Pub Date : 2024-05-23eCollection Date: 2024-04-01DOI: 10.1177/20552173241238632
Marco Salvetti, Sibyl Wray, Gereon Nelles, Nicholas Belviso, Achint Kumar, Thijs Koster, Wanda Castro-Borrero, Megan Vignos
Background: Interferon beta-1a remains an important treatment option for multiple sclerosis, particularly when safety or tolerability concerns may outweigh the benefits of higher-efficacy disease-modifying therapies. The five-year phase 4 Plegridy Observational Program (POP) study (NCT02230969) collected data on real-world safety and effectiveness of Plegridy® (peginterferon beta-1a) treatment in patients with relapsing multiple sclerosis.
Objective: To explore the real-world safety and effectiveness of peginterferon beta-1a in patients with relapsing multiple sclerosis, including factors influencing treatment discontinuation.
Methods: Data were collected prospectively from patients ≥ 18 years old with relapsing multiple sclerosis for overall population analysis and for subpopulations including newly/previously diagnosed patients, age, and experience with peginterferon beta-1a. Outcome measures included annualized relapse rates, adverse events, and predictors of time to treatment discontinuation.
Results: Mean (SD) treatment duration in the overall population (N = 1172) was 896.0 (733.15) days. Incidence of adverse events was higher in new than experienced users (79.4% vs. 57.0%). New users were more likely than experienced users to discontinue (hazard ratio = 1.60; P < 0.0001). The adjusted annualized relapse rate was 0.09, and at the end of 5 years, 77.1% of patients were relapse-free.
Conclusions: Peginterferon beta-1a is an effective therapy for managing relapsing multiple sclerosis. The identification of predictors of discontinuation can help inform strategies to enhance treatment persistence.
{"title":"Safety and clinical effectiveness of peginterferon beta-1a for relapsing multiple sclerosis in a real-world setting: Final results from the Plegridy Observational Program.","authors":"Marco Salvetti, Sibyl Wray, Gereon Nelles, Nicholas Belviso, Achint Kumar, Thijs Koster, Wanda Castro-Borrero, Megan Vignos","doi":"10.1177/20552173241238632","DOIUrl":"10.1177/20552173241238632","url":null,"abstract":"<p><strong>Background: </strong>Interferon beta-1a remains an important treatment option for multiple sclerosis, particularly when safety or tolerability concerns may outweigh the benefits of higher-efficacy disease-modifying therapies. The five-year phase 4 Plegridy Observational Program (POP) study (NCT02230969) collected data on real-world safety and effectiveness of Plegridy® (peginterferon beta-1a) treatment in patients with relapsing multiple sclerosis.</p><p><strong>Objective: </strong>To explore the real-world safety and effectiveness of peginterferon beta-1a in patients with relapsing multiple sclerosis, including factors influencing treatment discontinuation.</p><p><strong>Methods: </strong>Data were collected prospectively from patients ≥ 18 years old with relapsing multiple sclerosis for overall population analysis and for subpopulations including newly/previously diagnosed patients, age, and experience with peginterferon beta-1a. Outcome measures included annualized relapse rates, adverse events, and predictors of time to treatment discontinuation.</p><p><strong>Results: </strong>Mean (SD) treatment duration in the overall population (<i>N</i> = 1172) was 896.0 (733.15) days. Incidence of adverse events was higher in new than experienced users (79.4% vs. 57.0%). New users were more likely than experienced users to discontinue (hazard ratio = 1.60; <i>P </i>< 0.0001). The adjusted annualized relapse rate was 0.09, and at the end of 5 years, 77.1% of patients were relapse-free.</p><p><strong>Conclusions: </strong>Peginterferon beta-1a is an effective therapy for managing relapsing multiple sclerosis. The identification of predictors of discontinuation can help inform strategies to enhance treatment persistence.</p>","PeriodicalId":18961,"journal":{"name":"Multiple Sclerosis Journal - Experimental, Translational and Clinical","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11113050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-15eCollection Date: 2024-04-01DOI: 10.1177/20552173241252571
Phuong Tram Nguyen, Amin Zarghami, Kalina Makowiecki, Natasha Stevens, Chigozie Ezegbe, Kain Kyle, Chenyu Wang, Linda Ly, Katie De La Rue, Mark R Hinder, Lewis Johnson, Jennifer Rodger, Samantha Cooper, Carlie L Cullen, Michael Barnett, Kaylene M Young, Bruce V Taylor
Background: Low-intensity repetitive transcranial magnetic stimulation (rTMS), delivered as a daily intermittent theta burst stimulation (iTBS) for four consecutive weeks, increased the number of new oligodendrocytes in the adult mouse brain. Therefore, rTMS holds potential as a remyelinating intervention for people with multiple sclerosis (MS).
Objective: Primarily to determine the safety and tolerability of our rTMS protocol in people with MS. Secondary objectives include feasibility, blinding and an exploration of changes in magnetic resonance imaging (MRI) metrics, patient-reported outcome measures (PROMs) and cognitive or motor performance.
Methods: A randomised (2:1), placebo controlled, single blind, parallel group, phase 1 trial of 20 rTMS sessions (600 iTBS pulses per hemisphere; 25% maximum stimulator output), delivered over 4-5 weeks. Twenty participants were randomly assigned to 'sham' (n = 7) or active rTMS (n = 13), with the coil positioned at 90° or 0°, respectively.
Results: Five adverse events (AEs) including one serious AE reported. None were related to treatment. Protocol compliance was high (85%) and blinding successful. Within participant MRI metrics, PROMs and cognitive or motor performance were unchanged over time.
Conclusion: Twenty sessions of rTMS is safe and well tolerated in a small group of people with MS. The study protocol and procedures are feasible. Improvement of sham is warranted before further investigating safety and efficacy.
{"title":"Low-intensity repetitive transcranial magnetic stimulation is safe and well tolerated by people living with MS - outcomes of the phase I randomised controlled trial (TAURUS).","authors":"Phuong Tram Nguyen, Amin Zarghami, Kalina Makowiecki, Natasha Stevens, Chigozie Ezegbe, Kain Kyle, Chenyu Wang, Linda Ly, Katie De La Rue, Mark R Hinder, Lewis Johnson, Jennifer Rodger, Samantha Cooper, Carlie L Cullen, Michael Barnett, Kaylene M Young, Bruce V Taylor","doi":"10.1177/20552173241252571","DOIUrl":"https://doi.org/10.1177/20552173241252571","url":null,"abstract":"<p><strong>Background: </strong>Low-intensity repetitive transcranial magnetic stimulation (rTMS), delivered as a daily intermittent theta burst stimulation (iTBS) for four consecutive weeks, increased the number of new oligodendrocytes in the adult mouse brain. Therefore, rTMS holds potential as a remyelinating intervention for people with multiple sclerosis (MS).</p><p><strong>Objective: </strong>Primarily to determine the safety and tolerability of our rTMS protocol in people with MS. Secondary objectives include feasibility, blinding and an exploration of changes in magnetic resonance imaging (MRI) metrics, patient-reported outcome measures (PROMs) and cognitive or motor performance.</p><p><strong>Methods: </strong>A randomised (2:1), placebo controlled, single blind, parallel group, phase 1 trial of 20 rTMS sessions (600 iTBS pulses per hemisphere; 25% maximum stimulator output), delivered over 4-5 weeks. Twenty participants were randomly assigned to 'sham' (<i>n</i> = 7) or active rTMS (<i>n</i> = 13), with the coil positioned at 90° or 0°, respectively.</p><p><strong>Results: </strong>Five adverse events (AEs) including one serious AE reported. None were related to treatment. Protocol compliance was high (85%) and blinding successful. Within participant MRI metrics, PROMs and cognitive or motor performance were unchanged over time.</p><p><strong>Conclusion: </strong>Twenty sessions of rTMS is safe and well tolerated in a small group of people with MS. The study protocol and procedures are feasible. Improvement of sham is warranted before further investigating safety and efficacy.</p>","PeriodicalId":18961,"journal":{"name":"Multiple Sclerosis Journal - Experimental, Translational and Clinical","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140958537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-07eCollection Date: 2024-04-01DOI: 10.1177/20552173241252563
Alyssa N Nylander, William Rowles, Shane Poole, Riley Bove
Background: Immune checkpoint inhibitors (ICIs) represent a novel class of agents approved for the treatment of several cancers and progressive multifocal leukoencephalopathy (PML). However, due to the risk of autoimmune side effects, their use in people with autoimmune diseases such as multiple sclerosis (MS) has been limited.
Objective: To characterize outcomes in a cohort of adults with MS who received ICIs.
Methods: A single-center retrospective review of medical record data was performed for people with MS treated with ICIs.
Results: Seven people with MS were identified, with a mean (SD) age at ICI use of 55.4 (13.7) years and a mean MS duration of 18.2 (12.2) years. Six were treated for cancer; 1 was treated for PML. After mean (SD) follow-up of 1.76 (2.15) years after ICI, outcomes are: no evidence of disease (2), residual metastatic disease (1), death due to cancer (1), death due to PML (1), and lost to follow-up (2). Notably, 0 out of 7 patients experienced an MS relapse; two out of six had new asymptomatic demyelinating magnetic resonance imaging lesions. In the three patients with expanded disability status scale (EDSS) scores at baseline and follow-up, EDSS remained stable (mean delta 0.13).
Conclusion: In this cohort, no people with MS experienced clinical relapses and one-third experienced asymptomatic radiological activity following ICI treatment.
{"title":"Clinical outcomes after use of checkpoint inhibitor immunotherapies in people with multiple sclerosis.","authors":"Alyssa N Nylander, William Rowles, Shane Poole, Riley Bove","doi":"10.1177/20552173241252563","DOIUrl":"10.1177/20552173241252563","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) represent a novel class of agents approved for the treatment of several cancers and progressive multifocal leukoencephalopathy (PML). However, due to the risk of autoimmune side effects, their use in people with autoimmune diseases such as multiple sclerosis (MS) has been limited.</p><p><strong>Objective: </strong>To characterize outcomes in a cohort of adults with MS who received ICIs.</p><p><strong>Methods: </strong>A single-center retrospective review of medical record data was performed for people with MS treated with ICIs.</p><p><strong>Results: </strong>Seven people with MS were identified, with a mean (SD) age at ICI use of 55.4 (13.7) years and a mean MS duration of 18.2 (12.2) years. Six were treated for cancer; 1 was treated for PML. After mean (SD) follow-up of 1.76 (2.15) years after ICI, outcomes are: no evidence of disease (2), residual metastatic disease (1), death due to cancer (1), death due to PML (1), and lost to follow-up (2). Notably, 0 out of 7 patients experienced an MS relapse; two out of six had new asymptomatic demyelinating magnetic resonance imaging lesions. In the three patients with expanded disability status scale (EDSS) scores at baseline and follow-up, EDSS remained stable (mean delta 0.13).</p><p><strong>Conclusion: </strong>In this cohort, no people with MS experienced clinical relapses and one-third experienced asymptomatic radiological activity following ICI treatment.</p>","PeriodicalId":18961,"journal":{"name":"Multiple Sclerosis Journal - Experimental, Translational and Clinical","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11078085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-06eCollection Date: 2024-04-01DOI: 10.1177/20552173241251707
Lindsey M Marian, Kathleen A Harris, Devon S Conway
Background: Many patients report a wearing-off phenomenon with monoclonal antibody treatment for multiple sclerosis in which perceived benefits wear off before the next dose is due.
Objectives: To determine prevalence of the wearing-off effect, symptoms experienced, impact on treatment satisfaction, and associated patient characteristics.
Methods: Patients receiving natalizumab, ocrelizumab, ofatumumab, or rituximab at a tertiary multiple sclerosis center were invited to take an online survey interrogating their monoclonal antibody experience. Additional history and patient characteristic data were collected. Logistic regression was used to determine if patient characteristics predicted the wearing-off effect and linear regression to evaluate the impact of the wearing-off effect on treatment satisfaction. The models were adjusted for age, disease duration, race, sex, body mass index, education, and depression as measured by the Patient Health Questionnaire-9.
Results: We received 258 qualifying responses and 141 (54.7%) patients reported the wearing-off phenomenon. The most common symptom was fatigue (47.7%). Higher Patient Health Questionnaire-9 scores were significantly associated with the wearing-off phenomenon (OR = 1.02, p = 0.005). The wearing-off effect (β = -0.52, p = 0.04) and higher Patient Health Questionnaire-9 (β = -0.09, p < 0.01) scores were associated with significantly reduced treatment satisfaction.
Conclusion: The wearing-off phenomenon is common, associated with depression, and reduces treatment satisfaction. Research addressing mitigation strategies is needed.
{"title":"The patient-reported wearing-off phenomenon with monoclonal antibody treatments for multiple sclerosis.","authors":"Lindsey M Marian, Kathleen A Harris, Devon S Conway","doi":"10.1177/20552173241251707","DOIUrl":"10.1177/20552173241251707","url":null,"abstract":"<p><strong>Background: </strong>Many patients report a wearing-off phenomenon with monoclonal antibody treatment for multiple sclerosis in which perceived benefits wear off before the next dose is due.</p><p><strong>Objectives: </strong>To determine prevalence of the wearing-off effect, symptoms experienced, impact on treatment satisfaction, and associated patient characteristics.</p><p><strong>Methods: </strong>Patients receiving natalizumab, ocrelizumab, ofatumumab, or rituximab at a tertiary multiple sclerosis center were invited to take an online survey interrogating their monoclonal antibody experience. Additional history and patient characteristic data were collected. Logistic regression was used to determine if patient characteristics predicted the wearing-off effect and linear regression to evaluate the impact of the wearing-off effect on treatment satisfaction. The models were adjusted for age, disease duration, race, sex, body mass index, education, and depression as measured by the Patient Health Questionnaire-9.</p><p><strong>Results: </strong>We received 258 qualifying responses and 141 (54.7%) patients reported the wearing-off phenomenon. The most common symptom was fatigue (47.7%). Higher Patient Health Questionnaire-9 scores were significantly associated with the wearing-off phenomenon (OR = 1.02, <i>p</i> = 0.005). The wearing-off effect (β = -0.52, <i>p</i> = 0.04) and higher Patient Health Questionnaire-9 (β = -0.09, <i>p</i> < 0.01) scores were associated with significantly reduced treatment satisfaction.</p><p><strong>Conclusion: </strong>The wearing-off phenomenon is common, associated with depression, and reduces treatment satisfaction. Research addressing mitigation strategies is needed.</p>","PeriodicalId":18961,"journal":{"name":"Multiple Sclerosis Journal - Experimental, Translational and Clinical","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11075606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140876867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-06eCollection Date: 2024-04-01DOI: 10.1177/20552173241240937
Katherine A Koenig, Ken E Sakaie, Daniel Ontaneda, Kedar R Mahajan, Se-Hong Oh, Kunio Nakamura, Stephen E Jones, Stephen M Rao, Mark J Lowe
Background: Cognitive dysfunction is a known symptom of multiple sclerosis (MS), with memory recognized as a frequently impacted domain. Here, we used high-resolution MRI at 7 tesla to build on cross-sectional work by evaluating the longitudinal relationship of diffusion tensor imaging (DTI) measures of the fornix to episodic memory performance.
Methods: A sample of 80 people with multiple sclerosis (mean age 51.9 ± 8.1 years; 24% male) underwent baseline clinical evaluation, neuropsychological assessment, and MRI. Sixty-four participants had follow-up neuropsychological testing after 1-2 years. Linear regression was used to assess the relationship of baseline imaging measures to follow-up episodic memory performance, measured using the Selective Reminding Test and Brief Visuospatial Memory Test. A reduced prediction model included cognitive function at baseline, age, sex, and disease course.
Results: Radial (β = -0.222, p < 0.026; likelihood ratio test (LRT) p < 0.018), axial (β = -0.270, p < 0.005; LRT p < 0.003), and mean (β = -0.242, p < 0.0139; LRT p < 0.009) diffusivity of the fornix significantly added to the model, with follow-up analysis indicating that a longer prediction interval may increase accuracy.
Conclusion: These results suggest that fornix DTI has predictive value specific to memory function in MS and warrants additional investigation in the drive to develop predictors of disease progression.
背景:认知功能障碍是多发性硬化症(MS)的一个已知症状,而记忆被认为是一个经常受到影响的领域。在此,我们使用 7 特斯拉高分辨率核磁共振成像技术,在横断面研究的基础上,评估了穹窿部弥散张量成像(DTI)测量与外显记忆表现的纵向关系:80名多发性硬化症患者(平均年龄为51.9 ± 8.1岁;24%为男性)接受了基线临床评估、神经心理学评估和核磁共振成像检查。64名患者在1-2年后接受了后续神经心理学测试。采用线性回归评估了基线成像测量与后续外显记忆表现之间的关系,外显记忆表现采用选择性记忆测试和简短视觉空间记忆测试进行测量。简化预测模型包括基线认知功能、年龄、性别和病程:Radial (β = -0.222, p p p p p 结论:这些结果表明,穹窿 DTI 对多发性硬化症患者的记忆功能具有预测价值,值得进一步研究,以开发疾病进展的预测指标。
{"title":"High-resolution diffusion tensor imaging of the fornix predicts memory function in multiple sclerosis.","authors":"Katherine A Koenig, Ken E Sakaie, Daniel Ontaneda, Kedar R Mahajan, Se-Hong Oh, Kunio Nakamura, Stephen E Jones, Stephen M Rao, Mark J Lowe","doi":"10.1177/20552173241240937","DOIUrl":"10.1177/20552173241240937","url":null,"abstract":"<p><strong>Background: </strong>Cognitive dysfunction is a known symptom of multiple sclerosis (MS), with memory recognized as a frequently impacted domain. Here, we used high-resolution MRI at 7 tesla to build on cross-sectional work by evaluating the longitudinal relationship of diffusion tensor imaging (DTI) measures of the fornix to episodic memory performance.</p><p><strong>Methods: </strong>A sample of 80 people with multiple sclerosis (mean age 51.9 ± 8.1 years; 24% male) underwent baseline clinical evaluation, neuropsychological assessment, and MRI. Sixty-four participants had follow-up neuropsychological testing after 1-2 years. Linear regression was used to assess the relationship of baseline imaging measures to follow-up episodic memory performance, measured using the Selective Reminding Test and Brief Visuospatial Memory Test. A reduced prediction model included cognitive function at baseline, age, sex, and disease course.</p><p><strong>Results: </strong>Radial (β = -0.222, <i>p</i> < 0.026; likelihood ratio test (LRT) <i>p</i> < 0.018), axial (β = -0.270, <i>p</i> < 0.005; LRT <i>p</i> < 0.003), and mean (β = -0.242, <i>p</i> < 0.0139; LRT <i>p</i> < 0.009) diffusivity of the fornix significantly added to the model, with follow-up analysis indicating that a longer prediction interval may increase accuracy.</p><p><strong>Conclusion: </strong>These results suggest that fornix DTI has predictive value specific to memory function in MS and warrants additional investigation in the drive to develop predictors of disease progression.</p>","PeriodicalId":18961,"journal":{"name":"Multiple Sclerosis Journal - Experimental, Translational and Clinical","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11075608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140876866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-27eCollection Date: 2024-04-01DOI: 10.1177/20552173241248293
Chantelle Murley, Emma Pettersson, Jan Hillert, Alejandra Machado, Emilie Friberg
Background: The risk of coronavirus disease 2019 among people with multiple sclerosis with different disease-modifying therapies is not well established.
Objective: To investigate the occurrence of coronavirus disease 2019 and the remaining symptoms among people with multiple sclerosis and the associations with different disease-modifying therapies.
Methods: Individuals aged 20-50 listed in the Swedish Multiple Sclerosis Registry were invited to participate in a survey in 2021. Information on reported coronavirus disease 2019 infection and remaining symptoms were linked to individual-level register data. The risks by disease-modifying therapy of having coronavirus disease 2019 or having remaining symptoms were estimated with logistic regression.
Results: Of the 4393 participants, 1030 (23.4%) self-reported coronavirus disease 2019 (749 confirmed and 281 suspected). The observed odds for coronavirus disease 2019 did not differ by disease-modifying therapy (p-values <0.05). The majority reporting coronavirus disease 2019 had fully recovered (68.5%), 4.2% were currently/recently sick, and 27.0% had symptoms remaining after 2 months. The most frequently reported remaining symptoms involved one's sense of smell or taste (37.0%), fatigue (20.0%), and breathing (12.0%). No statistically significant associations were observed between having remaining symptoms and the disease-modifying therapy.
Conclusion: Despite the initial concerns of differing infection risks by MS treatments, we observed no differences in coronavirus disease 2019 occurrence or remaining symptoms among those who had coronavirus disease 2019. Nonetheless, exercising caution in interpreting our findings, it remains implicit that people with multiple sclerosis are particularly susceptible to infection and that lingering symptoms may persist beyond the initial infection.
{"title":"Coronavirus disease 2019 infection among working-aged people with multiple sclerosis and the impact of disease-modifying therapies.","authors":"Chantelle Murley, Emma Pettersson, Jan Hillert, Alejandra Machado, Emilie Friberg","doi":"10.1177/20552173241248293","DOIUrl":"https://doi.org/10.1177/20552173241248293","url":null,"abstract":"<p><strong>Background: </strong>The risk of coronavirus disease 2019 among people with multiple sclerosis with different disease-modifying therapies is not well established.</p><p><strong>Objective: </strong>To investigate the occurrence of coronavirus disease 2019 and the remaining symptoms among people with multiple sclerosis and the associations with different disease-modifying therapies.</p><p><strong>Methods: </strong>Individuals aged 20-50 listed in the Swedish Multiple Sclerosis Registry were invited to participate in a survey in 2021. Information on reported coronavirus disease 2019 infection and remaining symptoms were linked to individual-level register data. The risks by disease-modifying therapy of having coronavirus disease 2019 or having remaining symptoms were estimated with logistic regression.</p><p><strong>Results: </strong>Of the 4393 participants, 1030 (23.4%) self-reported coronavirus disease 2019 (749 confirmed and 281 suspected). The observed odds for coronavirus disease 2019 did not differ by disease-modifying therapy (<i>p</i>-values <0.05). The majority reporting coronavirus disease 2019 had fully recovered (68.5%), 4.2% were currently/recently sick, and 27.0% had symptoms remaining after 2 months. The most frequently reported remaining symptoms involved one's sense of smell or taste (37.0%), fatigue (20.0%), and breathing (12.0%). No statistically significant associations were observed between having remaining symptoms and the disease-modifying therapy.</p><p><strong>Conclusion: </strong>Despite the initial concerns of differing infection risks by MS treatments, we observed no differences in coronavirus disease 2019 occurrence or remaining symptoms among those who had coronavirus disease 2019. Nonetheless, exercising caution in interpreting our findings, it remains implicit that people with multiple sclerosis are particularly susceptible to infection and that lingering symptoms may persist beyond the initial infection.</p>","PeriodicalId":18961,"journal":{"name":"Multiple Sclerosis Journal - Experimental, Translational and Clinical","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11055478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1177/20552173241247680
J. Sabin, E. Salas, J. Martín-Martínez, A. Candeliere-Merlicco, F.J. Barrero, Ana Alonso, J. Sánchez-Menoyo, L. Borrega, M. Rodríguez-Rodríguez, M. Gómez-Gutiérrez, S. Eichau, M.A. Hernández-Pérez, C. Calles, E. Fernández-Díaz, O. Carmona, A. Orvíz, Ana López-Real, P. López-Muñoz, A. Mendoza, Eduardo Agüera, Jorge Mauriño, J. Ballesteros
A multicenter study involving 204 adults with relapsing-remitting multiple sclerosis (RRMS) assessed the dimensionality and item characteristics of the Mishel-Uncertainty of Illness Scale (MUIS), a generic self-assessment tool. Mokken analysis identified two dimensions in the MUIS with an appropriate item and overall scale scalability after excluding nonclassifiable items. A refined 12-item MUIS, employing a grade response model, effectively discriminated uncertainty levels among RRMS patients (likelihood ratio test p-value = .03). These findings suggest the potential value of the 12-item MUIS as a reliable measure for assessing uncertainty associated with the course of illness in RRMS.
{"title":"Assessing illness-related uncertainty in relapsing-remitting multiple sclerosis: A psychometric analysis of the Mishel Uncertainty of Illness Scale","authors":"J. Sabin, E. Salas, J. Martín-Martínez, A. Candeliere-Merlicco, F.J. Barrero, Ana Alonso, J. Sánchez-Menoyo, L. Borrega, M. Rodríguez-Rodríguez, M. Gómez-Gutiérrez, S. Eichau, M.A. Hernández-Pérez, C. Calles, E. Fernández-Díaz, O. Carmona, A. Orvíz, Ana López-Real, P. López-Muñoz, A. Mendoza, Eduardo Agüera, Jorge Mauriño, J. Ballesteros","doi":"10.1177/20552173241247680","DOIUrl":"https://doi.org/10.1177/20552173241247680","url":null,"abstract":"A multicenter study involving 204 adults with relapsing-remitting multiple sclerosis (RRMS) assessed the dimensionality and item characteristics of the Mishel-Uncertainty of Illness Scale (MUIS), a generic self-assessment tool. Mokken analysis identified two dimensions in the MUIS with an appropriate item and overall scale scalability after excluding nonclassifiable items. A refined 12-item MUIS, employing a grade response model, effectively discriminated uncertainty levels among RRMS patients (likelihood ratio test p-value = .03). These findings suggest the potential value of the 12-item MUIS as a reliable measure for assessing uncertainty associated with the course of illness in RRMS.","PeriodicalId":18961,"journal":{"name":"Multiple Sclerosis Journal - Experimental, Translational and Clinical","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140764721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1177/20552173241238627
R. Marrie, Ronak Patel, Stephen Allan Schaffer
Background People with multiple sclerosis (MS) have an increased risk of ischemic heart disease as compared to people without MS after accounting for traditional vascular risk factors. Objective We assessed whether subclinical atherosclerosis, an inflammatory disease of arteries, occurs in persons with MS who do not have traditional vascular risk factors, and whether the Framingham Score (FRS) predicted carotid intima media thickness (CIMT) similarly in people with and without MS. Methods We recruited participants with and without MS who did not have vascular disease. Participants completed questionnaires, physical assessments, underwent an ultrasound (CIMT), and provided samples for HbA1c and lipid measurements. We defined subclinical atherosclerosis as an average CIMT ≥75th percentile, and tested the association between MS/not-MS, FRS, and atherosclerosis using logistic regression. Results We recruited 106 participants with MS 101 without MS. The average (SD) CIMT did not differ between the MS (0.60 [0.11]) and non-MS (0.61 [0.12]) cohorts (p = 0.69), nor did the proportion with atherosclerosis (MS: 11.3% vs. non-MS 13.4%, p = 0.58). On regression analysis a 1-point increase in the FRS was associated with 11% increased odds of having atherosclerosis (95%CI: 1.04, 1.19) but MS was not. Conclusion MS was not associated with subclinical atherosclerosis.
{"title":"Subclinical atherosclerosis in multiple sclerosis","authors":"R. Marrie, Ronak Patel, Stephen Allan Schaffer","doi":"10.1177/20552173241238627","DOIUrl":"https://doi.org/10.1177/20552173241238627","url":null,"abstract":"Background People with multiple sclerosis (MS) have an increased risk of ischemic heart disease as compared to people without MS after accounting for traditional vascular risk factors. Objective We assessed whether subclinical atherosclerosis, an inflammatory disease of arteries, occurs in persons with MS who do not have traditional vascular risk factors, and whether the Framingham Score (FRS) predicted carotid intima media thickness (CIMT) similarly in people with and without MS. Methods We recruited participants with and without MS who did not have vascular disease. Participants completed questionnaires, physical assessments, underwent an ultrasound (CIMT), and provided samples for HbA1c and lipid measurements. We defined subclinical atherosclerosis as an average CIMT ≥75th percentile, and tested the association between MS/not-MS, FRS, and atherosclerosis using logistic regression. Results We recruited 106 participants with MS 101 without MS. The average (SD) CIMT did not differ between the MS (0.60 [0.11]) and non-MS (0.61 [0.12]) cohorts (p = 0.69), nor did the proportion with atherosclerosis (MS: 11.3% vs. non-MS 13.4%, p = 0.58). On regression analysis a 1-point increase in the FRS was associated with 11% increased odds of having atherosclerosis (95%CI: 1.04, 1.19) but MS was not. Conclusion MS was not associated with subclinical atherosclerosis.","PeriodicalId":18961,"journal":{"name":"Multiple Sclerosis Journal - Experimental, Translational and Clinical","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140768866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-29eCollection Date: 2024-01-01DOI: 10.1177/20552173241233952
Jérôme de Seze, Christine Clerc, Matthieu Béreau, Bertrand Bourre, Hélène Zephir, Nicolas Collongues, Laurent Kremer, Patrick Vermersch, Kevin Bigaut
Objective: To assess the efficacy of dalfampridine in patients with neuromyelitis optica spectrum disorder.
Methods: We included 15 consecutive patients, who were started on a treatment of dalfampridine 10 mg twice daily for 2 weeks. Efficacy assessment was based on walking ability improvement using Timed-25-Foot Walk and 12-item Multiple Sclerosis Walking Scale tests.
Results: The mean Timed-25-Foot Walk score was reduced from 14.8 (±2.4) to 11.3 (±1.9) seconds (p = 0.01). The mean score on the 12-item Multiple Sclerosis Walking Scale was reduced from 41.2 (±3.5) to 31.4 (±3.2) (p = 0.004).
Conclusion: Dalfampridine seems to be useful for symptomatic treatment of walking impairment in neuromyelitis optica spectrum disorder.
{"title":"Efficacy of dalfampridine in neuromyelitis optica spectrum disorder: A pilot study.","authors":"Jérôme de Seze, Christine Clerc, Matthieu Béreau, Bertrand Bourre, Hélène Zephir, Nicolas Collongues, Laurent Kremer, Patrick Vermersch, Kevin Bigaut","doi":"10.1177/20552173241233952","DOIUrl":"10.1177/20552173241233952","url":null,"abstract":"<p><strong>Objective: </strong>To assess the efficacy of dalfampridine in patients with neuromyelitis optica spectrum disorder.</p><p><strong>Methods: </strong>We included 15 consecutive patients, who were started on a treatment of dalfampridine 10 mg twice daily for 2 weeks. Efficacy assessment was based on walking ability improvement using Timed-25-Foot Walk and 12-item Multiple Sclerosis Walking Scale tests.</p><p><strong>Results: </strong>The mean Timed-25-Foot Walk score was reduced from 14.8 (±2.4) to 11.3 (±1.9) seconds (<i>p</i> = 0.01). The mean score on the 12-item Multiple Sclerosis Walking Scale was reduced from 41.2 (±3.5) to 31.4 (±3.2) (<i>p</i> = 0.004).</p><p><strong>Conclusion: </strong>Dalfampridine seems to be useful for symptomatic treatment of walking impairment in neuromyelitis optica spectrum disorder.</p>","PeriodicalId":18961,"journal":{"name":"Multiple Sclerosis Journal - Experimental, Translational and Clinical","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10908237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140022217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-25eCollection Date: 2024-01-01DOI: 10.1177/20552173241231678
Edgar R Valdivia-Tangarife, Fernando Cortés-Enríquez, Alejandra Morlett-Paredes, Teresita Villaseñor-Cabrera, Jorge I Gámez-Nava, Mario A Mireles-Ramírez, Laura González-López, Miguel Á Macías-Islas
Background: Between 29% and 67% of neuromyelitis optica spectrum disorder patients have cognitive alterations.
Objective: To assess the frequency of cognitive impairment in patients with neuromyelitis optica spectrum disorder in Mexico using the Brief International Cognitive Assessment for Multiple Sclerosis.
Methods: We evaluated 40 neuromyelitis optica spectrum disorder patients and 40 healthy controls from Mexico.
Results: 28 (70.0%) patients with neuromyelitis optica spectrum disorder had cognitive impairment in two or more cognitive domains. Student´s T test showed statistically poor performance by neuromyelitis optica spectrum disorder patients compared to healthy controls on all three neuropsychological test scores. This significant difference was observed on the Symbols Digit Modalities Test (t = 8.875; p ≤ 0.001); California Verbal Learning Test-II memory (t = 10.418; p ≤ 0.001); and Brief Visuospatial Memory Test Revised (t = 6.123; p ≤ 0.001).
Conclusions: This study showed that 70% of neuromyelitis optica spectrum disorder patients exhibited cognitive impairment in two or more cognitive domains. Determining the frequency of cognitive impairment will guide the decision of Neuropsychologists in planning cognitive rehabilitation across various domains.
{"title":"Frequency of cognitive impairment in patients with neuromyelitis optica spectrum disorder in Mexico.","authors":"Edgar R Valdivia-Tangarife, Fernando Cortés-Enríquez, Alejandra Morlett-Paredes, Teresita Villaseñor-Cabrera, Jorge I Gámez-Nava, Mario A Mireles-Ramírez, Laura González-López, Miguel Á Macías-Islas","doi":"10.1177/20552173241231678","DOIUrl":"10.1177/20552173241231678","url":null,"abstract":"<p><strong>Background: </strong>Between 29% and 67% of neuromyelitis optica spectrum disorder patients have cognitive alterations.</p><p><strong>Objective: </strong>To assess the frequency of cognitive impairment in patients with neuromyelitis optica spectrum disorder in Mexico using the Brief International Cognitive Assessment for Multiple Sclerosis.</p><p><strong>Methods: </strong>We evaluated 40 neuromyelitis optica spectrum disorder patients and 40 healthy controls from Mexico.</p><p><strong>Results: </strong>28 (70.0%) patients with neuromyelitis optica spectrum disorder had cognitive impairment in two or more cognitive domains. Student´s T test showed statistically poor performance by neuromyelitis optica spectrum disorder patients compared to healthy controls on all three neuropsychological test scores. This significant difference was observed on the Symbols Digit Modalities Test (<i>t</i> = 8.875; <i>p</i> ≤ 0.001); California Verbal Learning Test-II memory (<i>t</i> = 10.418; <i>p</i> ≤ 0.001); and Brief Visuospatial Memory Test Revised (<i>t</i> = 6.123; <i>p</i> ≤ 0.001).</p><p><strong>Conclusions: </strong>This study showed that 70% of neuromyelitis optica spectrum disorder patients exhibited cognitive impairment in two or more cognitive domains. Determining the frequency of cognitive impairment will guide the decision of Neuropsychologists in planning cognitive rehabilitation across various domains.</p>","PeriodicalId":18961,"journal":{"name":"Multiple Sclerosis Journal - Experimental, Translational and Clinical","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10896058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139975484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}