Publications by authors named "David Axel Laplaud"
Background: We hypothesized that differences in access to disease-modifying treatments (DMTs) could explain the association between socioeconomic status and disability progression in multiple sclerosis (MS).
Objective: This study aimed to analyze the association between education level and DMT use in France.
Methods: All patients from OFSEP network with MS onset over 1996-2014 and aged ⩾ 25 years at onset were included.
Background: Studies have reported an association between socioeconomic status and disability progression in multiple sclerosis (MS), but findings using the pre-MS individual socioeconomic status are missing.
Objective: The objective was to investigate the association between education level and disability progression.
Methods: All Observatoire Français de la Sclérose en Plaques (OFSEP) patients with MS clinical onset over 1960-2014, and aged ⩾25 years at MS onset were included.
Article Synopsis
- The study aimed to compare disability progression between primary progressive multiple sclerosis (PPMS) patients treated with anti-CD20 therapies (rituximab and ocrelizumab) and a control group that was untreated.
- Data was gathered retrospectively from the French MS registry, including factors like time to confirmed disability progression (CDP), relapse rates, and MRI activity in patients from 2016 to 2021.
- Results showed no significant difference in CDP or MRI activity between treated and untreated groups, although a trend suggested treated patients might experience fewer relapses, warranting further investigation.
Article Synopsis
- * Conducted over eight years (2015-2023) using data from a French MS registry, researchers categorized relapses based on MRI results to better understand their impact.
- * Findings indicate that certain factors, like treatment type and fatigue, increase the likelihood of clinically defined relapses without MRI evidence, suggesting a need for revised monitoring and treatment strategies for MS patients.
Article Synopsis
- A pilot study investigated the gut and oral microbiota in multiple sclerosis (MS) patients and found significant bacterial alterations compared to healthy volunteers (HV).
- The analysis revealed decreased diversity and specific bacteria depletion in MS patients, along with enrichment of inflammation-associated bacteria and altered microbial pathways.
- A distinctive oral metabolite signature was identified in MS patients, which has high specificity for discriminating them from HV and patients with rheumatoid arthritis, suggesting the potential for future research on oral microbiota in autoimmune diseases.
Article Synopsis
- A randomized clinical trial suggests that stopping medium-efficacy therapy for older patients with nonactive multiple sclerosis (MS) may be safe, but data is lacking for high-efficacy therapy (HET).
- This observational cohort study from the French MS registry examined 1857 older patients with relapsing-remitting MS on HET and aimed to find out if stopping HET increased relapse risks.
- The study included 1620 matched patients, with results indicating that both groups (continuing vs. discontinuing HET) were closely monitored over an average of 5.1 years to determine the time to first relapse.
Article Synopsis
- Moderately effective therapies (METs) have been the standard treatment for pediatric-onset multiple sclerosis (POMS), but there's still no clear consensus on treatment strategies as highly effective therapies (HETs) emerge.
- The study aimed to evaluate the effectiveness of HET compared to MET in reducing disease activity in treatment-naive children with relapsing-remitting POMS, using a retrospective cohort design over a median follow-up of 5.8 years.
- Results from 530 included patients indicated that both HET and MET reduced the risk of relapse within the first 2 years, with HET showing a significant 54% decrease in first relapses compared to MET.
Multiple sclerosis is an autoimmune disease of the central nervous system. Yet, the autoimmune targets are still undefined. The extracellular e1 sequence of KCNJ10, the inwardly rectifying potassium channel 4.
View Article and Find Full Text PDFBackground And Objectives: The question of the long-term safety of pregnancy is a major concern in patients with multiple sclerosis (MS), but its study is biased by reverse causation (women with higher disability are less likely to experience pregnancy). Using a causal inference approach, we aimed to estimate the unbiased long-term effects of pregnancy on disability and relapse risk in patients with MS and secondarily the short-term effects (during the perpartum and postpartum years) and delayed effects (occurring beyond 1 year after delivery).
Methods: We conducted an observational cohort study with data from patients with MS followed in the Observatoire Français de la Sclérose en Plaques registry between 1990 and 2020.
Background: In relapsing-remitting multiple sclerosis (RRMS), early identification of suboptimal responders can prevent disability progression.
Objective: We aimed to develop and validate a dynamic score to guide the early decision to switch from first- to second-line therapy.
Methods: Using time-dependent propensity scores (PS) from a French cohort of 12,823 patients with RRMS, we constructed one training and two validation PS-matched cohorts to compare the switched patients to second-line treatment and the maintained patients.
Recent approaches in gait analysis involve the use of wearable motion sensors to extract spatio-temporal parameters that characterize multiple aspects of an individual's gait. In particular, the medical community could largely benefit from this type of devices as they could provide the clinicians with a valuable tool for assessing gait impairment. Motion sensor data are however complex and there is an urgent unmet need to develop sound statistical methods for analyzing such data and extracting clinically relevant information.
View Article and Find Full Text PDFBackground: The effects of socio-economic status on mortality in patients with multiple sclerosis is not well known. The objective was to examine mortality due to multiple sclerosis according to socio-economic status.
Methods: A retrospective observational cohort design was used with recruitment from 18 French multiple sclerosis expert centers participating in the All patients lived in metropolitan France and had a definite or probable diagnosis of multiple sclerosis according to either Poser or McDonald criteria with an onset of disease between 1960 and 2015.
Article Synopsis
- The study aims to utilize advanced computational tools to improve the management of multiple sclerosis (MS), particularly for relapsing-remitting MS (RRMS) patients.
- Researchers analyzed phase 3 clinical trial data to compare the effectiveness of peg-interferon beta-1a against a placebo using various measures of disease activity.
- They created a prototype decision support system called MS Vista that personalizes treatment efficacy information for patients and enhances communication between healthcare providers and patients.
Background And Objectives: Kappa free light chains (KFLC) seem to efficiently diagnose MS. However, extensive cohort studies are lacking to establish consensus cut-offs, notably to rule out non-MS autoimmune CNS disorders. Our objectives were to (1) determine diagnostic performances of CSF KFLC, KFLC index, and KFLC intrathecal fraction (IF) threshold values that allow us to separate MS from different CNS disorder control populations and compare them with oligoclonal bands' (OCB) performances and (2) to identify independent factors associated with KFLC quantification in MS.
View Article and Find Full Text PDFArticle Synopsis
- Multiple sclerosis is a chronic inflammatory disease affecting the central nervous system, but its exact mechanisms are still not fully understood despite extensive research.
- Recent studies emphasize the roles of various immune cells like CD4+ T cells, CD8+ T cells, and B cells, but current understanding of their pathology is too general for effective targeted treatments.
- Emerging single-cell technologies from the last decade are facilitating more detailed research, helping to identify new cell populations and therapeutic targets in multiple sclerosis through focused studies on immune and central nervous system cells.
Background: In Multiple Sclerosis (MS) women, therapeutic management for pregnancy planning and during pregnancy still represents a challenge regarding timing of disease-modifying therapies (DMT) stop, risk of disease reactivation and potential fetal toxicity. The objective of this study was to describe disease activity during pregnancy and postpartum depending on treatment status before conception in women with MS.
Methods: 339 MS patients who have achieved a pregnancy between 2007 and 2017 were included.
Article Synopsis
- This study evaluates the rate of disease activity return in multiple sclerosis (MS) patients after they stop using disease-modifying therapy, focusing on relapse rates and factors influencing relapse.
- A large sample of 14,213 patients showed that relapse rates typically increased within 2 months after stopping treatment, with earlier commencement of new therapy reducing these rates significantly.
- Factors predicting relapse included having a higher relapse rate prior to stopping therapy, being younger, being female, and having a higher Expanded Disability Status Scale (EDSS) score, with subsequent therapy reducing both relapse risk and disability progression.
Background: No specific treatment has demonstrated its effectiveness to prevent post-partum relapses for multiple sclerosis (MS) women.
Objective: To assess the effectiveness of preventive high-dose corticosteroids in the post-partum period by comparing two strategies: (1) no preventive treatment and (2) standardized preventive treatment.
Methods: We selected five French Multiple Sclerosis centers using the same post-partum strategy for their patients-either high-dose steroids (treating centers TC) or no treatment (non-treating centers NTC).
"Clinical forms and pathophysiology of multiple sclerosis Multiple sclerosis is a chronic inflammatory disease of the central nervous system. Its triggering mechanisms are still uncertain, but it has been associated with many genetic and environmental factors. Four clinical forms are classically described.
View Article and Find Full Text PDFIn France, two therapeutic strategies can be offered after fingolimod (FNG) withdrawal to highly active relapsing-remitting multiple sclerosis (RRMS) patients: natalizumab (NTZ) or anti-CD20. We compared the effectiveness of these two strategies as a switch for FNG within the OFSEP database. The primary endpoint was the time to first relapse.
View Article and Find Full Text PDFWe compared Simoa and Ella immunoassays to assess serum neurofilament-light chain levels in 203 multiple sclerosis patients from the OFSEP HD study. There was a strong correlation (ρ = 0.86, p < 0.
View Article and Find Full Text PDFBackground: Long-term effectiveness of treatment remains a key question in multiple sclerosis (MS) and the cumulative effects of past treatment have not been investigated so far.
Objective: Explore the relationship between treatment exposure and disability risk in patients with relapsing-remitting multiple sclerosis (RRMS).
Methods: A total of 2285 adult patients from the French nationwide cohort were included.