Background/objective: Observational clinical data from cladribine-treated patients with relapsing forms of multiple sclerosis (MS) were recorded in the Australian MS registry powered by the MSBase registry platform (5-year follow-up) and analysed to complement information from the pivotal cladribine clinical trials in MS.
Methods: A cohort of 90 cladribine-treated patients with follow-up data reported by treating physicians and recorded in the Australian MSBase registry (database lock February 2016) were examined. Clinical data included Expanded Disability Status Scale (EDSS) scores, relapses and other disease-modifying drugs (DMDs) administered before and after cladribine treatment.
Results: Mean age on starting cladribine was 47 years; mean age at MS onset was 34 years, and median baseline EDSS score was 5.25. Disability trajectories in patients with sufficient follow-up suggested an overall increasing trend prior to cladribine treatment which was reduced during the 2-year post-treatment. Approximately 80% of patients were EDSS progression-free, 65% remained relapse-free after 2 years and median time to next DMD was 1.7 years.
Conclusion: These observational data suggest a disease-modifying effect in this cohort of relapsing MS patients characterised by older and more disabled patients. Since these data represent a single-arm cohort, clinical trials and larger comparative post-marketing studies are needed to validate and extend these findings.
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http://dx.doi.org/10.1177/1352458520921087 | DOI Listing |
J Neurol Neurosurg Psychiatry
December 2024
Department of Neurology, The Alfred Hospital, Melbourne, Victoria, Australia.
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 PDFNeurology
December 2024
From the Department of Neuroscience (P.S., A.V.D.W., P.G.S., Y.C.F., W.Z.Y., C.Z., V.G.J., H.B., M.M.), Central Clinical School, Monash University, Melbourne, Victoria; Department of Neurology (P.S., A.V.D.W., P.G.S., Y.C.F., W.Z.Y., V.G.J., H.B., M.M.), Alfred Health, Melbourne, Victoria, Australia; Department of Neurology (P.S., S.H.), Walton Centre NHS Foundation Trust, Liverpool, United Kingdom; Neuroimmunology Centre (S.S., I.R., T.K.), Department of Neurology, The Royal Melbourne Hospital, Parkville; CORe (S.S., I.R., T.K.), Department of Medicine, University of Melbourne, Victoria; Royal Hobart Hospital (Y.C.F.), Hobart, Tasmania, Australia; Nehme and Therese Tohme Multiple Sclerosis Center (S.J.K.), American University of Beirut Medical Center, Beirut, Lebanon; Department of Neurology (T.C.), Faculty of Medicine, University of Debrecen, Hungary; Department of Neurology (B.W.), Antwerp University Hospital, Edegem; Translational Neurosciences Research Group (B.W.), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium; Faculty of Medicine (M.E.), Isfahan University of Medical Sciences; Neurology (M.E.), Dr. Etemadifar MS Institute, Isfahan, Iran; Izmir University of Economics (S.O.), Medical Point Hospital; Multiple Sclerosis Research Association (S.O.), Izmir, Turkey; Department of Neurology and Center of Clinical Neuroscience (P.N., D.H.), First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic; Department of Neurology (A.A.), School of Medicine and Koc University Research Center for Translational Medicine (KUTTAM), Koc University, Istanbul, Turkey; College of Medicine & Health Sciences and Sultan Qaboos University Hospital (A.A.-A.), Sultan Qaboos University, Al-Khodh, Oman; Department of Neuroscience (C.M.R.-T.), Hospital Germans Trias I Pujol, Badalona, Spain; Department of Neurology (G.L.), University Hospital Ghent, Belgium; Department of Medical and Surgical Sciences and Advanced Technologies (F.P.), GF Ingrassia, Catania, Italy; Multiple Sclerosis Unit (F.P.), AOU Policlinico G Rodolico-San Marco, University of Catania; Department of Neuroscience (M.F.), MS Center, Neurology Unit, S. Maria delle Croci Hospital, AUSL Romagna, Ravenna, Italy; Department of Biotechnological and Applied Clinical Sciences (DISCAB) (M.F.), University of L'Aquila, Italy; Department of Neurology (C.B.), Karadeniz Technical University, Medical Faculty, Trabzon, Turkey; Department of Neurology (P.A.M.), Royal Brisbane Hospital; University of Queensland (P.A.M.), Australia; Department of Neurology (R.T.), Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey; Hunter Medical Research Institute (J.L.-S.), Neurology, University of Newcastle; and Hunter New England Health (J.L.-S.), John Hunter Hospital, New South Wales, Australia.
Ther Adv Neurol Disord
November 2024
Department of Neuroscience, Central Clinical School, Monash University, 99 Commercial Road, Melbourne, VIC 3004, Australia.
Background: The relationship between coronavirus disease 2019 (COVID-19) infection and multiple sclerosis (MS) relapse and disease progression remains unclear. Previous studies are limited by small sample sizes and most lack a propensity-matched control cohort.
Objective: To evaluate the effect of COVID-19 infection on MS disease course with a large propensity-matched cohort.
Neurol Neuroimmunol Neuroinflamm
November 2024
From the Department of Neuroscience (W.Z.Y., A.V.D.W., H.B., V.G.J.), School of Translational Medicine, Monash University; Department of Neurology (W.Z.Y., A.V.D.W., O.G.S., H.B., V.G.J.), Alfred Health, Melbourne; Department of Neurology (O.G.S., K.B.), Box Hill Hospital; Department of Neurosciences (O.G.S., K.B.), Eastern Health Clinical School, Monash University, Box Hill; Neuroimmunology Centre (T.K.), Department of Neurology, Royal Melbourne Hospital; CORe (T.K.), Department of Medicine, University of Melbourne, Australia; Amiri Hospital (R.A.), Sharq, Kuwait; Perron Institute for Neurological and Translational Science (A.G.K., M.J.F.-P., W.M.C.), University of Western Australia, Nedlands; Centre for Molecular Medicine and Innovative Therapeutics (A.G.K., M.J.F.-P.), Murdoch University, Perth; Sir Charles Gairdner Hospital (A.G.K., W.M.C.), QEIIMC, Nedlands; University of Newcastle (J.L.-S.), Newcastle; Hunter New England Health (J.L.-S.), John Hunter Hospital, New South Wales, Australia; Karadeniz Technical University (C.B.), Medical Faculty, Trabzon; Izmir University of Economics (S.O.), Medical Point Hospital, Izmir, Turkey; University Hospital Center Zagreb (M.H.); University of Zagreb (M.H.), School of Medicine, Croatia; Monash Health (N.A.J.); Department of Medicine (N.A.J.), School of Clinical Sciences, Monash University, Melbourne, Australia; CHUM and Universite de Montreal (A.P., M.G., P.D.), Canada; Neurology Department (S.M.B.), Faculty of Medicine, Mazandaran University of Medical Sciences, Iran; University of New South Wales (Suzanne Hodgkinson), Sydney, Australia; Cliniques Universitaires Saint-Luc (V.V.P.), Brussels; Université Catholique de Louvain (V.V.P.); Universitary Hospital Ghent (G.L.); Department of Neurology (B.W.), Antwerp University Hospital, Edegem; Translational Neurosciences Research Group (B.W.), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium; CSSS Saint-Jérôme (J.P.), Saint-Jerome, Canada; Department of Neuroscience (M.F.), Neurology Unit-MS Center, S. Maria delle Croci Hospital, AUSL Romagna, Ravenna, Italy; Department of Biotechnological and Applied Clinical Sciences (M.F.), University of L'Aquila, Italy; Groene Hart Ziekenhuis (K.D.G.), Gouda, Netherlands; Charles University in Prague and General University Hospital (D.H., E.K.H.), Prague, Czech Republic; Yeditepe University Kosuyolu Hospital (R.K.), Neurological Sciences, Istanbul, Turkey; Department of Medical and Surgical Sciences and Advanced Technologies (F.P.), GF Ingrassia, Catania; UOS Sclerosi Multipla (F.P.), AOU Policlinico "G Rodloico-San Marco", University of Catania, Italy; University of Queensland (P.A.M.), Brisbane; Royal Brisbane and Women's Hospital (P.A.M.), Australia; Centro Sclerosi Multipla (D.M.), UOC Neurologia, Azienda Ospedaliera per l'Emergenza Cannizzaro, Catania, Italy; Koc University (A.A.), Istanbul, Turkey; Nemocnice Jihlava (Radek Ampapa), Jihlava, Czech Republic; Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati Avellino (D.S.), Avellino, Italy; Zuyderland Medical Center (O.H.H.G.), Sittard-Geleen; School for Mental Health and Neuroscience (O.H.H.G.), Maastricht University, The Netherlands; Centro Hospitalar Universitario de Sao Joao (M.J.S.); Faculty of Health Sciences (M.J.S.), University Fernando Pessoa, Porto, Portugal; Royal Victoria Hospital (Stella Hughes), Belfast, United Kingdom; Department of Neurology (R.G., S.M.), Research laboratory LR18SP03, Clinical investigation Center Neurosciences and Mental Health, Razi Hospital; Faculty of Medicine of Tunis (R.G., S.M.), University of Tunis El Manar, Tunis, Tunisia; Austin Health (R.A.M.), Melbourne, Australia; Haydarpasa Numune Training and Research Hospital (R.T.), Istanbul, Turkey; Azienda Sanitaria Unica Regionale Marche - AV3 (E.C.), Macerata, Italy; Sultan Qaboos University (A.A.-A.), Al-Khodh, Oman; Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases (A.S.), Istanbul, Turkey; St. Michael's Hospital (J.O.), Toronto, Canada; and F. Hoffmann-La Roche Ltd (E.M.-L.R., S.G., N.P.), Basel, Switzerland.
Background 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.
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