Key result
Applying Treatment Optimization Recommendations at the first year of therapy accurately predicted continued disease activity, with the 'change treatment' group having a significantly higher relapse rate at 5 years (0.7 vs 0.07, p<0.001).
Why the study?
Does the application of automated Treatment Optimization Recommendations (TORs) at year 1 predict continued disease activity in multiple sclerosis patients treated with interferon beta-1a?
Cohort (n=55)
No
Does the application of automated Treatment Optimization Recommendations (TORs) at year 1 predict continued disease activity in multiple sclerosis patients treated with interferon beta-1a?
Absolute Event Rate: 0.7% vs 0.07%
p-value: p=<0.001
Applying automated Treatment Optimization Recommendations at the first year of interferon beta-1a therapy accurately predicts continued disease activity and disability progression in multiple sclerosis.
Supports TOR-based risk stratification in interferon-treated MS; leaves open whether early changes improve long-term outcomes.
BACKGROUND: A software based tool has been developed (Optem) to allow automatize the recommendations of the Canadian Multiple Sclerosis Working Group for optimizing MS treatment in order to avoid subjective interpretation. METHODS: Treatment Optimization Recommendations (TORs) were applied to our database of patients treated with IFN beta1a IM. Patient data were assessed during year 1 for disease activity, and patients were assigned to 2 groups according to TOR: "change treatment" (CH) and "no change treatment" (NCH). These assessments were then compared to observed clinical outcomes for disease activity over the following years. RESULTS: We have data on 55 patients. The "change treatment" status was assigned to 22 patients, and "no change treatment" to 33 patients. The estimated sensitivity and specificity according to last visit status were 73.9% and 84.4%. During the following years, the Relapse Rate was always higher in the "change treatment" group than in the "no change treatment" group (5 y; CH: 0.7, NCH: 0.07; p < 0.001, 12 m - last visit; CH: 0.536, NCH: 0.34). We obtained the same results with the EDSS (4 y; CH: 3.53, NCH: 2.55, annual progression rate in 12 m - last visit; CH: 0.29, NCH: 0.13). CONCLUSION: Applying TOR at the first year of therapy allowed accurate prediction of continued disease activity in relapses and disability progression.
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Ruíz-Peña et al. (2008) conducted a cohort in Relapsing-remitting multiple sclerosis (RRMS) (n=55). Suboptimal treatment response (Change Treatment status) vs. Optimal treatment response (No Change Treatment status) was evaluated on Relapse rate at 5 years (p=<0.001). Applying Treatment Optimization Recommendations at the first year of therapy accurately predicted continued disease activity, with the 'change treatment' group having a significantly higher relapse rate at 5 years (0.7 vs 0.07, p<0.001).
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