The Italian Multiple Sclerosis Database Network (MSDN): the risk of worsening according to IFNbeta exposure in multiple sclerosis.

Giovanni Savettieri, Aurora Fuiani, Damiano Paolicelli, Stecchi, Reggio, Maria Trojano, Ghezzi, Enrico Granieri, Capra, Bonavita, Gambi, Pozzilli, Paolo Livrea, Antonio Bertolotto, Marrosu, Montanari, Cosi, Durelli, Zorzon, Corrado MessinaGiulio Rosati, Aldo Quattrone, Maria Pia Amato, Giancarlo Comi, Comi, Mancardi, Elisabetta Di Monte, Meucci, Piazza, Rosati, Livrea, Pierluigi Russo, Savettieri, Gallo, Granieri

    Research output: Contribution to journalArticle

    26 Citations (Scopus)

    Abstract

    We evaluated the risk of worsening according to the length of exposure to interferon beta (IFNbeta) in a large cohort of 2090 multiple sclerosis patients collected by the Italian MS Database Network. Overall 44,140 patient-visits with a follow-up of 22,143 patient-years were evaluated. Forty-one per cent of patients were exposed to IFNbeta for up to 2 years, 39% for 2-4 years and 20% for more than 4 years. A Cox regression model was used to analyse two clinical outcomes: disability progression and worsening of relapse rate. The technique of propensity score was applied to reduce bias in the comparison of non-randomized groups. The risks of disability progression (HR =0.23; 95% CI: 0.17-0.30) and worsening of relapse rate (HR =0.19; 95% CI: 0.14-0.27) were reduced by about 4-5-fold in patients exposed to IFNbeta for more than four years, compared with patients exposed for up to two years. The propensity score technique confirmed the findings. The proportion of days covered by IFNbeta treatment was lower (P <0.0001) in patients exposed to IFNbeta for up to two years than in other groups. A clinical stabilization over two years of IFNbeta exposure may predict a subsequent good clinical response to treatment.
    Original languageEnglish
    Pages (from-to)578-585
    JournalMultiple Sclerosis
    Volume12
    Publication statusPublished - 2006

    Fingerprint

    Interferon-beta
    Multiple Sclerosis
    Databases
    Propensity Score
    Recurrence
    Proportional Hazards Models
    Therapeutics

    All Science Journal Classification (ASJC) codes

    • Neurology
    • Clinical Neurology

    Cite this

    The Italian Multiple Sclerosis Database Network (MSDN): the risk of worsening according to IFNbeta exposure in multiple sclerosis. / Savettieri, Giovanni; Fuiani, Aurora; Paolicelli, Damiano; Stecchi; Reggio; Trojano, Maria; Ghezzi; Granieri, Enrico; Capra; Bonavita; Gambi; Pozzilli; Livrea, Paolo; Bertolotto, Antonio; Marrosu; Montanari; Cosi; Durelli; Zorzon; Messina, Corrado; Rosati, Giulio; Quattrone, Aldo; Amato, Maria Pia; Comi, Giancarlo; Comi; Mancardi; Di Monte, Elisabetta; Meucci; Piazza; Rosati; Livrea; Russo, Pierluigi; Savettieri; Gallo; Granieri.

    In: Multiple Sclerosis, Vol. 12, 2006, p. 578-585.

    Research output: Contribution to journalArticle

    Savettieri, G, Fuiani, A, Paolicelli, D, Stecchi, Reggio, Trojano, M, Ghezzi, Granieri, E, Capra, Bonavita, Gambi, Pozzilli, Livrea, P, Bertolotto, A, Marrosu, Montanari, Cosi, Durelli, Zorzon, Messina, C, Rosati, G, Quattrone, A, Amato, MP, Comi, G, Comi, Mancardi, Di Monte, E, Meucci, Piazza, Rosati, Livrea, Russo, P, Savettieri, Gallo & Granieri 2006, 'The Italian Multiple Sclerosis Database Network (MSDN): the risk of worsening according to IFNbeta exposure in multiple sclerosis.', Multiple Sclerosis, vol. 12, pp. 578-585.
    Savettieri, Giovanni ; Fuiani, Aurora ; Paolicelli, Damiano ; Stecchi ; Reggio ; Trojano, Maria ; Ghezzi ; Granieri, Enrico ; Capra ; Bonavita ; Gambi ; Pozzilli ; Livrea, Paolo ; Bertolotto, Antonio ; Marrosu ; Montanari ; Cosi ; Durelli ; Zorzon ; Messina, Corrado ; Rosati, Giulio ; Quattrone, Aldo ; Amato, Maria Pia ; Comi, Giancarlo ; Comi ; Mancardi ; Di Monte, Elisabetta ; Meucci ; Piazza ; Rosati ; Livrea ; Russo, Pierluigi ; Savettieri ; Gallo ; Granieri. / The Italian Multiple Sclerosis Database Network (MSDN): the risk of worsening according to IFNbeta exposure in multiple sclerosis. In: Multiple Sclerosis. 2006 ; Vol. 12. pp. 578-585.
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    abstract = "We evaluated the risk of worsening according to the length of exposure to interferon beta (IFNbeta) in a large cohort of 2090 multiple sclerosis patients collected by the Italian MS Database Network. Overall 44,140 patient-visits with a follow-up of 22,143 patient-years were evaluated. Forty-one per cent of patients were exposed to IFNbeta for up to 2 years, 39{\%} for 2-4 years and 20{\%} for more than 4 years. A Cox regression model was used to analyse two clinical outcomes: disability progression and worsening of relapse rate. The technique of propensity score was applied to reduce bias in the comparison of non-randomized groups. The risks of disability progression (HR =0.23; 95{\%} CI: 0.17-0.30) and worsening of relapse rate (HR =0.19; 95{\%} CI: 0.14-0.27) were reduced by about 4-5-fold in patients exposed to IFNbeta for more than four years, compared with patients exposed for up to two years. The propensity score technique confirmed the findings. The proportion of days covered by IFNbeta treatment was lower (P <0.0001) in patients exposed to IFNbeta for up to two years than in other groups. A clinical stabilization over two years of IFNbeta exposure may predict a subsequent good clinical response to treatment.",
    author = "Giovanni Savettieri and Aurora Fuiani and Damiano Paolicelli and Stecchi and Reggio and Maria Trojano and Ghezzi and Enrico Granieri and Capra and Bonavita and Gambi and Pozzilli and Paolo Livrea and Antonio Bertolotto and Marrosu and Montanari and Cosi and Durelli and Zorzon and Corrado Messina and Giulio Rosati and Aldo Quattrone and Amato, {Maria Pia} and Giancarlo Comi and Comi and Mancardi and {Di Monte}, Elisabetta and Meucci and Piazza and Rosati and Livrea and Pierluigi Russo and Savettieri and Gallo and Granieri",
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    AU - Fuiani, Aurora

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    AU - Trojano, Maria

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    AU - Granieri, Enrico

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    AU - Bertolotto, Antonio

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    AU - Cosi, null

    AU - Durelli, null

    AU - Zorzon, null

    AU - Messina, Corrado

    AU - Rosati, Giulio

    AU - Quattrone, Aldo

    AU - Amato, Maria Pia

    AU - Comi, Giancarlo

    AU - Comi, null

    AU - Mancardi, null

    AU - Di Monte, Elisabetta

    AU - Meucci, null

    AU - Piazza, null

    AU - Rosati, null

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    AU - Russo, Pierluigi

    AU - Savettieri, null

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    AB - We evaluated the risk of worsening according to the length of exposure to interferon beta (IFNbeta) in a large cohort of 2090 multiple sclerosis patients collected by the Italian MS Database Network. Overall 44,140 patient-visits with a follow-up of 22,143 patient-years were evaluated. Forty-one per cent of patients were exposed to IFNbeta for up to 2 years, 39% for 2-4 years and 20% for more than 4 years. A Cox regression model was used to analyse two clinical outcomes: disability progression and worsening of relapse rate. The technique of propensity score was applied to reduce bias in the comparison of non-randomized groups. The risks of disability progression (HR =0.23; 95% CI: 0.17-0.30) and worsening of relapse rate (HR =0.19; 95% CI: 0.14-0.27) were reduced by about 4-5-fold in patients exposed to IFNbeta for more than four years, compared with patients exposed for up to two years. The propensity score technique confirmed the findings. The proportion of days covered by IFNbeta treatment was lower (P <0.0001) in patients exposed to IFNbeta for up to two years than in other groups. A clinical stabilization over two years of IFNbeta exposure may predict a subsequent good clinical response to treatment.

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