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Anti-CD20 Therapies in Drug-Naive Patients With Primary Progressive Multiple Sclerosis

dc.rights.licenseopenen_US
dc.contributor.authorHAY, Marion
dc.contributor.authorROLLOT, Fabien
dc.contributor.authorCASEY, Romain
dc.contributor.authorKERBRAT, Anne
dc.contributor.authorEDAN, Gilles
dc.contributor.authorMATHEY, Guillaume
dc.contributor.authorLABAUGE, Pierre
dc.contributor.authorDE SÈZE, Jérôme
dc.contributor.authorVUKUSIC, Sandra
dc.contributor.authorLAPLAUD, David-Axel
dc.contributor.authorPAPEIX, Caroline
dc.contributor.authorMOREAU, Thibault
dc.contributor.authorTHOUVENOT, Eric
dc.contributor.authorDEFER, Gilles
dc.contributor.authorLEBRUN-FRÉNAY, Christine
dc.contributor.authorCIRON, Jonathan
dc.contributor.authorBERGER, Eric
dc.contributor.authorSTANKOFF, Bruno
dc.contributor.authorCLAVELOU, Pierre
dc.contributor.authorMAILLART, Elisabeth
dc.contributor.authorHEINZLEF, Olivier
dc.contributor.authorZÉPHIR, Hélène
hal.structure.identifierNeurocentre Magendie : Physiopathologie de la Plasticité Neuronale [U1215 Inserm - UB]
dc.contributor.authorRUET, Aurélie
dc.contributor.authorCASEZ, Olivier
dc.contributor.authorMOULIN, Solène
dc.contributor.authorAL-KHEDR, Abdullatif
dc.contributor.authorBOURRE, Bertrand
dc.contributor.authorPELLETIER, Jean
dc.contributor.authorMAGY, Laurent
dc.contributor.authorNEAU, Jean-Philippe
dc.contributor.authorCAMDESSANCHÉ, Jean-Philippe
dc.contributor.authorDOGHRI, Inès
dc.contributor.authorWAHAB, Abir
dc.contributor.authorTCHIKVILADZÉ, Maia
dc.contributor.authorLABEYRIE, Céline
dc.contributor.authorHANKIEWICZ, Karolina
dc.contributor.authorLE PAGE, Emmanuelle
dc.contributor.authorMICHEL, Laure
dc.date.accessioned2024-10-15T16:16:25Z
dc.date.available2024-10-15T16:16:25Z
dc.date.issued2024-10-22
dc.identifier.issn0028-3878en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/202512
dc.description.abstractEnBackground and objectives: Although rituximab failed to demonstrate a significant effect on disability progression in primary progressive multiple sclerosis (PPMS), ocrelizumab succeeded. Our main objective was to analyze confirmed disability progression (CDP) in a cohort of patients with PPMS treated with anti-CD20 therapies compared with a weighted untreated control cohort.Methods: This was a retrospective study using data from the French MS registry (Observatoire Français de la Sclérose En Plaques). We included patients with PPMS treated or never treated with anti-CD20 therapies from 2016 to 2021, with an Expanded Disability Status Scale score of ≤6.5 at baseline. The primary outcome was time to first CDP. The secondary outcomes were time to first relapse, MRI activity at 2 years, identification of risk factors associated with CDP, and serious infection incidence rates (IIRs). Each outcome was studied using an inverse probability of treatment weighting method. The outcomes were modeled using a weighted proportional Cox model for the time-to-event outcomes and by a logistic regression regarding the MRI activity.Results: A total of 1,184 patients (426 treated and 758 untreated) fulfilled the inclusion criteria. Median age (Q1-Q3) was 56 years (49.3-63.8), and 52.7% were female. Among treated patients, 295 received rituximab, whereas 131 received ocrelizumab. At baseline, anti-CD20-treated patients were younger (median 51.9 vs 58.6 years, Cohen d = 0.683) and had more active disease (54.5 vs 27.8%, Cohen d = 0.562). 91.6% were drug-naive at inclusion. In time to first CDP analysis, no statistical significance was observed (hazard ratio [HR], 1.13; 95% CI 0.93-1.36, p = 0.2113). In time to first relapse analysis, a nonsignificant trend toward fewer patients relapsing in the treated group was observed (HR 0.83; 95% CI 0.48-1.28, p = 0.0809). For MRI activity, no significant difference was found between the 2 groups. Risk factors associated with CDP in the treated group were male sex and MS duration. IIR was 6.67 (95% CI 3.12-14.25) per 100 person-years in the treated group vs 2.67 (95% CI 0.80-8.86) in the untreated group.Discussion: Time to first CDP was not different between anti-CD20 treated and untreated patients with PPMS. Although our study is retrospective and mainly included patients treated by rituximab, our results indicate that there should be a constant evaluation of all available data to ascertain the best risk/benefit ratio for patients with PPMS.Classification of evidence: This study provides Class III evidence that anti-CD20 therapy of previously untreated patients with PPMS was not superior to no therapy in delaying time to first CDP.
dc.language.isoENen_US
dc.title.enAnti-CD20 Therapies in Drug-Naive Patients With Primary Progressive Multiple Sclerosis
dc.title.alternativeNeurologyen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1212/WNL.0000000000209886en_US
dc.subject.halSciences du Vivant [q-bio]/Médecine humaine et pathologieen_US
dc.subject.halSciences cognitives/Neurosciencesen_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
bordeaux.journalNeurologyen_US
bordeaux.pagee209886en_US
bordeaux.volume103en_US
bordeaux.hal.laboratoriesNeurocentre Magendie - U1215en_US
bordeaux.issue8en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamRelations glie-neuroneen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
bordeaux.import.sourcehal
hal.identifierhal-04719826
hal.version1
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exportfalse
workflow.import.sourcehal
dc.rights.ccPas de Licence CCen_US
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