Publications by authors named "Vukusic S"

The development of disease-modifying therapies (DMTs) for the treatment of multiple sclerosis (MS) has been highly successful in recent decades. It is now widely accepted that early initiation of DMTs after disease onset is associated with a better long-term prognosis. However, the question of when and how to de-escalate or discontinue DMTs remains open and critical.

View Article and Find Full Text PDF

Background And Objectives: Ocrelizumab labeling advises contraception for women during treatment and for 6-12 months thereafter. Because pregnancies may occur during this time, it is critical to understand pregnancy and infant outcomes in women with multiple sclerosis (MS) after ocrelizumab exposure.

Methods: Pregnancy cases reported to Roche global pharmacovigilance until 12 July 2023 were analyzed.

View Article and Find Full Text PDF

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 PDF

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.

View Article and Find Full Text PDF

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.

View Article and Find Full Text PDF
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.
View Article and Find Full Text PDF

Background And Objectives: People with multiple sclerosis (MS) have an increased risk of severe coronavirus infection due to their level of motor disability or exposure to certain immunosuppressive treatments. Thus, patients with MS have had priority access to coronavirus disease 2019 (COVID-19) vaccination. However, relapses after vaccination have been reported, leading some patients to not seek the recommended booster doses.

View Article and Find Full Text PDF
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.
View Article and Find Full Text PDF

Background: The Big Multiple Sclerosis Data (BMSD) network ( https://bigmsdata.org ) was initiated in 2014 and includes the national multiple sclerosis (MS) registries of the Czech Republic, Denmark, France, Italy, and Sweden as well as the international MSBase registry. BMSD has addressed the ethical, legal, technical, and governance-related challenges for data sharing and so far, published three scientific papers on pooled datasets as proof of concept for its collaborative design.

View Article and Find Full Text PDF
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.
View Article and Find Full Text PDF

Background: A scoping review found that most studies on women's health in multiple sclerosis (MS) focused on pregnancy, fetal/neonatal outcomes and sexual dysfunction. Few studies addressed menopause, contraception, gynecologic cancers/cancer screening. However, the perceived relative importance of these knowledge gaps to people living with MS and other partners is unknown.

View Article and Find Full Text PDF

Objectives: Immune checkpoint inhibitors (ICIs) are increasingly used in cancer treatment. Their mechanism of action raises the question of possible exacerbation of preexisting multiple sclerosis (MS). The aim of our study was to assess the risk of increased MS activity, defined by the occurrence of a relapse and/or a new MRI lesion, after ICI initiation.

View Article and Find Full Text PDF
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.
View Article and Find Full Text PDF

Background: Epidemiologic studies on coronavirus disease 2019 (COVID-19) in patients with multiple sclerosis (pwMS) have focused on the first waves of the pandemic until early 2021.

Objectives: We aimed to extend these data from the onset of the pandemic to the global coverage by vaccination in summer 2022.

Methods: This retrospective, multicenter observational study analyzed COVISEP registry data on reported COVID-19 cases in pwMS between January 2020 and July 2022.

View Article and Find Full Text PDF

Background: Counseling on pregnancy is still challenging, particularly regarding the use of disease-modifying treatments (DMTs). We are lacking long-term outcomes in children exposed to DMTs.

Objectives: This study aimed to set up a French pregnancy registry for women with multiple sclerosis (MS) and related disorders nested within the Observatoire Français de la Sclérose en Plaques (OFSEP) cohort.

View Article and Find Full Text PDF
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.
View Article and Find Full Text PDF
Article Synopsis
  • This study compares two methods for estimating death probabilities in multiple sclerosis (MS) patients: the Cause-Specific Framework (CSF) which requires known causes of death, and the Excess Mortality Framework (EMF) which does not.
  • Using data from a large MS registry and a subset with detailed death records, the researchers found that EMF generally estimated higher death probabilities than CSF across different age groups.
  • Overall, the analysis revealed varying mortality probabilities for MS patients based on the initial disease type, sex, and age; with significant differences particularly noted between relapsing-onset MS and primary progressive patients over a 30-year follow-up.
View Article and Find Full Text PDF

People with multiple sclerosis (pwMS) have an increased risk of infection. As disease-modifying therapies (DMTs) and other treatments may interact with the immune system, there may be concerns about vaccine efficacy and safety. Therefore, it is important to evaluate possible interactions between DMTs and vaccines.

View Article and Find Full Text PDF

Prior studies suggest that habituation of sensory responses is reduced in autism and that diminished habituation could be related to atypical autistic sensory experiences, for example, by causing brain responses to aversive stimuli to remain strong over time instead of being suppressed. While many prior studies exploring habituation in autism have repeatedly presented identical stimuli, other studies suggest group differences can still be observed in habituation to intermittent stimuli. The present study explored habituation of electrophysiological responses to auditory complex tones of varying intensities (50-80 dB SPL), presented passively in an interleaved manner, in a well-characterized sample of 127 autistic (M  = 65.

View Article and Find Full Text PDF

Background: Pseudocystic inflammatory demyelinating lesions (PIDLs) are poorly described in MS and might represent a diagnostic challenge.

Objectives: We described the clinical, radiological, pathological, and follow-up characteristics of 13 PIDL in 9 MS patients.

Methods: We constituted a single-center retrospective case series of PIDLs in MS, defined on MRI as expansive cyst-like lesions, with a fluid-signal content, and a diameter of 1 cm or more.

View Article and Find Full Text PDF

Today's medicine strives to be personalized, preventive, predictive and participatory. This implies to have access to multimodal data to better characterize patients groups and to combine clinical and imaging data with high-quality biological samples. Collecting such data is one of the objectives of the Observatoire français de la sclérose en plaques (OFSEP), the French MS registry.

View Article and Find Full Text PDF

Importance: In patients with multiple sclerosis (MS), factors associated with severe COVID-19 include anti-CD20 therapies and neurologic disability, but it is still unclear whether these 2 variables are independently associated with severe COVID-19 or whether the association depends on MS clinical course.

Objective: To assess the association between anti-CD20 therapies and COVID-19 severity in patients with relapsing-remitting MS (RRMS) and progressive MS (PMS).

Design, Setting, And Participants: This multicenter, retrospective cohort study used data from the COVISEP study, which included patients with MS and COVID-19 from February 1, 2020, to June 30, 2022, at 46 French MS expert centers, general hospitals, and private neurology practices.

View Article and Find Full Text PDF

Background And Purpose: With the new highly active drugs available for people with multiple sclerosis (pwMS), vaccination becomes an essential part of the risk management strategy. We aimed to develop a European evidence-based consensus for the vaccination strategy of pwMS who are candidates for disease-modifying therapies (DMTs).

Methods: This work was conducted by a multidisciplinary working group using formal consensus methodology.

View Article and Find Full Text PDF

Background: With the new highly active drugs available for people with multiple sclerosis (pwMS), vaccination becomes an essential part of the risk management strategy.

Objective: To develop a European evidence-based consensus for the vaccination strategy of pwMS who are candidates for disease-modifying therapies (DMTs).

Methods: This work was conducted by a multidisciplinary working group using formal consensus methodology.

View Article and Find Full Text PDF

Multiple sclerosis is often diagnosed in patients who are planning on having children. Although multiple sclerosis does not negatively influence most pregnancy outcomes, less is known regarding the effects of fetal exposure to novel disease-modifying therapies (DMTs). The withdrawal of some DMTs during pregnancy can modify the natural history of multiple sclerosis, resulting in a substantial risk of pregnancy-related relapse and disability.

View Article and Find Full Text PDF