Publications by authors named "Julie Prevost"
Background: Effectiveness of disease-modifying treatment (DMT) in people affected by primary progressive multiple sclerosis (PPMS) is limited. Whether specific subgroups may benefit more from DMT in a real-world setting remains unclear. Our aim was to investigate the potential effect of DMT on disability worsening among patients with PPMS stratified by different disability trajectories.
View Article and Find Full Text PDFBackground And Objectives: Women with multiple sclerosis (MS) are at risk of disease reactivation in the early postpartum period. Ocrelizumab (OCR) is an anti-CD20 therapy highly effective at reducing MS disease activity. Data remain limited regarding use of disease-modifying therapies (DMTs), including OCR, and disease activity during peripregnancy periods.
View Article and Find Full Text PDFBackground: Comparisons between cladribine and other potent immunotherapies for multiple sclerosis (MS) are lacking.
Objectives: To compare the effectiveness of cladribine against fingolimod, natalizumab, ocrelizumab and alemtuzumab in relapsing-remitting MS.
Methods: Patients with relapsing-remitting MS treated with cladribine, fingolimod, natalizumab, ocrelizumab or alemtuzumab were identified in the global MSBase cohort and two additional UK centres.
Article Synopsis
- The study aims to identify predictors of treatment switching in patients with relapsing-remitting MS using data from multiple national registries.
- A total of 269,822 treatment episodes from 110,326 patients were analyzed, focusing on those who started disease-modifying treatments during their RRMS phase.
- Key findings indicate that higher disability scores (EDSS), being female, and older age increase the likelihood of treatment switching, with certain DMTs initiated between 2007 and 2012 showing even higher rates of switching.
Article Synopsis
- This study investigates the relationship between environmental factors and progressive-onset multiple sclerosis (POMS) compared to relapse-onset multiple sclerosis (ROMS), aiming to better understand the causes of POMS.
- Data is drawn from two major studies, including a sample of 155 POMS, 204 ROMS, and 558 controls, ensuring that the POMS sample is representative of the broader Australian POMS population.
- The research addresses various methodological challenges, such as biases and differences between POMS and controls, and will present findings on the associations in future publications.
Article Synopsis
- The study investigates geographical differences in the risk of secondary progressive multiple sclerosis (SPMS) and how these may be influenced by factors like latitude and treatment types.
- It utilizes data from a global patient registry, focusing on relapsing-remitting multiple sclerosis patients and factors such as age, sex, and treatment efficacy.
- The research analyzes data from over 51,000 patients across 27 countries to establish patterns in the progression from relapsing-remitting to secondary progressive phases of the disease.
Article Synopsis
- The study highlights the risk of increased disease activity after stopping natalizumab, emphasizing the need for effective alternative therapies to manage relapsing-remitting multiple sclerosis (RRMS).
- It compares the effectiveness of switching to three disease-modifying therapies—dimethyl fumarate, fingolimod, and ocrelizumab—following natalizumab discontinuation among RRMS patients.
- The analysis included data from 1386 patients and focused on outcomes like annualized relapse rate and time to first relapse, revealing important insights into treatment persistence and effectiveness for managing disease after discontinuing natalizumab.
Disability accrual in primary and secondary progressive multiple sclerosis.
J Neurol Neurosurg Psychiatry
September 2023
Article Synopsis
- The study compares disability progression in primary progressive multiple sclerosis (PPMS) and secondary progressive multiple sclerosis (SPMS), revealing that SPMS has a later onset and slower disability accrual compared to PPMS.* -
- Analysis utilized data from the MSBase cohort, adjusting for factors like age, sex, and drug therapies, and included 1,872 PPMS patients and 2,575 SPMS patients.* -
- Findings suggest that although SPMS patients start with greater baseline disability, their slower progression may lead to similar disability levels over time, indicating the need for careful consideration when combining these groups in clinical trials.*
Background: The prognostic significance of non-disabling relapses in people with relapsing-remitting multiple sclerosis (RRMS) is unclear.
Objective: To determine whether early non-disabling relapses predict disability accumulation in RRMS.
Methods: We redefined mild relapses in MSBase as 'non-disabling', and moderate or severe relapses as 'disabling'.
Background: In the absence of evidence from randomised controlled trials, observational data can be used to emulate clinical trials and guide clinical decisions. Observational studies are, however, susceptible to confounding and bias. Among the used techniques to reduce indication bias are propensity score matching and marginal structural models.
View Article and Find Full Text PDFBackground And Purpose: This study assessed the effect of patient characteristics on the response to disease-modifying therapy (DMT) in multiple sclerosis (MS).
Methods: We extracted data from 61,810 patients from 135 centers across 35 countries from the MSBase registry. The selection criteria were: clinically isolated syndrome or definite MS, follow-up ≥ 1 year, and Expanded Disability Status Scale (EDSS) score ≥ 3, with ≥1 score recorded per year.
Comparing switch to ocrelizumab, cladribine or natalizumab after fingolimod treatment cessation in multiple sclerosis.
J Neurol Neurosurg Psychiatry
December 2022
Background: To compare the effectiveness and treatment persistence of ocrelizumab, cladribine and natalizumab in patients with relapsing-remitting multiple sclerosis switching from fingolimod.
Methods: Using data from MSBase registry, this multicentre cohort study included subjects who had used fingolimod for ≥6 months and then switched to ocrelizumab, cladribine or natalizumab within 3 months after fingolimod discontinuation. We analysed relapse and disability outcomes after balancing covariates using an inverse-probability-treatment-weighting method.
Background: Over the decades, several natural history studies on patients with primary (PPMS) or secondary progressive multiple sclerosis (SPMS) were reported from international registries. In PPMS, a consistent heterogeneity on long-term disability trajectories was demonstrated. The aim of this study was to identify subgroups of patients with SPMS with similar longitudinal trajectories of disability over time.
View Article and Find Full Text PDFArticle 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: Patients with relapsing-remitting multiple sclerosis commonly switch between disease-modifying therapies (DMTs). Identifying predictors of relapse when switching could improve outcomes.
Objective: To determine predictors of relapse hazard when switching to cladribine.
Article Synopsis
- This study looks at how to predict long-term disability in people with multiple sclerosis (MS) after they show signs of worsening over six months.
- Researchers checked data from thousands of patients to figure out who is more likely to have lasting problems.
- They found that things like age, sex, and how MS affects the person can help tell if someone will continue to get worse, which can help doctors in future treatments.
Article Synopsis
- The study aimed to explore how the latitude of residence and UVB radiation exposure affects the severity of multiple sclerosis (MS) among patients, using data from the MSBase registry.
- Results indicated that patients living at higher latitudes (above 40°) experienced more severe MS symptoms, while this trend was not observed in those living below this latitude.
- Additionally, lower UVB exposure during childhood (ages 6 and 18) was linked to faster progression of disability in MS, suggesting the importance of environmental factors in disease severity.
Background: The MSBase prediction model of treatment response leverages multiple demographic and clinical characteristics to estimate hazards of relapses, confirmed disability accumulation (CDA), and confirmed disability improvement (CDI). The model did not include Multiple Sclerosis Severity Score (MSSS), a disease duration-adjusted ranked score of disability.
Objective: To incorporate MSSS into the MSBase prediction model and compare model accuracy with and without MSSS.
Background: Increasingly, people with relapsing-remitting multiple sclerosis (RRMS) are switched to highly effective disease-modifying therapies (DMTs) such as ocrelizumab.
Objective: To determine predictors of relapse and disability progression when switching from another DMT to ocrelizumab.
Methods: Patients with RRMS who switched to ocrelizumab were identified from the MSBase Registry and grouped by prior disease-modifying therapy (pDMT; interferon-β/glatiramer acetate, dimethyl fumarate, teriflunomide, fingolimod or natalizumab) and washout duration (<1 month, 1-2 months or 2-6 months).
Article Synopsis
- Natalizumab outperforms fingolimod in reducing relapses in patients with relapsing-remitting multiple sclerosis (RRMS), but it's unclear if this holds true for all demographic groups.
- The study aimed to assess the effectiveness of these treatments across different patient subgroups, considering factors like age, sex, disease duration, and disability status.
- Results showed that natalizumab led to fewer relapses and a higher chance of improving disability in various subgroups, indicating its potential superiority, particularly in younger patients and those with less severe disease.
Background: Natalizumab and fingolimod were the first preparations recommended for disease breakthrough in priorly treated relapsing-remitting multiple sclerosis. Of three published head-to-head studies two showed that natalizumab is the more effective to prevent relapses and EDSS worsening.
Methods: By re-analyzing original published results from MSBase, France, and Denmark using uniform methodologies, we aimed at identifying the effects of differences in methodology, in the MS-populations, and at re-evaluating the differences in effectiveness between the two drugs.
Background: A delayed onset of treatment effect, termed therapeutic lag, may influence the assessment of treatment response in some patient subgroups.
Objectives: The objective of this study is to explore the associations of patient and disease characteristics with therapeutic lag on relapses and disability accumulation.
Methods: Data from MSBase, a multinational multiple sclerosis (MS) registry, and OFSEP, the French MS registry, were used.
Objective: To test the hypothesis that immunotherapy prevents long-term disability in relapsing-remitting multiple sclerosis (MS), we modeled disability outcomes in 14,717 patients.
Methods: We studied patients from MSBase followed for ≥1 year, with ≥3 visits, ≥1 visit per year, and exposed to MS therapy, and a subset of patients with ≥15-year follow-up. Marginal structural models were used to compare the cumulative hazards of 12-month confirmed increase and decrease in disability, Expanded Disability Status Scale (EDSS) step 6, and the incidence of relapses between treated and untreated periods.
In multiple sclerosis, treatment start or switch is prompted by evidence of disease activity. Whilst immunomodulatory therapies reduce disease activity, the time required to attain maximal effect is unclear. In this study we aimed to develop a method that allows identification of the time to manifest fully and clinically the effect of multiple sclerosis treatments ('therapeutic lag') on clinical disease activity represented by relapses and progression-of-disability events.
View Article and Find Full Text PDFBackground: Cerebellar and brainstem symptoms are common in early stages of multiple sclerosis (MS) yet their prognostic values remain unclear.
Objective: The aim of this study was to investigate long-term disability outcomes in patients with early cerebellar and brainstem symptoms.
Methods: This study used data from MSBase registry.