Abstract:
BACKGROUND:Severe relapses that required treatment were important outcomes in the sentinel trials of disease-modifying therapy (DMT). Identifying such relapses in administrative data would allow comparative-effectiveness studies of DMTs to be conducted in real-world clinical settings. METHODS:All relapsing-remitting (RRMS) and secondary-progressive (SPMS) patients living in Manitoba between 1999 and 2015 were identified using a validated case definition and linkage to the Manitoba MS Clinic database. All healthcare interactions potentially due to relapses were extracted from population-based administrative (hospital, physician claims and prescription) databases. These "relapse markers" included varying thresholds of outpatient prednisone scripts, day hospital or emergency room (ER) codes for intravenous (IV) methylprednisolone therapy, family physician, neurologist or ER physician billing codes and hospital admissions due to MS. Algorithms using combinations of these markers were compared with a reference standard of neurologist-defined relapses. The most useful algorithms were also examined on a biannual basis over the study period to assess for trends in the sensitivity of relapse detection. RESULTS:1131 participants with RRMS or SPMS were linked to administrative databases. Analysis of potential relapse markers over the whole 1999-2015 time period was limited by inconsistent coding of same day or ER admissions for IV methylprednisolone administration. Widespread adoption of high-dose oral outpatient prednisone for relapses since 2009 resulted in a progressive improvement in relapse marker sensitivity. The best algorithm consisted of oral prednisone prescriptions >50mg/day for 3-60 days and same day hospital or ER assessment codes with MS as the most responsible diagnosis (sensitivity 70%, specificity 100%, PPV 100%, NPV 96%, kappa 0.8 in 2013-2015). CONCLUSIONS:Severe relapses can be identified from administrative datasets with reasonable accuracy. The trend since 2009 toward outpatient relapse treatment will improve the sensitivity of relapse detection with longitudinal follow-up of this cohort and will allow comparison of severe relapse rates between different DMTs, supporting future comparative effectiveness studies.
journal_name
Mult Scler Relat Disordjournal_title
Multiple sclerosis and related disordersauthors
Marriott JJ,Chen H,Fransoo R,Marrie RAdoi
10.1016/j.msard.2017.11.022subject
Has Abstractpub_date
2018-01-01 00:00:00pages
134-139eissn
2211-0348issn
2211-0356pii
S2211-0348(17)30340-1journal_volume
19pub_type
杂志文章abstract:BACKGROUND:Disease-modifying therapy (DMT) for patients with relapsing-remitting multiple sclerosis (RRMS) have been shown to reduce relapses and new MRI lesions. However, few studies have assessed the impact of discontinuing DMT after a period of disease inactivity. OBJECTIVE:To investigate the impact of DMT disconti...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.07.021
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Multiple Sclerosis (MS) is a degenerative disease of central nervous system caused by an immune response against the myelin. About half of MS patients suffers from sleep disturbances. The circadian clock genes such as PER3 controls circadian rhythm and sleep. Due to the role of PER3 in sleep disturbances and...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2017.07.005
更新日期:2017-10-01 00:00:00
abstract::Multiple Sclerosis is a chronic, progressive and debilitating neurological disease which, despite extensive study for over 100 years, remains of enigmatic aetiology. Drawn from the epidemiological evidence, there exists a consensus that there are environmental (possibly infectious) factors that contribute to disease p...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2018.06.014
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Multiple sclerosis (MS) is the most common chronic inflammatory demyelinating disease of the central nervous system (CNS), and whether herpes simplex virus (HSV) infection is associated with the development of MS remains controversial. We aimed to investigate potential associations between MS or clinically i...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2020.102633
更新日期:2020-11-19 00:00:00
abstract::Thrombotic microangiopathy (TMA) is a rare but increasingly recognized complication of interferon-beta therapy, which can be associated with serious sequelae. We report on a 53-year-old woman with a longstanding history of relapsing-remitting multiple sclerosis, who developed TMA after 15 years of high-dose treatment ...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2016.09.002
更新日期:2016-11-01 00:00:00
abstract:INTRODUCTION:Italy has been the first European country severely affected by the COVID-19 pandemic. OBJECTIVE:To analyze the incidence of the clinical presentations suggestive for COVID-19 infection among patients with Multiple Sclerosis in the province of Lecco, in the North Italy, the closest province capital to Berg...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2020.102453
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Whilst there is a broad selection of drugs licensed as disease modifying treatments (DMTs) for people with relapsing multiple sclerosis (pwRMS), access to DMTs remains restricted, particularly for people with progressive MS (pwPMS). Cladribine has shown efficacy at all stages of MS. Following withdrawal from...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2018.11.001
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Multiple sclerosis (MS) is an inflammatory autoimmune neurologic disease that causes progressive destruction of myelin sheath and axons. Affecting more than 2 million people worldwide, MS may presents distinct clinical courses. However, information regarding key gene expression and genic pathways related to ...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2020.102243
更新日期:2020-09-01 00:00:00
abstract::We present a 26 year old Pakistani lady with first presentation of a demyelinating event, presenting as Parinaud's syndrome. The video demonstrates a convergence-retraction nystagmus on upgaze and failure of accommodation, and her brain imaging confirms a corresponding pre-tectal contrast enhancing T2 hyperintense les...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2013.09.003
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Numerous factors can affect multiple sclerosis (MS) patients' quality of life (QoL). We investigated how physical impairment, upper extremity function, cognitive impairment, cognitive reserve, symptoms of psychological distress, depression, fatigue as well as age and disease duration contribute to patient-re...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.01.049
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Considering the multiple treatments approved for multiple sclerosis (MS) by the Food and Drug Administration (FDA) and European Medicines Agency (EMA), determining a treatment strategy for patients with clinically isolated syndrome (CIS) and relapsing-remitting MS (RRMS) can be challenging. To date, an overv...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章,评审
doi:10.1016/j.msard.2020.101929
更新日期:2020-01-02 00:00:00
abstract:BACKGROUND:Research on Virtual Reality (VR) based motor rehabilitation for people with multiple sclerosis (MS) is rapidly growing in popularity, although few studies have focused on the upper limb (UL). The aims of this review were to investigate the effect of VR interventions on UL function in people with MS and deter...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章,评审
doi:10.1016/j.msard.2020.102610
更新日期:2020-10-31 00:00:00
abstract:BACKGROUND:Functional electrical stimulation (FES) is commonly used to ameliorate gait deficits in patients with multiple sclerosis (PwMS). This review critically evaluates the literature describing the orthotic and therapeutic effects of FES on gait in PwMS. METHODS:The PubMed, CINAHL, and ProQuest databases were sea...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章,评审
doi:10.1016/j.msard.2017.01.010
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Multiple Sclerosis (MS) specialists routinely evaluate misdiagnosed patients, or patients incorrectly assigned a diagnosis of MS. Misdiagnosis has significant implications for patient morbidity and healthcare costs, yet its contemporary incidence is unknown. We examined the incidence of MS misdiagnosis in ne...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.01.048
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:Review cases of positive neurologic phenomena initiated or worsened with dalfampridine in patients with multiple sclerosis. BACKGROUND:Oral, extended release dalfampridine (4-aminopyridine or 4-AP) is a potassium-channel blocker approved for the treatment of gait impairment in multiple sclerosis (MS). The en...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2013.05.003
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Few data exists on paediatric neuromyelitis optica spectrum disorder (NMOSD). Here, we investigated the clinical presentation, treatment responses and long-term prognoses in a large cohort of patients with NMOSD and compared between children and adults with aquaporin-4 antibody (AQP4-IgG). METHODS:A retrosp...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章,多中心研究
doi:10.1016/j.msard.2018.12.038
更新日期:2019-02-01 00:00:00
abstract:INTRODUCTION:All people with progressive MS in the United Kingdom should have access to physiotherapy through the National Health Service (NHS). However levels of access and delivery are unknown. Furthermore there is no research on perceived efficacy of physiotherapy or the use of complementary and alternative medicine...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2017.01.002
更新日期:2017-02-01 00:00:00
abstract::Neoplasms and reactivation of latent viruses have been observed in individuals taking fingolimod. Merkel cell carcinoma (MCC), a rare neuroendocrine skin cancer, is associated with immunosuppression and can be triggered by the oncogenic Merkel cell polyoma virus (MCPyV). We report a case of a 61-year-old man with mult...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2017.06.004
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:MS imposes a significant burden on patients, caregivers, employers, and the healthcare system. OBJECTIVE:To comprehensively evaluate the US MS burden using nationally representative data from the Medical Expenditure Panel Survey. METHODS:We identified non-institutionalized patients aged ≥18 with MS (ICD-9 ...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2013.09.004
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:A common and disruptive symptom of multiple sclerosis is difficulty in walking. Deficits in ankle proprioception and in plantarflexor muscle function may contribute to these mobility issues. In this study, ankle proprioceptive ability and plantarflexor performance of people with multiple sclerosis (PwMS) wer...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2020.102584
更新日期:2020-11-01 00:00:00
abstract::Multiple sclerosis (MS) is an inflammatory, demyelinating, neurodegenerative, immune-mediated disease primarily diagnosed in early adulthood. Multiple sclerosis mostly impacts women of reproductive potential, with pregnancy and birth outcomes being major concerns for many patients. While there is ample evidence that t...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章,评审
doi:10.1016/j.msard.2019.04.003
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Disturbances that occur in patients with multiple sclerosis (MS) are not restricted to motor, sensory, or urinary functions; they also include cognitive dysfunction, fatigue, and depression. Moreover, people with MS are known to have fewer social activities and a reduced quality of life. One aspect of social...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2014.02.001
更新日期:2014-07-01 00:00:00
abstract:UNLABELLED:Both female and male persons with MS are at increased risk for various forms of physical, sexual, and disability-specific abuse. An ongoing study revealed a subset of respondents in which the caregiver acknowledged mistreatment of the person with MS, but that person either denied or minimized mistreatment M...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2012.09.006
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:We characterize the variations in availability and affordability of NMO diagnostic testing and treatment by geographic region and country-level income group. METHODS:A structured survey was distributed in English, French, and Spanish in late 2018 to neurologists and other physicians who encounter NMO patien...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.05.013
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:In 2001, we conducted a survey on use of complementary and alternative medicine (CAM) in people with multiple sclerosis (pwMS) in Oregon and Southwest Washington to treat their disease. OBJECTIVES, METHODS:In 2018, we administered a revised survey in the same region to describe updated patterns of CAM use i...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2020.102041
更新日期:2020-06-01 00:00:00
abstract::The identification of AQP4-IgG, a specific and pathogenic antibody of NMO/SD has led to a broadening of the clinical spectrum of manifestations of NMO/SD including the presence of encephalic symptoms. Lesions are often distributed on peri‑ependymal area and sometimes affected the diencephalon leading to sleep disorder...
journal_title:Multiple sclerosis and related disorders
pub_type:
doi:10.1016/j.msard.2019.101869
更新日期:2020-02-01 00:00:00
abstract:INTRODUCTION:Interferon-beta (IFNβ) is currently the most used disease-modifying treatment for relapsing-remitting multiple sclerosis (RRMS), but it can lead to the production of neutralising antibodies (NABs) against IFNβ. CLINICAL CASE:A lady with a past history of genital herpes was diagnosed with RRMS, started IFN...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2014.11.007
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:The acute, fulminant type of Multiple Sclerosis (MS), known as Marburg Disease, has been shown to have poor response to conventional acute treatments typically used for demyelinating diseases. METHODS:We report a 20 y/o postpartum female who was consulted to the Neurology service given findings of subacute ...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.03.014
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Neuromyelitis optica spectrum disorders (NMOSD) typically lead to spastic paraparesis and spare the peripheral nervous system (PNS). CASE REPORT:Here, we describe an anti-aquaporin-4-seropositive NMOSD patient suffering from acute transverse myelitis with painful, flaccid paralysis and incontinence of urine...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2018.07.032
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Pain can interfere with the daily functioning of persons with multiple sclerosis (PwMS). Furthermore, beliefs about pain and activity engagement are reliably associated with persons' experience of chronic pain. This study aimed to explore the extent to which different aspects of PwMS' activity engagement is ...
journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2019.101882
更新日期:2020-02-01 00:00:00