Multiple Sclerosis Journal最新文献_第9页

Disability patterns in multiple sclerosis: A meta-analysis on RAW and PIRA in the real-world context. 多发性硬化症的残疾模式：现实世界中 RAW 和 PIRA 的荟萃分析。

IF 4.8 2区医学

Multiple Sclerosis Journal Pub Date : 2024-09-01 Epub Date: 2024-07-31 DOI: 10.1177/13524585241266180

Luca Prosperini, Serena Ruggieri, Shalom Haggiag, Carla Tortorella, Claudio Gasperini

{"title":"Disability patterns in multiple sclerosis: A meta-analysis on RAW and PIRA in the real-world context.","authors":"Luca Prosperini, Serena Ruggieri, Shalom Haggiag, Carla Tortorella, Claudio Gasperini","doi":"10.1177/13524585241266180","DOIUrl":"10.1177/13524585241266180","url":null,"abstract":"Objective: To summarize the current evidence on relapse-associated worsening (RAW) and progression independent of relapse activity (PIRA) through a quantitative synthesis of real-world studies.Methods: Scientific databases were searched to identify suitable articles. Random-effects meta-analyses, subgroup analyses and meta-regression models were ran to provide pooled estimates of RAW and PIRA events and to identify their potential moderators (PROSPERO registration: CRD42024503895).Results: Eighteen articles met the eligibility criteria, with a pooled sample size of 52,667 patients (93% relapsing-remitting, 6% clinically isolated syndrome and 1% progressive) followed for 2.4 to 12.1 years, yielding to 415,825 patient-years. Pooled event rates for RAW and PIRA were 1.6 (95 confidence interval (CI) = 1.1-2.1) and 3.1 (95% CI = 2.3-3.9) per 100 patient-years, respectively. Less RAW events were found in cohorts including patients with progressive course (β = -0.069, p = 0.006) and under high-efficacy disease-modifying treatments (DMTs) (β = -0.031, p = 0.007), while PIRA events were directly related to older age (β = 0.397, p = 0.027). In addition, we found significant differences in PIRA event rates according to the criteria adopted to define confirmed disability accrual (p < 0.05).Discussion: PIRA accounts for most events causing disability accumulation in the real-world setting, even at the earlier disease stages, whereas RAW represents a less frequent phenomenon, likely due to effective treatments. The detection and statistical analysis of PIRA outcomes pose challenges, raising the risk of erroneous inference. When interpreting our findings, caution is needed given the wide heterogeneity of included studies.","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"1309-1321"},"PeriodicalIF":4.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trends in direct healthcare utilization observed for persons with MS among teleneurology users and diverse populations. 在远程神经学用户和不同人群中观察到的多发性硬化症患者直接使用医疗服务的趋势。

IF 4.8 2区医学

Multiple Sclerosis Journal Pub Date : 2024-09-01 Epub Date: 2024-09-06 DOI: 10.1177/13524585241272948

Kaitlyn N Palmer, Daniel Ontaneda, Tucker Harvey, Elizabeth S Mearns, Anisha M Patel, Nikki Win, Bryan R Cobb, Stephen Roush, Marisa P McGinley

{"title":"Trends in direct healthcare utilization observed for persons with MS among teleneurology users and diverse populations.","authors":"Kaitlyn N Palmer, Daniel Ontaneda, Tucker Harvey, Elizabeth S Mearns, Anisha M Patel, Nikki Win, Bryan R Cobb, Stephen Roush, Marisa P McGinley","doi":"10.1177/13524585241272948","DOIUrl":"10.1177/13524585241272948","url":null,"abstract":"Background: The impact of teleneurology on healthcare utilization (HCU) in MS is unknown.Objective: Evaluate the association between teleneurology and HCU.Methods: A retrospective longitudinal analysis of HCU among adult MS and clinically isolated syndrome (CIS) patients residing in the Cleveland/Akron area from July 2020 to July 2022. Negative binomial regression models evaluated the association between number of laboratory and MRI orders per visit and number of emergency visits per patient across patient groups with variable proportions of teleneurology visits.Results: A total of 3208 patients completed 15,795 visits. Patients using teleneurology had more visits (rate ratio (RR) 1.707-1.719, p < 0.001). Teleneurology visits had fewer laboratory (RR 0.571) and MRI orders (RR 0.693, p < 0.001). There was no difference in emergency care utilization for teleneurology patients (p ⩾ 0.05). More emergency visits were observed in Black (RR 1.414) and Medicaid (RR 1.893) patients, regardless of visit type (p < 0.001).Conclusion: Teleneurology visits were associated with fewer orders, suggesting teleneurology may be incorporated into healthcare models without increasing utilization related to the visit. Teleneurology was also associated with increased visit volumes but no difference in emergency HCU. More studies are needed to clarify the ultimate impact of teleneurology on overall HCU. More emergency visits, regardless of visit type, were observed among at-risk populations, warranting further investigation.","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"1350-1362"},"PeriodicalIF":4.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Monitoring cognitive functioning in MS will trigger anxiety in patients: No. 监测多发性硬化症患者的认知功能会引发患者焦虑：不会

IF 4.8 2区医学

Multiple Sclerosis Journal Pub Date : 2024-09-01 Epub Date: 2024-06-16 DOI: 10.1177/13524585241261199

Martin Klein

引用次数: 0

Brain reserve and timing of clinical onset in multiple sclerosis. 多发性硬化症的脑储备和临床发病时间。

IF 4.8 2区医学

Multiple Sclerosis Journal Pub Date : 2024-09-01 Epub Date: 2024-09-05 DOI: 10.1177/13524585241272046

Maria Petracca, Serena Ruggieri, Riccardo Nistri, Ilaria Tomasso, Elena Barbuti, Valeria Pozzilli, Shalom Haggiag, Carla Tortorella, Claudio Gasperini, Carlo Pozzilli, Luca Prosperini

{"title":"Brain reserve and timing of clinical onset in multiple sclerosis.","authors":"Maria Petracca, Serena Ruggieri, Riccardo Nistri, Ilaria Tomasso, Elena Barbuti, Valeria Pozzilli, Shalom Haggiag, Carla Tortorella, Claudio Gasperini, Carlo Pozzilli, Luca Prosperini","doi":"10.1177/13524585241272046","DOIUrl":"10.1177/13524585241272046","url":null,"abstract":"Background: A latent period of variable length elapses between multiple sclerosis (MS) biological onset and the occurrence of the first clinical episode reflecting a central nervous system (CNS) demyelinating event. Factors affecting the duration of such interval are unknown.Objective: To explore whether brain reserve, which moderates the impact of structural damage along MS course, could also affect the timing of MS clinical onset.Methods: We conducted a time-to-event analysis in 326 relapsing-onset multiple sclerosis patients to ascertain the effect of brain reserve, that is, larger maximal lifetime brain growth (MLBG) estimated as intracranial volume, on the risk of an earlier disease onset. For this purpose, we carried out a Cox proportional hazards regression model stratified by sex and adjusted by site and pre-morbid MS risk factors. All patients reached the event (i.e. the disease onset) with no censored case; the age (years) at disease onset was set as the main time variable.Results: We identified a protective effect of brain reserve on the time to disease onset (HR = 0.11, 95% CI = 0.02-0.83, p = 0.032), unchanged when accounting for MS risk factors.Conclusion: Brain reserve might counteract the pathological mechanisms ongoing after biological initiation, thus delaying the disease overt clinical manifestation.","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"1290-1295"},"PeriodicalIF":4.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The first global landscape analysis of multiple sclerosis research funding. 首次对全球多发性硬化症研究经费进行分析。

IF 4.8 2区医学

Multiple Sclerosis Journal Pub Date : 2024-09-01 Epub Date: 2024-07-31 DOI: 10.1177/13524585241265961

Bruce Bebo, Tim Coetzee, Emma Gray, Anne Helme, Pamela Kanellis, Douglas Landsman, Michaela Mai, Beatriz Martinez de la Cruz, Julia Morahan, Emmanuelle Plassart, Baylee Pickrell, Sarah Rawlings, Lasse Skovgaard, Paola Zaratin, Lindsay Rechtman

{"title":"The first global landscape analysis of multiple sclerosis research funding.","authors":"Bruce Bebo, Tim Coetzee, Emma Gray, Anne Helme, Pamela Kanellis, Douglas Landsman, Michaela Mai, Beatriz Martinez de la Cruz, Julia Morahan, Emmanuelle Plassart, Baylee Pickrell, Sarah Rawlings, Lasse Skovgaard, Paola Zaratin, Lindsay Rechtman","doi":"10.1177/13524585241265961","DOIUrl":"10.1177/13524585241265961","url":null,"abstract":"Introduction: Multiple sclerosis (MS) is an immune-mediated central nervous system disorder and a growing global health challenge affecting nearly 3 million people worldwide. Incidence and prevalence continue to increase with no known cause or cure. Globally governments and non-profit organizations fund research toward better understanding of and treatments for multiple sclerosis.Methods: This study identified MS research projects funded between 2021 and 2023 by government and non-profit organization sources. Projects were described by type of scientific approach, Pathways to Cure research category (i.e. Stop, Restore, End), and other key characteristics.Results: Over 2,300 MS research projects were identified through 16 non-profit MS organizations and 18 government databases. The overall global portfolio of these projects is valued at nearly one and a half billion Euros. The majority of projects were classified in the Stop category (60%). Research collaboration occurs in many forms among the research community; around 272 projects were reported to be co-funded.Conclusion: Global MS research collaboration will accelerate progress toward increased knowledge, effective treatments, improved health outcomes, and ultimately cures for MS. This landscape analysis highlights the current distribution of MS research investment between topics and begins to suggest where the MS community should focus to increase potential impact for current and future endeavors.","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"1363-1369"},"PeriodicalIF":4.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

PACTRIMS 2024 PACTRIMS 2024

IF 5.8 2区医学

Multiple Sclerosis Journal Pub Date : 2024-08-29 DOI: 10.1177/13524585241269222

引用次数: 0

Acute urticaria following ofatumumab injection for multiple sclerosis. 多发性硬化症患者注射奥妥木单抗后出现急性荨麻疹。

IF 4.8 2区医学

Multiple Sclerosis Journal Pub Date : 2024-08-26 DOI: 10.1177/13524585241273084

Giulia Ciccarese, Aurora Zanghì, Astrid Herzum, Cristian Fidanzi, Maria Parodi, Francesco Drago

引用次数: 0

Expert opinion on the use of contraception in people with multiple sclerosis. 关于多发性硬化症患者使用避孕药具的专家意见。

IF 4.8 2区医学

Multiple Sclerosis Journal Pub Date : 2024-08-01 Epub Date: 2024-03-08 DOI: 10.1177/13524585241228103

Jan Hillert, Riley Bove, Lisa B Haddad, Kerstin Hellwig, Maria Houtchens, Melinda Magyari, Gabriele S Merki-Feld, Scott Montgomery, Rossella E Nappi, Egon Stenager, Heidi Thompson, Zeliha Tulek, Elisabetta Verdun Di Cantogno, Manuela Simoni

{"title":"Expert opinion on the use of contraception in people with multiple sclerosis.","authors":"Jan Hillert, Riley Bove, Lisa B Haddad, Kerstin Hellwig, Maria Houtchens, Melinda Magyari, Gabriele S Merki-Feld, Scott Montgomery, Rossella E Nappi, Egon Stenager, Heidi Thompson, Zeliha Tulek, Elisabetta Verdun Di Cantogno, Manuela Simoni","doi":"10.1177/13524585241228103","DOIUrl":"10.1177/13524585241228103","url":null,"abstract":"Background: Current guidance on the selection of appropriate contraception for people with multiple sclerosis (PwMS) is lacking.Objective: To address this gap, an expert-led consensus program developed recommendations to support clinicians in discussing family planning and contraception with women and men with multiple sclerosis (MS).Methods: A multidisciplinary steering committee (SC) of 13 international clinical experts led the program, supported by an extended faculty of 32 experts representing 18 countries. A modified Delphi methodology was used for decision-making and consensus-building. The SC drafted 15 clinical questions focused on patient-centered care, selection of contraception, and timing of stopping/starting contraception and disease-modifying therapies (DMTs). Statements addressing each question were drafted based on evaluation of published evidence and the experts' clinical experience. Consensus was reached if ⩾75% of respondents agreed (scoring 7-9 on a 9-point scale) with each recommendation.Results: Consensus was reached on 24 of 25 proposed recommendations, including how and when to discuss contraception, types and safety of contraceptives, and how to evaluate the most appropriate contraceptive options for specific patient groups, including those with significant disability or being treated with DMTs.Conclusion: These expert recommendations provide the first practical, relevant, and comprehensive guidance for clinicians on the selection of contraception in PwMS.","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"1093-1106"},"PeriodicalIF":4.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140059954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trends in central nervous system-active polypharmacy among people with multiple sclerosis. 多发性硬化症患者服用中枢神经系统活性药物的趋势。

IF 4.8 2区医学

Multiple Sclerosis Journal Pub Date : 2024-08-01 Epub Date: 2024-05-15 DOI: 10.1177/13524585241251986

Hayden Naizer, Joseph Wozny, Trudy Millard Krause, Ethan Huson, Leorah Freeman

{"title":"Trends in central nervous system-active polypharmacy among people with multiple sclerosis.","authors":"Hayden Naizer, Joseph Wozny, Trudy Millard Krause, Ethan Huson, Leorah Freeman","doi":"10.1177/13524585241251986","DOIUrl":"10.1177/13524585241251986","url":null,"abstract":"Background: People with multiple sclerosis (pwMS) are at risk of concurrently using multiple central nervous system (CNS)-active drugs, yet the prevalence of CNS-active polypharmacy remains unmeasured in pwMS.Objective: The objective is to measure the prevalence of CNS-active polypharmacy in pwMS.Methods: This serial, cross-sectional study measured CNS-active polypharmacy in people with MS in the United States from 2008 to 2021 using insurance claims data. CNS-active polypharmacy was defined as the concurrent prescription of ⩾3 CNS-active drugs for >30 continuous days. CNS-active drugs included antidepressants, antiepileptics, antipsychotics, benzodiazepines, nonbenzodiazepine benzodiazepine receptor agonist hypnotics, opioids, and skeletal muscle relaxants.Results: The number of subjects included at each time point ranged from 23,917 subjects in 2008 to 55,797 subjects in 2021. In 2021, subjects with CNS-active polypharmacy were more likely to be 46-65 years of age and have CNS-related comorbidities compared to those without CNS-active polypharmacy. From 2008 to 2021, the age-adjusted prevalence of CNS-active polypharmacy among female subjects increased from 19.8% (95% confidence interval (CI) = 19.1-20.4) to 26.4% (95% CI = 25.9-26.8) versus 15.9% (95% CI = 14.8-17.0) to 18.6% (95% CI = 17.9-19.2) in male subjects.Conclusion: The prevalence of CNS-active polypharmacy has increased among people with MS with a growing disparity by sex.","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"1139-1150"},"PeriodicalIF":4.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

No association between oral contraceptive exposure and subsequent MS: A population-based nested case-control study in primary care. 口服避孕药暴露与后续多发性硬化症之间无关联：一项基于人群的初级保健巢式病例对照研究。

IF 4.8 2区医学

Multiple Sclerosis Journal Pub Date : 2024-08-01 Epub Date: 2024-06-14 DOI: 10.1177/13524585241258691

Qiqi Zhang, Alastair J Noyce, John Robson, Gavin Giovannoni, Charles R Marshall, Ruth Dobson

{"title":"No association between oral contraceptive exposure and subsequent MS: A population-based nested case-control study in primary care.","authors":"Qiqi Zhang, Alastair J Noyce, John Robson, Gavin Giovannoni, Charles R Marshall, Ruth Dobson","doi":"10.1177/13524585241258691","DOIUrl":"10.1177/13524585241258691","url":null,"abstract":"Background: Conflicting data exist around oral contraceptive exposure and subsequent multiple sclerosis (MS).Objective: To use routinely collected primary healthcare data to explore the potential association between oral contraceptive exposure and subsequent MS in females at population level.Methods: We performed a nested case-control study using electronic primary care data, with complete electronic ascertainment from 1990. Logistic regression was used to evaluate associations between contraceptive exposure and MS, without and with adjusting for age, ethnicity and deprivation.Results: A total of 4455 females were included: 891 cases and 3564 controls. No association was seen between oral contraceptive exposure and subsequent MS, or between any contraceptive, combined oral contraceptive pill (COCP) or progesterone-only pill (POP) use 0-2, 2-5 or >5 years prior to MS. Conclusions: In the largest population-based study to date, we find no evidence of an association between oral contraceptive exposure and subsequent MS diagnosis.","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"1221-1226"},"PeriodicalIF":4.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141321260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0