| Title: |
Comparing ocrelizumab to interferon/glatiramer acetate in people with multiple sclerosis over age 60 |
| Authors: |
Foong, Yi Chao; Merlo, Daniel; Gresle, Melissa; Buzzard, Katherine; Zhong, Michael; Yeh, Wei Zhen; Jokubaitis, Vilija; Monif, Mastura; Skibina, Olga; Ozakbas,, Serkan; Patti, Francesco; Grammond, Pierre; Amato, Maria Pia; Kalincik, Tomas; Horakova, Dana; Kubala Havrdova, Eva; Weinstock-Guttman, Bianca; Lechner Scott, Jeanette; Boz, Cavit; Sa, Maria Jose; Butzkueven, Helmut; van der Walt, Anneke; Zhu, Chao; on behalf of MSBASE study group; Ozakbas, Serkan; Havrdova, Eva Kubala; Lechner-Scott, Jeannette; Walt, Anneke vander |
| Publisher Information: |
BMJ Publishing Group Ltd |
| Publication Year: |
2024 |
| Collection: |
HighWire Press (Stanford University) |
| Subject Terms: |
Multiple sclerosis |
| Description: |
Background Ongoing controversy exists regarding optimal management of disease modifying therapy (DMT) in older people with multiple sclerosis (pwMS). There is concern that the lower relapse rate, combined with a higher risk of DMT-related infections and side effects, may alter the risk-benefit balance in older pwMS. Given the lack of pwMS above age 60 in randomised controlled trials, the comparative efficacy of high-efficacy DMTs such as ocrelizumab has not been shown in older pwMS. We aimed to evaluate the comparative effectiveness of ocrelizumab, a high-efficacy DMT, versus interferon/glatiramer acetate (IFN/GA) in pwMS over the age of 60. Methods Using data from MSBase registry, this multicentre cohort study included pwMS above 60 who switched to or started on ocrelizumab or IFN/GA. We analysed relapse and disability outcomes after balancing covariates using an inverse probability treatment weighting (IPTW) method. Propensity scores were obtained based on age, country, disease duration, sex, baseline Expanded Disability Status Scale, prior relapses (all-time, 12 months and 24 months) and prior DMT exposure (overall number and high-efficacy DMTs). After weighting, all covariates were balanced. Primary outcomes were time to first relapse and annualised relapse rate (ARR). Secondary outcomes were 6-month confirmed disability progression (CDP) and confirmed disability improvement (CDI). Results A total of 248 participants received ocrelizumab, while 427 received IFN/GA. The IPTW-weighted ARR for ocrelizumab was 0.01 and 0.08 for IFN/GA. The IPTW-weighted ARR ratio was 0.15 (95% CI 0.06 to 0.33, p |
| Document Type: |
text |
| File Description: |
text/html |
| Language: |
English |
| Relation: |
http://jnnp.bmj.com/cgi/content/short/95/8/767; http://dx.doi.org/10.1136/jnnp-2023-332883 |
| DOI: |
10.1136/jnnp-2023-332883 |
| Availability: |
http://jnnp.bmj.com/cgi/content/short/95/8/767; https://doi.org/10.1136/jnnp-2023-332883 |
| Rights: |
Copyright (C) 2024, BMJ Publishing Group Ltd |
| Accession Number: |
edsbas.B4294B53 |
| Database: |
BASE |