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Lack of magnetic resonance imaging lesion activity as a treatment target in multiple sclerosis: An evaluation using electronically collected outcomes.

Abstract：

BACKGROUND:The appropriate treatment target in multiple sclerosis (MS) is unclear. Lack of magnetic resonance imaging (MRI) lesion activity, a component of the no evidence of disease activity concept, has been proposed as a treatment target in MS. We used our MS database to investigate whether aggressively pursuing MRI stability by changing disease modifying therapy (DMT) when MRI activity is observed leads to better clinical and imaging outcomes. METHODS:The Knowledge Program (KP) is a database linked to our electronic medical record allowing capture of patient and clinician reported outcomes. Through KP query and chart review, we identified all relapsing-remitting MS patients visiting between 1 January 2008 and 31 December 2014 with active MRIs despite DMT. Propensity modeling based on demographic and disease characteristics was used to match DMT switchers to non-switchers. KP and MRI outcomes were compared 18 months after the active MRI using mixed-effects linear regression models. RESULTS:We identified 417 patients who met criteria for our analysis. After propensity matching, 78 switchers and 91 non-switchers were analyzed. There was no difference in clinical or radiologic outcomes between these groups at 18 months. CONCLUSIONS:We did not find a short-term benefit of changing DMT to pursue MRI stability.

journal_name

Mult Scler Relat Disord

journal_title

Multiple sclerosis and related disorders

authors

Conway DS,Thompson NR,Cohen JA

doi

10.1016/j.msard.2016.07.017

subject

Has Abstract

pub_date

2016-09-01 00:00:00

pages

129-34

eissn

2211-0348

issn

2211-0356

pii

S2211-0348(16)30126-2

journal_volume

9

pub_type

杂志文章

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