Übergang SPMS (Therapien)

Boggy, Mittwoch, 27.11.2019, 15:37 (vor 1614 Tagen) @ carp27

hätte mal eine Frage ob es irgendwo belastbare Statistiken gibt, ob Therapien (Basistherapien und die verschiedenen Eskalationstherapien) den Übergang zur SPMS beeinflussen?
Oder haben Sie darauf eine nur sehr geringe Wirkung?

Ich habe dies gefunden; ist in Englisch, und ich kann eine Übersetzung jetzt nicht leisten. Sehr langer Artikel.

Association of Initial Disease-Modifying Therapy With Later Conversion to Secondary Progressive Multiple Sclerosis

J. William L. Brown, MRCP1,2,3; Alasdair Coles, PhD1; Dana Horakova, PhD4,5; et al
January 15, 2019
JAMA. 2019;321(2):175-187. doi:10.1001/jama.2018.20588

https://jamanetwork.com/journals/jama/fullarticle/2720726

Key Points

Question Among patients with relapsing-remitting multiple sclerosis (MS), what is the association between disease-modifying therapies (DMTs) and the risk of conversion to secondary progressive multiple sclerosis (MS)?

Findings In this cohort study involving 1555 patients with relapsing-remitting MS, initial treatment with fingolimod, natalizumab, or alemtuzumab was associated with a lower risk of conversion to secondary progressive MS compared with interferon beta or glatiramer acetate (hazard ratio, 0.66).

Meaning These findings, considered along with the risks associated with these therapies, may help inform decisions regarding disease-modifying treatment selection for patients with relapsing-remitting MS.

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Discussion

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These results suggest that initial treatment with glatiramer acetate or interferon beta is associated with reduced conversion to secondary progressive MS compared with untreated patients. There is no consensus in the literature.

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Limitations

This study has several limitations.
First, given its observational design, the study is unable to ascribe causality and cannot distinguish between prevention and delay of conversion to secondary progressive MS.
The longest comparison however showed a favorable association of early (vs later) glatiramer acetate or interferon beta, enduring to the end of follow-up 17 years after baseline (median disease duration 20 years; Figure 3, A).
Second, the absence of EDSS functional score subcomponents precluded using the secondary progressive MS definition with the highest combination of sensitivity, specificity and accuracy; (...)

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Gruß
Boggy

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