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Article Dans Une Revue Multiple Sclerosis Journal Année : 2023

Improving the decision to switch from first to second-line therapy in multiple sclerosis: a dynamic scoring system

1 SPHERE - MethodS in Patients-centered outcomes and HEalth ResEarch
2 UCBL - Université Claude Bernard Lyon 1
3 CRNL - Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center
4 HCL - Hospices Civils de Lyon
5 REPERES - Recherche en Pharmaco-épidémiologie et Recours aux Soins
6 EHESP - École des Hautes Études en Santé Publique [EHESP]
7 APEMAC - Adaptation, mesure et évaluation en santé. Approches interdisciplinaires
8 Service de neurologie [CHRU Nancy]
9 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
10 Centre d’Investigation Clinique Plurithématique (CIC - P) - CIC Strasbourg
11 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
12 CHU Nantes - Centre Hospitalier Universitaire de Nantes
13 U1064 Inserm - CRTI - Centre de Recherche en Transplantation et Immunologie
14 UB - Université de Bordeaux
15 U1215 Inserm - UB - Neurocentre Magendie : Physiopathologie de la Plasticité Neuronale
16 CIC Bordeaux
17 TIMONE - Hôpital de la Timone [CHU - APHM]
18 LilNCog - Lille Neurosciences & Cognition - U 1172
19 CIC - Centre d'Investigation Clinique [Rennes]
20 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
21 MICMAC - Microenvironment, Cell Differentiation, Immunology and Cancer
22 CHU Nice [Cimiez]
23 CHU Clermont-Ferrand
24 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
25 IGF - Institut de Génomique Fonctionnelle
26 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
27 Hôpital universitaire Robert Debré [Reims]
28 ICM - Institut du Cerveau = Paris Brain Institute
29 CHU Saint-Antoine [AP-HP]
30 CHU Amiens-Picardie
31 CHU de la Martinique [Fort de France]
32 CHU Pitié-Salpêtrière [AP-HP]
33 Service de Neurologie [CHRU Besançon]
34 CHI Poissy-Saint-Germain
35 Centre Hospitalier de Saint-Denis [Ile-de-France]
36 CEP - Centre d'épidémiologie des populations
37 CHU Dijon
38 Fondation Ophtalmologique Adolphe de Rotschild
39 CHU Rouen
40 CHU Henri Mondor [Créteil]
41 CHU Montpellier
42 CHU Limoges
43 CHU Caen
44 Hôpital Bretonneau
45 CHU de Poitiers - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
46 HITH - U1176 Inserm - CHU Bicêtre - Hémostase, Inflammation, Thrombose
47 Centre Hospitalier Sud Francilien
48 CeRéMAIA - Hôpital André Mignot - Centre de Référence des Maladies Auto-Inflammatoires et des Amyloses [CH Versailles]
49 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
50 CIC 1402 - CIC Poitiers – Centre d'investigation clinique de Poitiers
X. Moisset
  • Fonction : Auteur
A. Al Khedr
  • Fonction : Auteur
B. Bourre
  • Fonction : Auteur
A. Montcuquet
  • Fonction : Auteur
G. Defer
  • Fonction : Auteur

Résumé

Background - In relapsing-remitting multiple sclerosis (RRMS), early identification of suboptimal responders can prevent disability progression. Objective - We aimed to develop and validate a dynamic score to guide the early decision to switch from first- to second-line therapy. Methods - Using time-dependent propensity scores (PS) from a French cohort of 12,823 patients with RRMS, we constructed one training and two validation PS-matched cohorts to compare the switched patients to second-line treatment and the maintained patients. We used a frailty Cox model for predicting individual hazard ratios (iHRs). Results - From the validation PS-matched cohort of 348 independent patients with iHR ⩽ 0.69, we reported the 5-year relapse-free survival at 0.14 (95% confidence interval (CI) 0.09-0.22) for the waiting group and 0.40 (95% CI 0.32-0.51) for the switched group. From the validation PS-matched cohort of 518 independent patients with iHR > 0.69, these values were 0.37 (95% CI 0.30-0.46) and 0.44 (95% CI 0.37-0.52), respectively. Conclusions - By using the proposed dynamic score, we estimated that at least one-third of patients could benefit from an earlier switch to prevent relapse.
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Dates et versions

hal-04221685 , version 1 (28-09-2023)

Identifiants

Citer

C. Sabathe, Romain Casey, S. Vukusic, Emmanuelle Leray, G. Mathey, et al.. Improving the decision to switch from first to second-line therapy in multiple sclerosis: a dynamic scoring system. Multiple Sclerosis Journal, 2023, 29 (2), pp.236-247. ⟨10.1177/13524585221139156⟩. ⟨hal-04221685⟩
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