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agate Site Admin
Joined: 17 May 2006 Posts: 5694 Location: Oregon
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Posted: Thu Apr 04, 2013 6:30 pm Post subject: (AAN) Predictors of treatment failure in 1st-line DMDs |
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Presented at the AAN conference in San Diego, March 16-23, 2013:
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P01.196] Clinical Predictors of Treatment Failure in First-Line Immunomodulatory Therapy in Multiple Sclerosis
Robert Carruthers, Boston, MA, Muhammad Taimur A. Malik, Brookline, MA, Brian Healy, Brookline, MA, Taha Gholipour, Brookline, MA, Howard Weiner, Boston, MA, Tanuja Chitnis, Brookline, MA
OBJECTIVE:
To find clinical predictors of non-response to first-line therapies in MS.
BACKGROUND:
The highly variable natural history of multiple sclerosis creates a need to identify patients who are unlikely to benefit from the three formulations of interferon-b (IFN-ß 1a SC, IFN-ß 1a IM, IFN-ß 1b) and glatiramer acetate (GA). Presently, there are no reliable clinical biomarkers that predict non-response to first-line medications from disease outset.
DESIGN/METHODS:
Patients enrolled in the CLIMB study were included for analysis if they took a first-line medication for more than two years. For each patient, the clinical, radiological and attack histories in our Oracle database were validated using a clinical chart review.
The primary outcome measure for this study was the time to the first clinical or radiological event. Clinical events were defined as either a new relapse or sustained progression on EDSS. MRI events were defined as the appearance of either T2 or gadolinium-enhancing lesions based on the radiologist's finalized report.
With a separate analysis for each medicine, the impact of several clinical descriptors on the time to event (gender, race, age, disease duration, age at onset, initial motor symptoms, EDSS at most recent visit) was assessed using Cox proportional hazards regression model.
RESULTS:
The final sample consisted of 48 IFN-ß 1a SC, 27 IFN-ß 1b, 89 IFN-ß 1a IM, and 96 GA treated patients. Median time to first event for each of the groups was between 1.1 and 2.3 years. Younger age at treatment initiation and younger age at onset were significantly associated with an increased hazard of an event for IFN-ß 1a SC treated patients. None of the other predictors were associated with an increased hazard of an event for other treatment groups.
CONCLUSIONS:
Clinical predictors provide limited information regarding the hazard of an event in patients treated with injectable first-line MS treatments.
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Supported by: In part by an investigator–initiated grant to the Partners MS Center (CLIMB STUDY) from Merck-Serono and a NMSS research grant to TC.
Category - MS and Related Diseases: Clinical Science
Session P01: Multiple Sclerosis: MS Treatments |
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