| Title: |
Disease reactivation after cessation of disease-modifying therapy in relapsing-remitting multiple sclerosis |
| Authors: |
Roos, Izanne; Malpas, Charles; Leray, Emmanuelle; Casey, Romain; Horakova, Dana; Havrdová, Eva Kubala; Debouverie, Marc; Patti, Francesco; de Sèze, Jérôme; Izquierdo, Guillermo; Eichau, Sara; Edan, Gilles; Prat, Alexandre; Girard, Marc; Ozakbas, Serkan; Grammond, Pierre; Zephir, Helene; Ciron, Jonathan; Maillart, Elisabeth; Moreau, Thibault; Amato, Maria Pia; Labauge, Pierre; Alroughani, Raed; Buzzard, Katherine; Skibina, Olga; Terzi, Murat; Laplaud, David Axel; Berger, Eric; Grand'Maison, Francois; Lebrun-Frenay, Christine; Cartechini, Elisabetta; Boz, Cavit; Lechner-Scott, Jeannette; Clavelou, Pierre; Stankoff, Bruno; Prevost, Julie; Kappos, Ludwig; Pelletier, Jean; Shaygannejad, Vahid; Yamout, Bassem; Gerlach, Oliver; Spitaleri, Daniele; van Pesch, Vincent; Gout, Olivier; Turkoglu, Recai; Heinzlef, Olivier; Thouvenot, Eric; Vukusic, Sandra; Butzkueven, Helmut; Kalincik, Tomas |
| Contributors: |
University of Melbourne; The Royal Melbourne Hospital; Recherche sur les services et le management en santé (RSMS); Université de Rennes (UR)-École des Hautes Études en Santé Publique (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS); Université de Rennes (UR); École des Hautes Études en Santé Publique (EHESP); Arènes: politique, santé publique, environnement, médias (ARENES); Université de Rennes (UR)-Institut d'Études Politiques IEP - Rennes-École des Hautes Études en Santé Publique (EHESP)-Université de Rennes 2 (UR2)-Centre National de la Recherche Scientifique (CNRS); Département Méthodes quantitatives en santé publique (METIS); Hospices Civils de Lyon (HCL); Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL); Université Claude Bernard Lyon 1 (UCBL); Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM); Université Jean Monnet (EPSCPE) (UJM EPE)-Université Jean Monnet (EPSCPE) (UJM EPE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS); Observatoire Français de la Sclérose En Plaques Lyon (OFSEP); Univerzita Karlova Praha, Česká republika = Charles University Prague, Czech Republic = Université Charles Prague, Republique tchèque (UK); 1. lékařská fakulta, Univerzita Karlova Praha, Česká republika = First Faculty of Medicine, Charles University Prague, Czech Republic (1. LF UK / 1st Faculty of Medicine); Service de neurologie CHRU Nancy; Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy); Adaptation, mesure et évaluation en santé. Approches interdisciplinaires (APEMAC); Université de Lorraine (UL); G.F. Ingrassia Hospital; Università degli studi di Catania = University of Catania (Unict); Service de Neurologie Strasbourg; Centre Hospitalier Universitaire Strasbourg (CHU Strasbourg); Hôpitaux Universitaires de Strasbourg (HUS)-Hôpitaux Universitaires de Strasbourg (HUS)-Nouvel Hôpital Civil de Strasbourg; Hôpitaux Universitaires de Strasbourg (HUS); CIC Strasbourg (Centre d’Investigation Clinique Plurithématique (CIC - P)); Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Nouvel Hôpital Civil de Strasbourg; Hôpitaux Universitaires de Strasbourg (HUS)-Hôpitaux Universitaires de Strasbourg (HUS)-Hôpital de Hautepierre Strasbourg; Hospital Universitario Virgen Macarena Séville (HUVM); Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Pontchaillou; Centre Hospitalier de l'Université de Montréal (CHUM); Université de Montréal (UdeM); Dokuz Eylül Üniversitesi = Dokuz Eylül University Izmir (DEÜ); Centre Hospitalier Régional Universitaire CHU Lille (CHRU Lille); Centre de Ressources et de Compétences sur la Sclérose en Plaques (CRC-SEP) Lille (CRC-SEP Nord-Pas de Calais); Université de Lille; Département Neurologie CHU Toulouse; Pôle Neurosciences CHU Toulouse; Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse); CHU Pitié-Salpêtrière AP-HP; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU); Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon); NEUROFARBA Department Firenze, Italy; Università degli Studi di Firenze = University of Florence = Université de Florence (UniFI); Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier); Université de Montpellier (UM); Al-Amiri Hospital; Box Hill Hospital; Monash University Melbourne; The Alfred Hospital; Ondokuz Mayis University (OMU); Centre Hospitalier Universitaire de Nantes = Nantes University Hospital (CHU Nantes); Service de Neurologie CHRU Besançon; Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon); Unité de Recherche Clinique Côte d’Azur (UR2CA); Centre Hospitalier Universitaire de Nice (CHU Nice)-Université Côte d'Azur (UniCA); Hôpital Pasteur Nice (CHU); Macerata Hospital = AST Macerata; Karadeniz Technical University (KTU); University of Newcastle Callaghan, Australia (UoN); John Hunter Hospital (JHH); Service Neurologie CHU Clermont-Ferrand; CHU Gabriel Montpied Clermont-Ferrand; CHU Clermont-Ferrand-CHU Clermont-Ferrand-Pôle Médecine interne, Neurologie, Neurochirurgie, Ophtalmologie CHU Clermont-Ferrand (MNDO); CHU Clermont-Ferrand-CHU Clermont-Ferrand; Neuro-Dol (Neuro-Dol); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne (UCA); Sorbonne Université (SU); CHU Saint-Antoine AP-HP; University Hospital Basel Basel; Université de Bâle = University of Basel = Basel Universität (Unibas); Hôpital de la Timone CHU - APHM (TIMONE); Aix Marseille Université (AMU); دانشگاه علوم پزشکی اصفهان - Isfahan University of Medical Sciences Isfahan, Iran (IUMS); Nehme and Therese Tohme Multiple Sclerosis Center Beyrouth, Liban (AUBMC); American University of Beirut Medical Center Beyrouth, Liban (AUBMC); American University of Beirut (AUB)-American University of Beirut (AUB); Zuyderland MC; San Giuseppe Moscati Hospital Avellino, Italie; Cliniques Universitaires Saint-Luc Bruxelles; Université Catholique de Louvain = Catholic University of Louvain (UCLouvain); Fondation Ophtalmologique Adolphe de Rothschild Paris; Haydarpasa Numune Training and Research Hospital; Centre hospitalier intercommunal de Poissy/Saint-Germain-en-Laye - CHIPS Poissy; Service de Neurologie CHU Nimes (Pôle NIRR); Hôpital Universitaire Carémeau Nîmes (CHU Nîmes); Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes); Institut de Génomique Fonctionnelle (IGF); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS); Hôpital neurologique et neurochirurgical Pierre Wertheimer CHU - HCL; European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS); Collaboration internationale |
| Source: |
37th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS 2021); https://univ-rennes.hal.science/hal-04772073; 37th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS 2021), Oct 2021, Virtuel - Online, France. Sage, MULTIPLE SCLEROSIS JOURNAL, 27 (Suppl 2), pp.673-676, ePoster 878, 2021; https://journals.sagepub.com/doi/epdf/10.1177/13524585211044667 |
| Publisher Information: |
CCSD; Sage |
| Publication Year: |
2021 |
| Collection: |
Université Jean Monnet – Saint-Etienne: HAL |
| Subject Terms: |
Disease reactivation; Multiple Sclerosis; [SDV]Life Sciences [q-bio] |
| Subject Geographic: |
Virtuel - Online; France |
| Description: |
International audience ; Introduction: Multiple sclerosis (MS) treatment interruptions are common and leave patients vulnerable to breakthrough disease activity. The safe duration of the ‘switchover time’ for different therapies is not known.Aims: To evaluate the rate and predictors of return of disease activity after cessation of disease-modifying therapy.Methods: Retrospective cohort study from two large observational MS registries: MSBase and OFSEP. Patients with relapsing-remitting MS who had ceased a disease-modifying therapy and were followed up for the subsequent 12-months were included in the analysis. The primary study outcome was annualised relapse rate in the 12 months after disease-modifying therapy discontinuation stratified by patients who did, and did not, commence a subsequent therapy. The secondary endpoint was the predictors of first relapse and disability accumulation after treatment discontinuation.Results: 18 029 eligible treatment discontinuation epochs were identified for seven therapies. Rates of relapse started to increase 2 months after natalizumab cessation. Commencement of a subsequent therapy within 2-4 months reduced the magnitude of disease reactivation. After discontinuation of fingolimod, rates of relapse increased overall, and stabilised faster in patients who started a new therapy within 1-2 months. Magnitude of disease reactivation for other therapies was low, but reduced further by commencement of another treatment 1-10 months after treatment discontinuation. Predictors of relapse were higher relapse rate in the year before cessation, female sex, younger age and higher EDSS. Commencement of a subsequent therapy reduced both the risk of relapse (HR 0.76, CI 0.72-0.81) and disability accumulation (0.73, 0.65-0.80).Conclusions: Understanding the rate of disease reactivation after discontinuing different MS immunotherapies will help guide optimal wash-out times for therapeutic agents during treatment sequencing. To minimise the risk of disease reactivation, treatment wash-out ... |
| Document Type: |
conference object; still image |
| Language: |
English |
| Availability: |
https://univ-rennes.hal.science/hal-04772073 |
| Accession Number: |
edsbas.785EB50B |
| Database: |
BASE |