Treatment persistence and clinical outcomes in patients starting B cell depleting therapies within the Swiss MS Cohort.

IF 2.5 Q2 CLINICAL NEUROLOGY

Multiple Sclerosis Journal - Experimental, Translational and Clinical Pub Date : 2025-02-26 eCollection Date: 2025-01-01 DOI:10.1177/20552173251315457

Giulio Disanto, Sabine Schaedelin, Johanna Oechtering, Johannes Lorscheider, Riccardo Galbusera, Sebastian Finkener, Lutz Achtnichts, Patrice Lalive, Stefanie Müller, Caroline Pot, Robert Hoepner, Anke Salmen, Chiara Zecca, Lars G Hemkens, Marcus D'Souza, Bettina Fischer-Barnicol, Renaud Du Pasquier, Patrick Roth, Özgür Yaldizli, Maximilian Einsiedler, Tobias Derfuss, Ludwig Kappos, Claudio Gobbi, Cristina Granziera, Marjolaine Uginet, Aleksandra Maleska Maceski, Keltie McDonald, David Leppert, Pascal Benkert, Jens Kuhle

{"title":"Treatment persistence and clinical outcomes in patients starting B cell depleting therapies within the Swiss MS Cohort.","authors":"Giulio Disanto, Sabine Schaedelin, Johanna Oechtering, Johannes Lorscheider, Riccardo Galbusera, Sebastian Finkener, Lutz Achtnichts, Patrice Lalive, Stefanie Müller, Caroline Pot, Robert Hoepner, Anke Salmen, Chiara Zecca, Lars G Hemkens, Marcus D'Souza, Bettina Fischer-Barnicol, Renaud Du Pasquier, Patrick Roth, Özgür Yaldizli, Maximilian Einsiedler, Tobias Derfuss, Ludwig Kappos, Claudio Gobbi, Cristina Granziera, Marjolaine Uginet, Aleksandra Maleska Maceski, Keltie McDonald, David Leppert, Pascal Benkert, Jens Kuhle","doi":"10.1177/20552173251315457","DOIUrl":null,"url":null,"abstract":"Background: Persistence to B cell depleting therapies (BCDT) like ocrelizumab and rituximab may be higher compared with other disease-modifying therapies (DMT) in multiple sclerosis (MS). Clinical trials directly comparing these treatments are lacking.Objective: To compare the risk of treatment discontinuation, relapse, and confirmed disability worsening in patients starting BCDT vs other DMT within real-world settings.Methods: In a longitudinal cohort study, patients with relapsing MS starting BCDT (ocrelizumab/rituximab, n = 269) after enrolment into the Swiss MS Cohort (SMSC) were evaluated for treatment discontinuation, occurrence of relapses, and disability worsening in comparison with platform (n = 57) and oral (n = 454) DMT, or natalizumab (n = 73) using Cox regression with double robust adjustment for baseline covariates.Results: Patients starting BCDT were less likely to discontinue treatment than all other DMT combined (HR = 0.26, 95% CI = 0.18-0.36, p < .01), oral DMT (HR = 0.28, 95% CI = 0.20-0.39, p < .01) and natalizumab (HR = 0.35, 95% CI = 0.21-0.58, p < .01). BCDT were associated with lower risk of relapses as compared to oral DMT HR = 0.59, 95% CI = 0.39-0.88, p < .01), but not to natalizumab (HR = 0.90, 95% CI = 0.45-1.82, p = .778). Disability worsening was not significantly different between treatment groups.Conclusion: We provide real-world evidence for patients being more persistent to BCDT than to other treatments, and better clinical outcomes may partly explain this.","PeriodicalId":18961,"journal":{"name":"Multiple Sclerosis Journal - Experimental, Translational and Clinical","volume":"11 1","pages":"20552173251315457"},"PeriodicalIF":2.5000,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866361/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Multiple Sclerosis Journal - Experimental, Translational and Clinical","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/20552173251315457","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Persistence to B cell depleting therapies (BCDT) like ocrelizumab and rituximab may be higher compared with other disease-modifying therapies (DMT) in multiple sclerosis (MS). Clinical trials directly comparing these treatments are lacking.

Objective: To compare the risk of treatment discontinuation, relapse, and confirmed disability worsening in patients starting BCDT vs other DMT within real-world settings.

Methods: In a longitudinal cohort study, patients with relapsing MS starting BCDT (ocrelizumab/rituximab, n = 269) after enrolment into the Swiss MS Cohort (SMSC) were evaluated for treatment discontinuation, occurrence of relapses, and disability worsening in comparison with platform (n = 57) and oral (n = 454) DMT, or natalizumab (n = 73) using Cox regression with double robust adjustment for baseline covariates.

Results: Patients starting BCDT were less likely to discontinue treatment than all other DMT combined (HR = 0.26, 95% CI = 0.18-0.36, p < .01), oral DMT (HR = 0.28, 95% CI = 0.20-0.39, p < .01) and natalizumab (HR = 0.35, 95% CI = 0.21-0.58, p < .01). BCDT were associated with lower risk of relapses as compared to oral DMT HR = 0.59, 95% CI = 0.39-0.88, p < .01), but not to natalizumab (HR = 0.90, 95% CI = 0.45-1.82, p = .778). Disability worsening was not significantly different between treatment groups.

Conclusion: We provide real-world evidence for patients being more persistent to BCDT than to other treatments, and better clinical outcomes may partly explain this.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊