Prognostic factors for disease activity in newly diagnosed teriflunomide-treated patients with multiple sclerosis: a nationwide Danish study

Mie Reith Mahler; Melinda Magyari; Luigi Pontieri; Frederik Elberling; Rolf Pringler Holm; Arkadiusz Weglewski; Mai Bang Poulsen; Lars Kristian Storr; Plamen Anzhelov Bekyarov; Zsolt Illes; Matthias Kant; Tobias Sejbaek; Morten Leif Stilund; Peter V. Rasmussen; Maria Brask; Inga Urbonaviciute; Finn Sellebjerg

doi:10.1136/jnnp-2023-333265

Prognostic factors for disease activity in newly diagnosed teriflunomide-treated patients with multiple sclerosis: a nationwide Danish study

Mie Reith Mahler^*, Melinda Magyari, Luigi Pontieri, Frederik Elberling, Rolf Pringler Holm, Arkadiusz Weglewski, Mai Bang Poulsen, Lars Kristian Storr, Plamen Anzhelov Bekyarov, Zsolt Illes, Matthias Kant, Tobias Sejbaek, Morten Leif Stilund, Peter V. Rasmussen, Maria Brask, Inga Urbonaviciute, Finn Sellebjerg

^*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

Abstract

Background Clinicians frequently rely on relapse counts, T2 MRI lesion load (T2L) and Expanded Disability Status Scale (EDSS) scores to guide treatment decisions for individuals diagnosed with multiple sclerosis (MS). This study evaluates how these factors, along with age and sex, influence prognosis during treatment with teriflunomide (TFL). Methods We conducted a nationwide cohort study using data from the Danish Multiple Sclerosis Registry. Eligible participants had relapsing-remitting MS or clinically isolated syndrome and initiated TFL as their first treatment between 2013 and 2019. The effect of age, pretreatment relapses, T2L and EDSS scores on the risk of disease activity on TFL were stratified by sex. Results In total, 784 individuals were included (57.4% females). A high number of pretreatment relapses (≥2) was associated with an increased risk of disease activity in females only (OR and (95% CI): 1.76 (1.11 to 2.81)). Age group 50+ was associated with a lower risk of disease activity in both sexes (OR females=0.28 (0.14 to 0.56); OR males=0.22 (0.09 to 0.55)), while age 35-49 showed a different impact in males and females (OR females=0.79 (0.50 to 1.23); OR males=0.42 (0.24 to 0.72)). EDSS scores and T2L did not show any consistent associations. Conclusion A high number of pretreatment relapses was only associated with an increased risk of disease activity in females, while age had a differential impact on the risk of disease activity according to sex. Clinicians may consider age, sex and relapses when deciding on TFL treatment.

Originalsprog	Engelsk
Tidsskrift	Journal of Neurology, Neurosurgery and Psychiatry
Vol/bind	95
Nummer	10
Sider (fra-til)	979-987
Antal sider	9
ISSN	0022-3050
DOI	https://doi.org/10.1136/jnnp-2023-333265
Status	Udgivet - 17 sep. 2024

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Mahler, M. R., Magyari, M., Pontieri, L., Elberling, F., Holm, R. P., Weglewski, A., Poulsen, M. B., Storr, L. K., Bekyarov, P. A., Illes, Z., Kant, M., Sejbaek, T., Stilund, M. L., Rasmussen, P. V., Brask, M., Urbonaviciute, I., & Sellebjerg, F. (2024). Prognostic factors for disease activity in newly diagnosed teriflunomide-treated patients with multiple sclerosis: a nationwide Danish study. Journal of Neurology, Neurosurgery and Psychiatry, 95(10), 979-987. https://doi.org/10.1136/jnnp-2023-333265

@article{76064433784c4d0099a1a077fadd8e63,

title = "Prognostic factors for disease activity in newly diagnosed teriflunomide-treated patients with multiple sclerosis: a nationwide Danish study",

abstract = "Background Clinicians frequently rely on relapse counts, T2 MRI lesion load (T2L) and Expanded Disability Status Scale (EDSS) scores to guide treatment decisions for individuals diagnosed with multiple sclerosis (MS). This study evaluates how these factors, along with age and sex, influence prognosis during treatment with teriflunomide (TFL). Methods We conducted a nationwide cohort study using data from the Danish Multiple Sclerosis Registry. Eligible participants had relapsing-remitting MS or clinically isolated syndrome and initiated TFL as their first treatment between 2013 and 2019. The effect of age, pretreatment relapses, T2L and EDSS scores on the risk of disease activity on TFL were stratified by sex. Results In total, 784 individuals were included (57.4% females). A high number of pretreatment relapses (≥2) was associated with an increased risk of disease activity in females only (OR and (95% CI): 1.76 (1.11 to 2.81)). Age group 50+ was associated with a lower risk of disease activity in both sexes (OR females=0.28 (0.14 to 0.56); OR males=0.22 (0.09 to 0.55)), while age 35-49 showed a different impact in males and females (OR females=0.79 (0.50 to 1.23); OR males=0.42 (0.24 to 0.72)). EDSS scores and T2L did not show any consistent associations. Conclusion A high number of pretreatment relapses was only associated with an increased risk of disease activity in females, while age had a differential impact on the risk of disease activity according to sex. Clinicians may consider age, sex and relapses when deciding on TFL treatment.",

author = "Mahler, {Mie Reith} and Melinda Magyari and Luigi Pontieri and Frederik Elberling and Holm, {Rolf Pringler} and Arkadiusz Weglewski and Poulsen, {Mai Bang} and Storr, {Lars Kristian} and Bekyarov, {Plamen Anzhelov} and Zsolt Illes and Matthias Kant and Tobias Sejbaek and Stilund, {Morten Leif} and Rasmussen, {Peter V.} and Maria Brask and Inga Urbonaviciute and Finn Sellebjerg",

note = "Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.",

year = "2024",

month = sep,

day = "17",

doi = "10.1136/jnnp-2023-333265",

language = "English",

volume = "95",

pages = "979--987",

journal = "Journal of Neurology, Neurosurgery and Psychiatry",

issn = "0022-3050",

publisher = "BMJ Publishing Group",

number = "10",

}

Mahler, MR, Magyari, M, Pontieri, L, Elberling, F, Holm, RP, Weglewski, A, Poulsen, MB, Storr, LK, Bekyarov, PA, Illes, Z, Kant, M, Sejbaek, T, Stilund, ML , Rasmussen, PV, Brask, M, Urbonaviciute, I & Sellebjerg, F 2024, 'Prognostic factors for disease activity in newly diagnosed teriflunomide-treated patients with multiple sclerosis: a nationwide Danish study', Journal of Neurology, Neurosurgery and Psychiatry, bind 95, nr. 10, s. 979-987. https://doi.org/10.1136/jnnp-2023-333265

Prognostic factors for disease activity in newly diagnosed teriflunomide-treated patients with multiple sclerosis: a nationwide Danish study. / Mahler, Mie Reith; Magyari, Melinda; Pontieri, Luigi et al.
I: Journal of Neurology, Neurosurgery and Psychiatry, Bind 95, Nr. 10, 17.09.2024, s. 979-987.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

TY - JOUR

T1 - Prognostic factors for disease activity in newly diagnosed teriflunomide-treated patients with multiple sclerosis

T2 - a nationwide Danish study

AU - Mahler, Mie Reith

AU - Magyari, Melinda

AU - Pontieri, Luigi

AU - Elberling, Frederik

AU - Holm, Rolf Pringler

AU - Weglewski, Arkadiusz

AU - Poulsen, Mai Bang

AU - Storr, Lars Kristian

AU - Bekyarov, Plamen Anzhelov

AU - Illes, Zsolt

AU - Kant, Matthias

AU - Sejbaek, Tobias

AU - Stilund, Morten Leif

AU - Rasmussen, Peter V.

AU - Brask, Maria

AU - Urbonaviciute, Inga

AU - Sellebjerg, Finn

PY - 2024/9/17

Y1 - 2024/9/17

N2 - Background Clinicians frequently rely on relapse counts, T2 MRI lesion load (T2L) and Expanded Disability Status Scale (EDSS) scores to guide treatment decisions for individuals diagnosed with multiple sclerosis (MS). This study evaluates how these factors, along with age and sex, influence prognosis during treatment with teriflunomide (TFL). Methods We conducted a nationwide cohort study using data from the Danish Multiple Sclerosis Registry. Eligible participants had relapsing-remitting MS or clinically isolated syndrome and initiated TFL as their first treatment between 2013 and 2019. The effect of age, pretreatment relapses, T2L and EDSS scores on the risk of disease activity on TFL were stratified by sex. Results In total, 784 individuals were included (57.4% females). A high number of pretreatment relapses (≥2) was associated with an increased risk of disease activity in females only (OR and (95% CI): 1.76 (1.11 to 2.81)). Age group 50+ was associated with a lower risk of disease activity in both sexes (OR females=0.28 (0.14 to 0.56); OR males=0.22 (0.09 to 0.55)), while age 35-49 showed a different impact in males and females (OR females=0.79 (0.50 to 1.23); OR males=0.42 (0.24 to 0.72)). EDSS scores and T2L did not show any consistent associations. Conclusion A high number of pretreatment relapses was only associated with an increased risk of disease activity in females, while age had a differential impact on the risk of disease activity according to sex. Clinicians may consider age, sex and relapses when deciding on TFL treatment.

AB - Background Clinicians frequently rely on relapse counts, T2 MRI lesion load (T2L) and Expanded Disability Status Scale (EDSS) scores to guide treatment decisions for individuals diagnosed with multiple sclerosis (MS). This study evaluates how these factors, along with age and sex, influence prognosis during treatment with teriflunomide (TFL). Methods We conducted a nationwide cohort study using data from the Danish Multiple Sclerosis Registry. Eligible participants had relapsing-remitting MS or clinically isolated syndrome and initiated TFL as their first treatment between 2013 and 2019. The effect of age, pretreatment relapses, T2L and EDSS scores on the risk of disease activity on TFL were stratified by sex. Results In total, 784 individuals were included (57.4% females). A high number of pretreatment relapses (≥2) was associated with an increased risk of disease activity in females only (OR and (95% CI): 1.76 (1.11 to 2.81)). Age group 50+ was associated with a lower risk of disease activity in both sexes (OR females=0.28 (0.14 to 0.56); OR males=0.22 (0.09 to 0.55)), while age 35-49 showed a different impact in males and females (OR females=0.79 (0.50 to 1.23); OR males=0.42 (0.24 to 0.72)). EDSS scores and T2L did not show any consistent associations. Conclusion A high number of pretreatment relapses was only associated with an increased risk of disease activity in females, while age had a differential impact on the risk of disease activity according to sex. Clinicians may consider age, sex and relapses when deciding on TFL treatment.

UR - http://www.scopus.com/inward/record.url?scp=85190132357&partnerID=8YFLogxK

U2 - 10.1136/jnnp-2023-333265

DO - 10.1136/jnnp-2023-333265

M3 - Journal article

C2 - 38569873

AN - SCOPUS:85190132357

SN - 0022-3050

VL - 95

SP - 979

EP - 987

JO - Journal of Neurology, Neurosurgery and Psychiatry

JF - Journal of Neurology, Neurosurgery and Psychiatry

IS - 10

ER -

Prognostic factors for disease activity in newly diagnosed teriflunomide-treated patients with multiple sclerosis: a nationwide Danish study

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