A potential trade-off with the wait and see approach is that more efficacious treatments are used as initial therapy. Nevertheless, the benefit: risk of such treatments may be an important consideration along with other disease-related factors in individualizing patient treatment decisions.
URI: https://digitalcollection.zhaw.ch/handle/11475/26177
Fulltext version: Published version
License (according to publishing contract): Not specified
Departement: School of Engineering
Organisational Unit: Institute of Data Analysis and Process Design (IDP)
Published as part of the ZHAW project: Therapievergleich für Multiple Sklerose
Appears in collections:Publikationen School of Engineering

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Braune, S., Drewek, A., Bergmann, A., Schuler, M., Ait-Tihyaty, M., H Le, H., Keenan, A., Gandhi, K., & van Denderen, J. (2022, October). Is there an impact of early initiation of disease-modifying therapies in patients with relapsing-remitting multiple sclerosis in the German registry? 38th Congress of the European Committee for Treatment and Research in Multiple Sclerosis, Amsterdam, the Netherlands, 26-28 Oktober 2022.
Braune, S. et al. (2022) ‘Is there an impact of early initiation of disease-modifying therapies in patients with relapsing-remitting multiple sclerosis in the German registry?’, in 38th Congress of the European Committee for Treatment and Research in Multiple Sclerosis, Amsterdam, The Netherlands, 26-28 Oktober 2022.
S. Braune et al., “Is there an impact of early initiation of disease-modifying therapies in patients with relapsing-remitting multiple sclerosis in the German registry?,” in 38th Congress of the European Committee for Treatment and Research in Multiple Sclerosis, Amsterdam, The Netherlands, 26-28 Oktober 2022, Oct. 2022.
BRAUNE, Stefan, Anna DREWEK, Arnfin BERGMANN, Maximilian SCHULER, Maria AIT-TIHYATY, Hoa H LE, Alex KEENAN, Kavita GANDHI und Jacqueline VAN DENDEREN, 2022. Is there an impact of early initiation of disease-modifying therapies in patients with relapsing-remitting multiple sclerosis in the German registry? In: 38th Congress of the European Committee for Treatment and Research in Multiple Sclerosis, Amsterdam, The Netherlands, 26-28 Oktober 2022. Conference poster. Oktober 2022
Braune, Stefan, Anna Drewek, Arnfin Bergmann, Maximilian Schuler, Maria Ait-Tihyaty, Hoa H Le, Alex Keenan, Kavita Gandhi, and Jacqueline van Denderen. 2022. “Is There an Impact of Early Initiation of Disease-Modifying Therapies in Patients with Relapsing-Remitting Multiple Sclerosis in the German Registry?” Conference poster. In 38th Congress of the European Committee for Treatment and Research in Multiple Sclerosis, Amsterdam, the Netherlands, 26-28 Oktober 2022.
Braune, Stefan, et al. “Is There an Impact of Early Initiation of Disease-Modifying Therapies in Patients with Relapsing-Remitting Multiple Sclerosis in the German Registry?” 38th Congress of the European Committee for Treatment and Research in Multiple Sclerosis, Amsterdam, the Netherlands, 26-28 Oktober 2022, 2022.


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